Oxford Medical Case Reports

https://academic.oup.com/omcr

List of Papers (Total 92)

Unilateral leg oedema due to spontaneous Achilles tendon rupture

This is a case of severe unilateral lower leg oedema in a 77-year-old man, due to a spontaneous, complete Achilles tendon rupture. What makes this case unusual is the absence of trauma in the patient’s history. The correct diagnosis was made only after magnetic resonance imaging. However, a thorough clinical re-examination of the patient revealed an inability to stand and walk on...

One down, one to go: coronary anomaly dual LAD blood supply with worsening chronic stable angina and 100% occluded left short LAD type IV variant

Although rare, usually asymptomatic, and without concurrent disease, dual left anterior descending arteries (LAD) poses great challenges. We describe a 55-year-old male with no history of coronary disease, who presented with worsening substernal chest pain with exertion, and was ruled out for myocardial infarction. On left heart catheterization and subsequent computed tomography...

A case of atenolol-induced sinus node dysfunction presenting as escape-capture bigeminy

Medications that are routinely used in clinical practice to treat hypertension such as beta blockers or non-dihydropyridine calcium channel blockers can depress sinus node function, resulting in symptoms and electrocardiographic changes consistent with sinus node dysfunction. In some patients, medications are potentially a reversible cause of apparent sinus node dysfunction. We...

Acute interstitial pneumonia as first presentation of anti-synthetase syndrome: an atypical case

Anti-synthetase syndrome is characterized by myositis associated with interstitial lung disease (ILD), the usual pattern of ILD being non-specific interstitial pneumonia type or usual interstitial pneumonia. We report a case of anti-synthetase syndrome presenting as acute interstitial pneumonia which is reported only once before. With this case, we emphasize the need to consider...

Normal function of a 43-year-old Braunwald Cutter heart valve

We present the case of a 72-year-old woman diagnosed with rheumatic fever at the age of 6. In 1972, she was diagnosed with mitral valve insufficiency and mitral valve stenosis, then in 1974, a decision was made to perform mitral valve replacement surgery with a 32-mm Braunwald-Cutter ball cage prosthesis. An echocardiogram performed in 2014 revealed normal biventricular systolic...

Mammalian meat allergy following a tick bite: a case report

The alpha-gal allergy is an emerging IgE-mediated reaction against the galactose-alpha-1,3-galactose carbohydrate found in mammalian meats. Patients with this condition will develop anaphylactic symptoms 3–6 h after the ingestion of mammalian meat food products such as beef, pork or lamb. The prevalence of this allergy is drastically increasing and severe reactions including...

Direct ICE imaging from inside the left atrial appendage during ablation of persistent atrial fibrillation

We present the case of a 59-year-old patient with persistent atrial fibrillation, referred for atrial fibrillation ablation. The procedure was performed with the help of NAVX 3D mapping system (Saint Jude Medical) and iLAB Ultra ICE Plus ultrasound imaging catheter (Boston Scientific). The catheter permits cross-sectional images perpendicular to catheter's long axis. From inside...

Case report of a patient with ‘one-and-a-half plus syndrome: nine syndrome’

This case talks about ‘One-and-a-half plus syndrome’, a clinical syndrome affecting binocular vision and facial nerve. One-and-a-half plus syndrome is a less known clinical syndrome which constitutes of a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other direction. Despite the known association between ischemia, autoimmune disorders...

Percutaneous management of ostial stenosis of the left internal mammary artery graft

A 61-year-old man, who had undergone coronary artery bypass surgery 10 years earlier, presented with a non-ST segment elevation myocardial infarction. He was treated with medical therapy and taken to the Cardiac Catheterization Laboratory. A left heart catheterization demonstrated an ostial stenosis in the left internal mammary artery graft, which was felt to be the culprit...

Clozapine-induced myocarditis

Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology...

Breast cancer metastasis to the spleen: a case report and literature review

Splenic metastasis from cancers is extremely rare. They usually occur and are detected simultaneously with metastasis to other organs. We present a case of splenic metastasis from carcinoma of the breast occurring 5 years after initial treatment. The metastatic recurrence was an oligometastic form made from the association of a unique bone metastasis to a rib and the metastasis...

Duodenal membranes: a late diagnosis evidenced by foreign bodies

One of the causes of congenital incomplete duodenal obstruction is the presence of duodenal membranes. This condition requires a high index of suspicion for an early and accurate diagnosis. We present two cases of duodenal obstruction with initial diagnosis of foreign bodies that were surgically intervened and where incomplete duodenal membranes were an incidental finding. The...

Purple urine bag syndrome: a case report and review of the literature

Purple urine bag syndrome (PUBS) is a rare and striking manifestation associated with urinary tract infection involving bright purple discoloration of the lining and tubing of a urinary catheter bag. We present the interesting case of a 90-year-old female patient who developed PUBS and include a review of the relevant literature to date. Uniquely, in this case, PUBS acts as an...

A case of oncogenic osteomalacia owing to inguinal tumor

The oncogenic hypophosphatemic osteomalacia is a very incapacitating disease and the mortality rate, mainly due to metabolic disorder, depends on the early diagnosis, since the surgery is curative. The major difficulty is to consider this kind of disease in patients with complex clinical presentation. Moreover, medical centers have to provide a good diagnostic infrastructure...

Dilemma in management: a patient with active systemic lupus erythematosus presenting with pulmonary cavitary lesion

Pulmonary manifestations of systemic lupus erythematosus (SLE) include, but are not limited to, pneumonia, interstitial pneumonitis, atelectasis and pleural effusion. Cavitary lung lesions are rarely associated with SLE. We present herein the case of a female patient with SLE and lupus nephritis who presented to the hospital with respiratory failure, rash and arthralgias. She was...