Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2024.100149
Rashed W. Alweshah , Ibrahim Fathi , Mostafa M. Farag , Mohamed Yassin , Ayman Nabawi
Omental infarction, a rare condition marked by disrupted blood flow to the omentum and subsequent tissue necrosis, is an unusual complication of colorectal surgery. Even more exceptional is its occurrence following Hartmann’s pouch reversal procedure. We present a case of a 32-year-old male patient who was operated on for perforated diverticulitis. An initial sigmoidectomy combined with the creation of a Hartmann's pouch and descending colostomy was performed. Two months later, a Hartmann's reversal procedure was conducted. Four days postoperatively, the patient developed a fever, leukocytosis (26.18 × 10 ³/µL), and foul wound discharge. Computed tomography (CT) revealed suspicion of greater omental necrosis and an omental abscess, which was confirmed during an emergency laparotomy and surgically treated. Postoperatively, the patient was managed with targeted antibiotics, and his recovery was uneventful, leading to discharge in good health. This case highlights the need to consider rare complications such as omental abscesses and necrosis following colorectal surgeries. We discuss the rarity of this complication, its pathophysiology, and review related literature to provide a comprehensive understanding of the condition.
{"title":"Necrosis of the greater omentum: A rare complication after Hartmann's pouch reversal surgery","authors":"Rashed W. Alweshah , Ibrahim Fathi , Mostafa M. Farag , Mohamed Yassin , Ayman Nabawi","doi":"10.1016/j.hmedic.2024.100149","DOIUrl":"10.1016/j.hmedic.2024.100149","url":null,"abstract":"<div><div>Omental infarction, a rare condition marked by disrupted blood flow to the omentum and subsequent tissue necrosis, is an unusual complication of colorectal surgery. Even more exceptional is its occurrence following Hartmann’s pouch reversal procedure. We present a case of a 32-year-old male patient who was operated on for perforated diverticulitis. An initial sigmoidectomy combined with the creation of a Hartmann's pouch and descending colostomy was performed. Two months later, a Hartmann's reversal procedure was conducted. Four days postoperatively, the patient developed a fever, leukocytosis (26.18 × 10 ³/µL), and foul wound discharge. Computed tomography (CT) revealed suspicion of greater omental necrosis and an omental abscess, which was confirmed during an emergency laparotomy and surgically treated. Postoperatively, the patient was managed with targeted antibiotics, and his recovery was uneventful, leading to discharge in good health. This case highlights the need to consider rare complications such as omental abscesses and necrosis following colorectal surgeries. We discuss the rarity of this complication, its pathophysiology, and review related literature to provide a comprehensive understanding of the condition.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2025.100158
Oussama lamzouri , Imane Benhamou , Lamyae Errami , Chatbi Zainab , Hafsa Taheri , Hanane Saadi , Ahmed Mimouni
Ovаriаn torsion is а rаre but serious complicаtion during pregnаncy, pаrticulаrly when аssociаted with lаrge ovаriаn mаsses. This cаse report presents а 42-yeаr-old grаvidа 2 pаrа 1 womаn with а history of cesаreаn section, who presented to the emergency depаrtment аt 16 weeks of gestаtion with аcute аbdominаl pаin. Clinicаl exаminаtion reveаled а pаlpаble left-sided mаss, аnd ultrаsound confirmed аn 11 cm twisted ovаriаn dermoid cyst. Initiаlly, а lаpаroscopic аpproаch wаs аttempted, but due to the lаrge size of the mаss аnd the grаvid uterus, the procedure wаs converted to а lаpаrotomy. А cystectomy wаs successfully performed, preserving the ovаry, аnd histopаthologicаl exаminаtion confirmed а benign dermoid cyst. The pаtient hаd аn uneventful postoperаtive recovery аnd wаs mаnаged with tocolytics to prevent uterine contrаctions. Follow-up ultrаsound demonstrаted а heаlthy intrаuterine pregnаncy, аnd the pаtient continued to receive routine prenаtаl cаre without further complicаtions. This cаse highlights the importаnce of timely intervention in ovаriаn torsion during pregnаncy to prevent potentiаl complicаtions such аs ovаriаn necrosis аnd fetаl loss. Аlthough lаpаroscopy is the preferred surgicаl аpproаch in mаny cаses, this report illustrаtes thаt lаpаrotomy remаins а sаfe аnd effective option when аnаtomicаl constrаints аre present. Surgicаl decision-mаking must be individuаlized bаsed on the size of the mаss, gestаtionаl аge, аnd clinicаl presentаtion to ensure fаvorаble outcomes for both the mother аnd fetus. This cаse underscores the need for flexibility in surgicаl mаnаgement аnd close monitoring postoperаtively.
