Browsing by Author "Rizvi, Uzma"

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    Brodifacoum contamination of synthetic cannabinoid causing unexplained coagulopathy in multiple trauma: A case report
    (Elsevier, 2024-04-01) Thomas, Anthony V.; Johnson, Mackenzie L.; Tincher, Anna M.; Zackariya, Saniya; Khan, Hassaan; Rizvi, Uzma; Thomas, Scott G.; Noveroske, Timothy W.; Fulkerson, Daniel H.; Moore, Ernest E.; Walsh, Mark M.; Medicine, School of Medicine
    An 18-year-old female presented to the emergency department after a motor vehicle collision. Initial imaging revealed a liver laceration. Subsequent labs showed significantly elevated prothrombin time, international normalized ratio, and activated partial thromboplastin time. Thromboelastography demonstrated a flatline tracing. The patient denied use of anticoagulation but admitted to synthetic cannabinoid use. It was believed the patient had taken synthetic cannabinoid contaminated by brodifacoum. She was therefore given prothrombin complex concentrate and vitamin K with blood products. The patient underwent sequential embolization, laparotomy, thoracotomy, and repair of the vena cava with a shunt. Thirty minutes postoperatively, her coagulation tests and thromboelastography were much improved. Two and a half hours postoperatively, it was determined she had sustained non-survivable injuries. The patient experienced brain death due to prolonged hypotension as a result of hemorrhagic shock with bleeding exacerbated by brodifacoum. To our knowledge, this is the first case reported of a trauma-induced coagulopathy exacerbated by brodifacoum-contaminated synthetic cannabinoid. Her coagulopathy was clearly not due to trauma alone and contributed greatly to the difficulty in controlling hemorrhage. The synthetic cannabinoid-associated coagulopathy rendered her otherwise potentially survivable injuries fatal. Given the frequency of multiple trauma and the recent increase in the prevalence of synthetic cannabinoid, it can be expected that the incidence of trauma complicated by synthetic cannabinoid-associated coagulopathy will increase in the near future. For patients that present with prolonged prothrombin time and/or activated partial thromboplastin time, it is important to inquire about recent synthetic cannabinoid use.
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    Progressive Choreiform Movements in a Child: Early Recognition and Management of Sydenham Chorea
    (Ubiquity Press, 2025-02-06) Jaronik, Jason M.; Scott, Nicholas A.; Harley, Bruce D.; Marsh, Phillip L.; Khan, Hassaan A.; Zackariya, Sufyan; Tincher, Anna M.; Thomas, Anthony V.; Al-Fadhl, Mahmoud D.; Bales, John R.; Lain, Morgan C.; Rizvi, Uzma; Bjork, Randall J.; Walsh, Mark M.; Medicine, School of Medicine
    Background: Sydenham chorea, a rare neurological manifestation of acute rheumatic fever, persists in developed countries due to rheumatogenic strains of group A streptococcus. Phenomenology shown: This case demonstrates the evolution from subtle early symptoms to definitive severe choreiform movements in Sydenham chorea in a 10-year-old female. Educational value: This case highlights the importance of early recognition, multidisciplinary management, and vigilance in medication administration to optimize outcomes in rare conditions such as Sydenham chorea. Highlights: This case highlights the diagnostic and management challenges of Sydenham chorea, showcasing its progression from subtle early symptoms to definitive severe choreiform movements. It demonstrates the importance of early recognition, multidisciplinary care, and cautious medication administration to optimize outcomes in this rare neurological condition associated with rheumatic fever.