Year 2023, Volume 7 - Issue 3

Background: In the context of a global COVID-19 pandemic, there have been a variety of reports about the impact of infection to the fetus and in the immediate newborn period. Many babies appear to have a mild clinical course, but there is limited data about preterm infants. Case Presentation: A 28 week male infant was delivered with signs of fetal distress, four days after maternal infection with COVID-19. At this time, the delta variant of the virus predominated. After an initial period of stability, the baby significantly deteriorated in the second week and intensive care was escalated approaching maximal therapy. Given the life-threatening severity of the clinical condition, an off-licence trial of remdesivir was started alongside dexamethasone. With this treatment, the patient made a significant improvement and recovered. Conclusion: This case shows the feasibility of using remdesivir in the very premature neonatal population and seems to have been well tolerated.

Background: Vocal cord hemorrhages are due to the rupture of the blood vessel within the submucosa of the vocal fold. It is common in singers, post upper respiratory tract infections and in patients on anticoagulation. In this case report, we present an unusual presentation of a vocal cord hemorrhage following a sneeze. Case Report: This paper presents the case of a 34-year-old male who presented with change of the quality of his voice and throat pain following a sneeze. He was found to have right vocal cord hemorrhage on nasoendoscopy and was managed with total voice rest and rehydration. Patient made full recovery following conservative management. Conclusion: This case report is important as it highlights sneezing as a mechanism of vocal cord hemorrhage. It also shows the importance of having a low index of suspicion for performing nasoendoscopy following voice changes.

Background: Hepatic portal venous gas (HPVG) has rarely been described in the presence of benign, non-life-threatening conditions such as gastric emphysema and gastric dilatation. In such cases, management and patient prognosis have evolved to become highly dependent on the etiology. Nevertheless, although such conditions can be benign and conservative management can be applied, close monitoring of the patient's status is necessary to avoid any complication like gastric necrosis. Case Presentation: We report a case of acute gastric dilatation with HPVG in the presence of gastric emphysema and closed loop small bowel obstruction, complicated by gastric necrosis, in a patient with adjustable gastric band. Conclusion: HPVG can have benign etiologies which influence its mortality rate, management, and prognosis. These should be detected, and patients should be monitored closely, especially if managed conservatively, to avoid complications.

Background: Practices of manual siphoning of fuel around the globe has exponentially increased the incidence of chemical pneumonitis. As evident by studies, chemical pneumonitis constitutes quite significant proportion of community-acquired pneumonia. In this case report, we follow up on the case of hydrocarbon pneumonitis along with its diagnostic uncertainty and treatment challenges. Case Presentation: A 66-year-old male presented with shortness of breath, fever, and hemoptysis after accidentally aspirating diesel while siphoning it from a generator. computed tomography pulmonary angiogram revealed bilateral pneumonitis and ruled out pulmonary embolism. He required high-flow oxygen initially due to extensive nature of pneumonia and was managed conservatively with broad-spectrum antibiotics and steroids. He recovered to discharge after 21 days. This represents a case of chemical, hydrocarbon (exogenous lipoid) pneumonitis, complicated by transudative pleural effusion and likely bacterial superinfection. Conclusion: Chemical pneumonitis is associated with varied symptoms and radiological presentation. Its treatment is essentially same as pneumonia caused by other pathogens. Timely diagnosis, escalation, and treatment can reduce the morbidity and mortality caused by these harmful insults.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a therapeutic intervention for refractory ascites and variceal bleeding. However, the development of hepatic encephalopathy (HE) is a known complication. TIPS diameter can be reduced to decrease further HE episodes when refractory to pharmacotherapy. However, TIPS reduction for refractory hepatic encephalopathy (rHE) is poorly described. This case series identifies various characteristics and outcomes among this unique patient cohort. Case Presentation: In this cohort of 8 patients, 63% were male, 75% were Caucasian, and 38% had alcohol-associated cirrhosis. Following TIPS reduction, the number of HE-related admissions (mean, median) decreased from 2.1 and 2 to 1.6 and 0.5 while the number of non-HE admissions following TIPS reduction increased from 0.6 and 0 to 1 and 0.5. Conclusion: TIPS reduction reduced the number of hospitalizations for rHE but the total number of hospitalizations for all causes increased, demonstrating the high resource utilization for those with rHE following TIPS. Therefore, careful selection for initial TIPS placement remains a priority.