International Journal of Medical and Pharmaceutical Case Reports

Use of Doxycycline in a Renal Impaired Patient with Enterococcal Sepsis

Anthony A. Iwuafor — 2021-07-02

Aim: This report highlights the use of doxycycline therapy other than the more standard regimen that includes an aminoglycoside in the management of enterococcal infection in patients with renal impairment without causing further damages to the kidney due to aminoglycoside therapy.

Presentation of Case: A case of enterococcal septicemia in a 29-year-old woman who was admitted on account of acute kidney injury secondary to pregnancy induced hypertension in the setting of pre-eclampsia. She was referred from another centre where she had emergency caesarean section done on account of severe pre-eclampsia at 36 weeks gestational age. Blood culture yielded Enterococcus species. When other antibiotic regimen failed, she was started on doxycycline. Patient had good clinical response and was discharged 7 days after commencement of doxycycline.

Discussion: Enterococci have emerged as important agent of human disease largely because of their resistance to antimicrobial agents. They are important nosocomial pathogens capable of causing serious and potentially life-threatening infections, including sepsis. The incidence of enterococcal infections, mainly hospital-acquired, has increased over the past 2 decades and isolates with novel mechanism of resistance to antimicrobial agents are more and more frequent. Furthermore, they have great capacity for transmitting these resistances to other species and even to other genera.

Conclusion: Doxycycline is a safe and effective alternative antibiotic for the treatment of enterococcal sepsis in patients with impaired renal status.

Myocarditis Secondary to COVID 19 Infection: A Case-Report

Gueye Khadidiatou — 2021-07-07

Introduction: Coronavirus disease 2019 (COVID 19) is an emerging viral infection caused by the strain of coronavirus SARS-CoV-2, primarily affecting the respiratory system. However, it can be responsible for heart damage.

The aim of this work was to report a case of symptomatic myocarditis in a 53-year-old patient.

Patient and Observation: We report the case of a 53-year-old patient with no particular history or cardiovascular risk factor found who had consulted in June 2020 in a hospital for dyspnea, dizziness and palpitations in whom the electrocardiogram had demonstrated ventricular tachycardia. The echocardiography was normal and coronary artery disease was ruled out on coronary angiography and antiarrhythmic treatment allowed it to regress. Two months later, after a break in therapy, this tachycardia recurred despite several electrical and chemical cardioversions. Subsequently, myocarditis was suspected. This motivated the realization of a cardiac magnetic resonance imaging (MRI) which came back in favor of myocarditis. As part of the etiological research, RT-PCR and COVID 19 serology were requested and the serology returned positive for IgG.

Conclusion: COVID 19 disease is known for its respiratory manifestations. However, several cases of cardiac involvement, in particular myocardial damage, have been described and among these, a considerable proportion of arrhythmias. They can be multifactorial in origin, due to the virus itself, or the prolongation of the QT interval from various drug therapies. These arrhythmias are the source of sudden death, hence the interest of RT-PCR and COVID 19 serology, but also the need for early and appropriate management, as well as long-term monitoring of patients. cured patients.

A Case Report on Autoimmune Thyroid Disease (ATD) Associated with Chronic Angioedema

K. Shivaraju — 2021-07-19

Angioedema may be a rare condition that manifests itself by abrupt localized edema caused by the fluid outflow from blood vessels into surrounding skin and tissue. This case report presents a 54-year old male patient with chronic angioedema (lip) for one year without urticaria. Six months ago, he approached the local clinic and used regular antihistamines by the physician advice. Still, there was no improvement in patient condition. Then he came to the outpatient department of internal medicine of our hospital. Therefore, we have done a series of investigations, in then he diagnosed with Hypothyroidism (TSH 8.05UIu/ml). Then he has prescribed levothyroxine 25mcg. After one month's review, he examined for Anti-thyroid peroxidase antibodies (Anti-TPO). In that examination, those were positive or elevated (mild). According to our research, this may probably be the first autoimmune thyroid disease associated with chronic angioedema without urticaria or hives.

A Case Report on Mucormycosis in Non-Diabetic, Non-Covid Recovered Patient with no History of Steroid use

Gautam Panduranga — 2021-07-27

Rhino cerebral orbital mucormycosis is an aggressively spreading fungal infection caused by filamentous fungi of the Mucoraceae family and is found to be more prone in patients with comorbidities that include: uncontrolled diabetes mellitus, immune-suppressed patients, iron and aluminum overload, chronic steroid therapy, severe trauma, and protein-energy malnutrition.

A 51year old male patient was admitted to the hospital with a complaint of headache and intermittent fever. The patient had no history of diabetes or denovo hypertension. Based on the analysis of histopathological and radiological investigations, the patient was diagnosed with mucormycosis. The patient furthermore underwent an endoscopic surgical debridement followed by standard treatment including antifungal antibiotic(amphotericin-B) and azole antifungals (posaconazole) along with symptomatic treatment. Though the patient was given all possible therapy available, no improvement was seen in the patient's condition (poor prognosis).