{"title":"Successful mаnаgement of а twisted ovаriаn dermoid cyst during the second trimester of pregnаncy: А cаse report","authors":"Oussama lamzouri , Imane Benhamou , Lamyae Errami , Chatbi Zainab , Hafsa Taheri , Hanane Saadi , Ahmed Mimouni","doi":"10.1016/j.hmedic.2025.100158","DOIUrl":"10.1016/j.hmedic.2025.100158","url":null,"abstract":"<div><div>Ovаriаn torsion is а rаre but serious complicаtion during pregnаncy, pаrticulаrly when аssociаted with lаrge ovаriаn mаsses. This cаse report presents а 42-yeаr-old grаvidа 2 pаrа 1 womаn with а history of cesаreаn section, who presented to the emergency depаrtment аt 16 weeks of gestаtion with аcute аbdominаl pаin. Clinicаl exаminаtion reveаled а pаlpаble left-sided mаss, аnd ultrаsound confirmed аn 11 cm twisted ovаriаn dermoid cyst. Initiаlly, а lаpаroscopic аpproаch wаs аttempted, but due to the lаrge size of the mаss аnd the grаvid uterus, the procedure wаs converted to а lаpаrotomy. А cystectomy wаs successfully performed, preserving the ovаry, аnd histopаthologicаl exаminаtion confirmed а benign dermoid cyst. The pаtient hаd аn uneventful postoperаtive recovery аnd wаs mаnаged with tocolytics to prevent uterine contrаctions. Follow-up ultrаsound demonstrаted а heаlthy intrаuterine pregnаncy, аnd the pаtient continued to receive routine prenаtаl cаre without further complicаtions. This cаse highlights the importаnce of timely intervention in ovаriаn torsion during pregnаncy to prevent potentiаl complicаtions such аs ovаriаn necrosis аnd fetаl loss. Аlthough lаpаroscopy is the preferred surgicаl аpproаch in mаny cаses, this report illustrаtes thаt lаpаrotomy remаins а sаfe аnd effective option when аnаtomicаl constrаints аre present. Surgicаl decision-mаking must be individuаlized bаsed on the size of the mаss, gestаtionаl аge, аnd clinicаl presentаtion to ensure fаvorаble outcomes for both the mother аnd fetus. This cаse underscores the need for flexibility in surgicаl mаnаgement аnd close monitoring postoperаtively.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2024.100142
Sandeep Kundra, Snimer K. Sidhu, Shaveta Kundra, Erajot K. Sandhu, Jaspal Kaur
Background
Aortopulmonary window (APW), results from failure of septation of the aorticopulmonary trunk during the fifth to eight weeks of gestational age. Patients with APWs rarely survive beyond early life stages without surgical interventions. Herein, we report anesthetic management of a woman who survived this disorder into adulthood and presented in a pregnant state and was taken up for cesarean delivery.
Case presentation
A 29 year female presented with 39 weeks pregnancy. Examination revealed a systolic murmur and cardiomegaly. Echocardiography revealed APW with left to right shunt. An emergency cesarean section under General Anesthesia (GA) was performed due to commencement of labor pains without adequate cervix dilatation.
Conclusion
The anesthetic management of a patient with APW is challenging, however, the present case describes the use of general anesthesia with good maternal and neonatal outcomes.
