Open Access Case Study

Isolated Leg Monoparesis in a Patient with Atrial Fibrillation and Acute Ischemic Small Vessel Disease

Sook Vui Chong, Chin Hong Kua, Nan Nitra Than

Asian Journal of Case Reports in Medicine and Health, Page 1-8

Monoparesis is most commonly caused by dysfunction of the lower motor neurons (LMNs) which innervates the affected limb. This includes lesion affecting the anterior nuclei, ventral nerve roots, lumbosacral plexus, or peripheral nerve. Nevertheless, it can also be due to upper motor neuron lesion, typically seen in lesions of the spinal cord. In general, many conditions that cause hemiplegia, paraplegia or quadriplegia may begin as monoplegia. We illustrate an elderly patient with hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation, who presented with acute monoparesis and radiological evidence suggestive of recent infarct and small vessel disease.

Open Access Case Study

Isolated XIITH Cranial Nerve Palsy Secondary to Diffuse Large B Cell Lymphoma – A Rare Occurrence

Manjiri Naik, Rohit Jacob

Asian Journal of Case Reports in Medicine and Health, Page 9-12

Isolated XIITH Cranial Nerve Palsy is an uncommon presentation. When it presents in isolation, it can be diagnostically challenging. We report a 43 year old male presenting with Unilateral Hypoglossal Nerve palsy marking the beginning of ongoing metastasis. This case report focusses on the importance of a meticulous approach towards diagnosis and finding the underlying cause.

Open Access Case Study

A Successful Treatment of a Patient Infected with Pan-drug Resistant Acinetobacter baumannii Ventriculitis with Intravenous Sulbactam: A Case Study

P. Keandoungchun, P. Narischat, W. Laosuebsakhunthai, A. Ubontachart

Asian Journal of Case Reports in Medicine and Health, Page 13-20

The post neurosurgical ventriculitis caused by Acinetobacter baumannii (A. baumannii) is an important problem disorder in neurosurgical patients that can lead to serious medical complications, or even to death. This is because A. baumannii frequently can develop multi-drug resistance to several classes of antibiotic, rendering conventional treatment method ineffective. In this case study, we report a case where our patient who is infected with post neurosurgical ventriculitis from A. baumannii (pan-drug resistant strain) is successfully treated with 12 grams per day of intravenous sulbactam concurrent with usual dose of intravenous tigecycline and intraventricular colistin. This successful treatment can be another novel adjunctive therapy for the treatment of CNS infection caused by A. baumannii (pan-drug resistant) using intravenous non-colistin base plus intraventricular colistin base regimen in post neurosurgical condition.

Open Access Case Study

Guillain-Barre Syndrome Associated with Acute Hepatitis A Infection: A Case Report

Masoud Mardani, Rozita Khodashahi, Yazdanali Faghani

Asian Journal of Case Reports in Medicine and Health, Page 21-25

Background and Aim: Guillain-Barré syndrome (GBS) is considered as an inflammatory postmanifestation of infectious, which acute ascending motor weakness, hyporeflexia or areflexia and sometimes sensory loss are hallmarks of this clinical syndrome. It is an acute polyradiculoneuropathy often provoked by an infectious agent. It is an acute polyradiculoneuropathy often provoked by an infectious agent, but its development following acute hepatitis A has rarely been reported.

Case Presentation: The authors report a 35 years old female of Guillain-Barre syndrome following acute hepatitis A in a young female, that developed symmetrically ascending motor weakness two weeks after the onset of initial symptoms of hepatitis infection. Our case presented with high-grade fever, vomiting and jaundice. The diagnosis of GBS was made according to clinical manifestations and albuminocytologic dissociation in cerebrospinal fluid. The patient was transferred in the ICU, NGT fixed, and plasmapheresis started. Patient’s neurological condition improved after 8 times plasmapheresis every 48 h after seven day in ICU. Treatment outcome was satisfactory and her facial palsy had almost completely improved.

Conclusion: Although GBS due to hepatitis A is very rar, this complication should be kept in mind and the best way to prevent Hepatitis A through vaccination and personal hygiene especially in close contact with an infected household member, beside good environmental sanitation.

Open Access Case Study

Diffuse Large B-cell Lymphoma of the External Auditory Canal: Case Report

Hemanth Kowdley Subrahmanyam, Wendy Smith

Asian Journal of Case Reports in Medicine and Health, Page 26-29

A 68 yr old male presented with hearing loss due to an obstructing mass in his ear canal. A CT scan confirmed a non-erosive mass, which was biopsied. A diagnosis of Diffuse Large B-Cell Lymphoma was made. Following 6 courses of intra-thecal methotrexate the patient is asymptomatic and in remission. Diffuse Large B-Cell Lymphoma (DLBCL) of the EAC (external auditory canal) is extremely unusual with only 8 cases of documented DLBCL in the literature.