AbstractMetformin remains the first-line pharmacologic treatment for type 2 diabetes mellitus due to its well-established efficacy and safety profile. However, a rare but serious complication is metformin-associated lactic acidosis (MALA), which carries a mortality rate of up to 36.2% in hospitalized patients. Those with chronic kidney disease and cardiovascular comorbidities are particularly vulnerable to severe outcomes. Among the rare manifestations of MALA is complete bilateral blindness, which typically requires urgent hemodialysis for reversal. Here, we present a case of MALA-induced blindness that was unexpectedly reversed through supportive medical management alone, prior to hemodialysis. This case underscores the critical role of early recognition and intervention by intensive care physicians in optimizing MALA outcomes. Further studies are warranted to elucidate the effects of MALA on the visual pathways, particularly the susceptibility of retinal cells and photoreceptors to metformin toxicities.

2025-03-28·Oxford Medical Case Reports

When the farm turns fatal: a rare infection causing heart block

Article

作者: Abid, Shaun ; Dulgher, Maxim ; Stolear, Anton ; Zarich, Stuart ; Sethi, Samdish

AbstractBrucellosis, a zoonotic infection typically presenting with nonspecific symptoms, rarely leads to cardiac complications, particularly conduction abnormalities. We report a unique case of an 84-year-old female who presented with dizziness, bradycardia, and hypotension, ultimately diagnosed with complete heart block. On admission, blood cultures and further diagnostic workup identified Brucella bacteremia as the underlying cause, with further history revealing that she had recently traveled from a farm in Colombia, a brucellosis-endemic area. The patient underwent dual-chamber pacemaker implantation to stabilize her heart rhythm and was initiated on a three-month antibiotic regimen of doxycycline and rifampin. This case highlights the importance of considering brucellosis as a differential diagnosis for heart block in patients with recent travel from endemic regions. Early recognition and intervention, including antibiotic therapy and pacemaker placement when necessary, are essential for achieving favorable outcomes in brucellosis-related cardiac complications.

2025-03-25·Cureus

Acute-on-Chronic Pancreatitis in a Patient With Ehlers-Danlos Syndrome: A Rare Association

Article

作者: Ladel, Luisa ; Shafique, Seaf ; Nguyen, Kadi ; Joseph, Rebecca

Ehlers-Danlos Syndrome (EDS) is a connective tissue disorder known for its vascular complications, but it is rarely associated with chronic pancreatitis (CP). We describe a 32-year-old female with EDS who presented with acute-on-chronic pancreatitis, following prior episodes of pancreatitis and pseudocyst formation two years prior. This patient's EDS may have predisposed her to recurrent pancreatic inflammation, highlighting the potential role of tissue fragility in pancreatitis susceptibility. This case suggests a need for increased awareness of EDS as a risk factor for pancreatitis and emphasizes the importance of lifestyle counseling to prevent triggers.

100 项与 Norwalk Health Services Corp. 相关的药物交易

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