Ludwig’s angina is a diffuse cellulitis in the submandibular, sublingual, and submental spaces, characterized by its propensity to spread rapidly to the surrounding tissues. Early recognition and treatment for Ludwig’s angina are of paramount importance due to the myriad of complications that can occur in association with Ludwig’s angina. Known complications of Ludwig’s angina include carotid arterial rupture or sheath abscess, thrombophlebitis of the internal jugular vein, mediastinitis, empyema, pericardial effusion, osteomyelitis of the mandible, subphrenic abscess, aspiration pneumonia, and pleural effusion. By reporting a case of Ludwig’s angina, we hope to raise the awareness in our medical community for this rare clinical entity.This case describes a 54-year-old woman with Ludwig’s angina that evolved from a chronic odontogenic infection. She presented with perioral swelling with the involvement of bilateral submandibular and sublingual areas, accompanied by excruciating pain, chills, fever, and vomiting. She was treated with clindamycin and cefoxitin for infection and vigorously hydrated.This case is exemplary for the successful management of this potentially lethal clinical condition. Our early recognition and aggressive treatment helped to prevent complications from Ludwig’s angina.
Several commonly used chemotherapeutic agents, antibiotics, antivirals, and antiepileptic medications can cause partial or full Fanconi syndrome, disorders which can generally be described as transport defects in the proximal renal tubule, associated with non-anion gap metabolic acidosis. Fanconi syndrome is underreported and therefore often missed in the clinical setting. Herein, we present a case report that details the course of a 64-year-old female with a history of stage IV undifferentiated pleomorphic sarcoma who after her sixth chemotherapeutic cycle (adriamycin, ifosfamide, and mesna) developed severe hypokalemia, hypophosphatemia, and proteinuria without glycosuria, eventually diagnosed with partial Fanconi syndrome. The aim of this report is to highlight the importance of routine serum and urine monitoring in patients undergoing therapy with potentially nephrotoxic agents to avoid potentially fatal renal nephrotoxicity, including partial and full Fanconi syndrome.
Hashimoto's thyroiditis and Graves' disease are thyroid-specific autoimmune disorders with distinct pathological mechanism. Clinical presentation and histopathological features also vary greatly in these disorders. Sequential conversation from Hashimoto's thyroiditis (HT) to Graves' disease (GD) has been rarely reported throughout the world. Herein, we report a woman with history of HT, who then developed GD requiring total thyroidectomy. By reporting this case, we hope to raise awareness about this phenomenon among clinicians and illustrate the potential mechanisms behind such change. Improving recognition and identification of this potential conversation between HT and GD would allow clinicians to expeditiously implement appropriate treatment, increasing the quality of care.
Mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome refers to a condition in which features of Behcet’s disease (BD) and relapsing polychondritis (RP) occur in the same individual. The existence of MAGIC syndrome suggests a potential common etiology for BD and RP. However, connecting these two diseases and referring to this condition as MAGIC syndrome might have been premature, as there is currently insufficient knowledge on BD and RP. In this critical review, we argue that these two clinical entities could possibly be unique disease processes rather than two ends of the same disease spectrum. Distinguishing the clinical difference between BD and RP is critical for the management of patients diagnosed with MAGIC syndrome, as biological therapeutic approaches for BD and RP differ. Also, inaccurate perception regarding the relationship of these two diseases could mislead researchers in their endeavors to unravel the pathophysiological mechanisms behind these two diseases.
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