{"title":"Successful Caesarean section in a patient with Aortico pulmonary window: A peculiar case report","authors":"Sandeep Kundra, Snimer K. Sidhu, Shaveta Kundra, Erajot K. Sandhu, Jaspal Kaur","doi":"10.1016/j.hmedic.2024.100142","DOIUrl":"10.1016/j.hmedic.2024.100142","url":null,"abstract":"<div><h3>Background</h3><div>Aortopulmonary window (APW), results from failure of septation of the aorticopulmonary trunk during the fifth to eight weeks of gestational age. Patients with APWs rarely survive beyond early life stages without surgical interventions. Herein, we report anesthetic management of a woman who survived this disorder into adulthood and presented in a pregnant state and was taken up for cesarean delivery.</div></div><div><h3>Case presentation</h3><div>A 29 year female presented with 39 weeks pregnancy. Examination revealed a systolic murmur and cardiomegaly. Echocardiography revealed APW with left to right shunt. An emergency cesarean section under General Anesthesia (GA) was performed due to commencement of labor pains without adequate cervix dilatation.</div></div><div><h3>Conclusion</h3><div>The anesthetic management of a patient with APW is challenging, however, the present case describes the use of general anesthesia with good maternal and neonatal outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ameloblastoma is the second most common odontogenic tumour and the most common one to be reported histopathologically. The six histological variants of ameloblastoma are well established in the diagnosis of ameloblastoma, among which desmoplastic type still presents challenges to clinicians. In this multi-centric case series, we have complied with various clinical, radiological and histopathological parameters to better understand a unique variant from cases diagnosed between 1993 and 2023. The calculated mean age for desmoplastic ameloblastoma in the present case series was 55.5 years, with a higher female predilection and two-thirds of cases in the anterior mandible. Radiologically, Type I and II were the predominant presentation. Histopathologically, stromal hyalinization and osteoplasia were noted. The 61.1 % of cases were associated with another sub-type of ameloblastoma. The varied presentation has necessitated a rethink of using newer radiological techniques for early diagnosis, treatment planning and newly defined histopathological criteria for ‘Hybrid’ ameloblastoma.
{"title":"Desmoplastic ameloblastoma: A multicentric study of 18 case series with literature review","authors":"Madhusudan Astekar , Roopa Rao , Karpagaselvi Sanjai , Krishna Sireesha Sundaragiri , Gaurav Sapra , Shylaja Sanjeevareddygari , Srikant Natarajan , Sima P. Odedra","doi":"10.1016/j.hmedic.2024.100148","DOIUrl":"10.1016/j.hmedic.2024.100148","url":null,"abstract":"<div><div>Ameloblastoma is the second most common odontogenic tumour and the most common one to be reported histopathologically. The six histological variants of ameloblastoma are well established in the diagnosis of ameloblastoma, among which desmoplastic type still presents challenges to clinicians. In this multi-centric case series, we have complied with various clinical, radiological and histopathological parameters to better understand a unique variant from cases diagnosed between 1993 and 2023. The calculated mean age for desmoplastic ameloblastoma in the present case series was 55.5 years, with a higher female predilection and two-thirds of cases in the anterior mandible. Radiologically, Type I and II were the predominant presentation. Histopathologically, stromal hyalinization and osteoplasia were noted. The 61.1 % of cases were associated with another sub-type of ameloblastoma. The varied presentation has necessitated a rethink of using newer radiological techniques for early diagnosis, treatment planning and newly defined histopathological criteria for ‘Hybrid’ ameloblastoma.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2025.100164
Iqra Qazi, Nicole Hancock
Coccidioidomycosis, also known as valley fever, is a fungal infection caused by inhalation of soilborne spores. It primarily affects the respiratory system and presents with symptoms ranging from mild flu-like illness to severe pneumonia. Here we report a case of a 68-year-old male with fevers, worsening fatigue, and rash following a recent COVID-19 diagnosis. The patient had traveled to Florida, Arizona, Mexico, and Nevada within a month prior to symptom onset. Imaging revealed a lung nodule with associated mediastinal lymphadenopathy. Biopsy confirmed disseminated coccidioidomycosis. This case emphasizes the necessity of including coccidioidomycosis in the differential diagnosis for patients with respiratory symptoms and rashes, particularly those with recent travel to endemic regions. Heightened clinical awareness and prompt diagnostic evaluation are crucial for timely management.
