Журнал клинических случаев

Spinal and bulbar muscular atrophy (SBMA) is a rare neuromuscular disorder. Here, we present the case of a 53-year-old male diagnosed with SBMA, who underwent left leg amputation for a compound fracture with gas gangrene. The patient was hospitalized with gas gangrene and sepsis, and required non-invasive positive pressure ventilation, inotropes, and continuous hemodiafiltration. The patient gave consent for mechanical ventilation and underwent an amputation. Before and after the amputation, the patient had recurrent severe atelectasis of the left lower lobe, and large emboli composed of coagulated blood cells and sputum were extracted. SBMA itself is not curable, although the morbidity and complications related to SBMA can be managed using essential procedures.

We present a case of a 63-year-old man with a past medical history of end stage kidney disease on dialysis that was admitted to the hospital due to a native valve infective endocarditis secondary to a healthcare associated bloodstream infection caused by an uncommon gram-negative bacillus: Enterobacter cloacae. The patient was treated with antimicrobial therapy for 6 weeks and was later discharged. In this case, we will discuss the risk factors, pathophysiology diagnostic criteria and treatment options associated with this rare infection.

The rising incidence of hepatocellular carcinoma (HCC) in non-cirrhotic patients in recent years implies the presence of other factors that could contribute to liver carcinogenesis. Metabolic-associated fatty liver disease (MAFLD) can progress to HCC, which poses a significant burden on the healthcare systems worldwide and has a high mortality rate. An aggressive non-invasive surveillance strategy is necessary in order to detect liver cancer in non-cirrhotic patients, especially in those with risk factors such as diabetes, obesity or older age. An acute clinical presentation is possible through complications, such as the development of hemoperitoneum due to the non-traumatic HCC rupture.

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