Журнал клинических случаев

Ebola virus infection is a present considerable problem that killed many people in Africa in 2014. The problem is still uncontrollable and becomes the important issue in global public health. With rapid increasing number of infected cases, the problem is still hard to be managed.

The incidence and existence of human immunodeficiency virus concerning women of reproductive age continues to increase globally. The care of HIV-infected women is not simple and must be focused on including the current and future health of these women, the minimization of the risk of maternal–infant transmission and the maintenance of the well-being of the fetus and neonate. Many maternal and obstetrical factors can affect the vertical transmission. The answer to this problem is the optimal medical and obstetrical care.

Ischemic lesions involving the Corpus Callosum (CC) are rare. Symptoms are nonspecific and clinical findings vary depending on the site and size of the lesions. We describe a rare case of watershed infarct involving the whole corpus callosum but sparing the more common border-zone infarcts between the anterior cerebral artery–middle cerebral artery and the middle cerebral artery posterior cerebral artery and review the relevant literature with special emphasis on the vascular anatomy of the corpus callosum.

Major uterine malformations negatively impacts on outcome of pregnancy and in very severe cases there is impairment of menstrual function. Term pregnancy with live birth in women major malformations of the uterus is possible but may be associated with complications. A case report of a 30 year old woman G4P1+2, with history of one previous caesarean section who presented with a transverse lie and obstructed labour at 41 weeks plus 2 days in December 2013 is presented. She had an urgent caesarean section performed when she presented as emergency after absconding from an elective caesarean section at 39 weeks plus 2 days. A complete bicornuate uterus with normal tubes and ovaries were among the finding at caesarean section. The puerperium was normal for both mother and baby. It was a live birth at term from a pregnancy in a uterus with a major uterine malformation.

Successful pregnancies with live births at term in a complete bicornuate uterus after previous pregnancy losses are possible as seen in this case reported. However poor health seeking behavior and harmful practices during pregnancy and labour an in woman with major malformation of the uterus can result in serious maternal and fetal complications.

Tanyildiz HG, Malbora B, Yesil S, Candir MO, Bozkurt C, Sahin G. Vitamin B12 Deficiency Mimicking Acute Leukemia in a Child. Deficiency of vitamin B12 is an important cause of megaloblastic anemia and bone marrow depression. Morphological and functional changes in bone marrow are observed related with vitamin B12 deficiency. Most importantly dysplastic changes can be mistaken as myelodysplastic syndrome or acute leukemia. In adult cases of vitamin B12 deficiencies mimicking acute leukemia were reported. Our case is an alerting example of vitamin B12 deficiency in children mimicking acute leukemia with dysplastic findings.

Adenovirus infection can involve many organ systems, including respiratory, ocular, metabolic, renal and gastrointestinal. Adenovirus infection is the principal pathogen in epidemics of conjunctivitis or keratoconjunctivitis. In this report, we present three cases of epithelial defect with adenoviral keratoconjunctivitis after initiation of topical corticosteroids.

A 45-year-old woman presented with few months history of left upper quadrant abdominal pain radiating to her left shoulder. Computed Tomographic Angiography (CTA) demonstrated two successive splenic artery aneurysms 2.2 and 2.8 cm in diameter in the distal splenic artery. Her symptomatic nature and the aneurysm’s size necessitated proceeding with treatment. The aneurysms were treated by endovascular coil and thrombin embolization. A few hours post-procedure, she developed acute portal vein thrombosis (aPVT), followed by acute pancreatitis and near-total splenic infarction. Treatment with anticoagulant therapy and antibiotics led to a good recovery. She was discharged on warfarin therapy for 6 months. 40 days after embolization, an abdominal CTA revealed a patent portal vein, occlusion of the aneurysms and partial splenic infarction. We present an overview of the natural history, treatment options and side effects of treatment of splenic artery aneurysms.

Secondary involvement of the mitral valve is well documented in primary aortic valve endocarditis. An important causative mechanism, involving both left-sided valves, is ‘mitral kissing vegetation’. This results from large aortic vegetations prolapsing into the left ventricular outflow tract and “kissing” with the ventricular surface of the anterior mitral leaflet thus causing secondary infection.