{"title":"Disseminated coccidioidomycosis following travel to an endemic region and COVID-19 infection: Case report and case-based literature review","authors":"Iqra Qazi, Nicole Hancock","doi":"10.1016/j.hmedic.2025.100164","DOIUrl":"10.1016/j.hmedic.2025.100164","url":null,"abstract":"<div><div>Coccidioidomycosis, also known as valley fever, is a fungal infection caused by inhalation of soilborne spores. It primarily affects the respiratory system and presents with symptoms ranging from mild flu-like illness to severe pneumonia. Here we report a case of a 68-year-old male with fevers, worsening fatigue, and rash following a recent COVID-19 diagnosis. The patient had traveled to Florida, Arizona, Mexico, and Nevada within a month prior to symptom onset. Imaging revealed a lung nodule with associated mediastinal lymphadenopathy. Biopsy confirmed disseminated coccidioidomycosis. This case emphasizes the necessity of including coccidioidomycosis in the differential diagnosis for patients with respiratory symptoms and rashes, particularly those with recent travel to endemic regions. Heightened clinical awareness and prompt diagnostic evaluation are crucial for timely management.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Severe serotonin syndrome (SS) secondary to escitalopram is not commonly reported. We present the first case of severe recurrent SS with late-onset seizures following a single escitalopram overdose ingestion.
Case presentation
A 17-year-old girl was referred to the Emergency Department (ED) after allegedly ingesting about 330 mg of escitalopram due to suicidal ideation. She developed mild serotonin syndrome (tremors, hyperreflexia) and prolonged QTc of 620 ms, which resolved within 24 h, and she was discharged after about 48 h of observation. In less than 24 h, she was brought to the ED by her mother due to reduced responsiveness and jerky movement of all limbs. There was no repeated ingestion of escitalopram. On arrival, her Glasgow coma scale (GCS) was full but tachycardic, and she had a temperature of 38 °C, and prolonged QTc (610 ms). In the ED, the patient had myoclonic jerks and fitted (general tonic-clonic) 3 times before being intubated for airway protection. Cyproheptadine was started in the ED as SS symptoms persisted despite multiple diazepam boluses and heavy sedation with midazolam, morphine, and propofol. The serotonin syndrome fully resolved after five days.
Conclusion
Changes in escitalopram’s pharmacokinetics following a massive overdose are unknown. Severe recurrent SS and late-onset seizures can occur up to 72 h following a significant escitalopram overdose ingestion, and the patient should be closely monitored for a longer duration.
{"title":"Severe recurrent serotonin syndrome with late-onset seizures following a single escitalopram overdose ingestion: A case report","authors":"Hock Peng Koh , Nafisah Idris , Muhamad Shazwan Sazali , Paula Suen Suen Teoh","doi":"10.1016/j.hmedic.2024.100153","DOIUrl":"10.1016/j.hmedic.2024.100153","url":null,"abstract":"<div><h3>Introduction</h3><div>Severe serotonin syndrome (SS) secondary to escitalopram is not commonly reported. We present the first case of severe recurrent SS with late-onset seizures following a single escitalopram overdose ingestion.</div></div><div><h3>Case presentation</h3><div>A 17-year-old girl was referred to the Emergency Department (ED) after allegedly ingesting about 330 mg of escitalopram due to suicidal ideation. She developed mild serotonin syndrome (tremors, hyperreflexia) and prolonged QTc of 620 ms, which resolved within 24 h, and she was discharged after about 48 h of observation. In less than 24 h, she was brought to the ED by her mother due to reduced responsiveness and jerky movement of all limbs. There was no repeated ingestion of escitalopram. On arrival, her Glasgow coma scale (GCS) was full but tachycardic, and she had a temperature of 38 °C, and prolonged QTc (610 ms). In the ED, the patient had myoclonic jerks and fitted (general tonic-clonic) 3 times before being intubated for airway protection. Cyproheptadine was started in the ED as SS symptoms persisted despite multiple diazepam boluses and heavy sedation with midazolam, morphine, and propofol. The serotonin syndrome fully resolved after five days.</div></div><div><h3>Conclusion</h3><div>Changes in escitalopram’s pharmacokinetics following a massive overdose are unknown. Severe recurrent SS and late-onset seizures can occur up to 72 h following a significant escitalopram overdose ingestion, and the patient should be closely monitored for a longer duration.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2024.100140
Pyne Rudra , Sil Shiladitya , Ghosh Subhankar , Saha Nilanjana
Introduction
Neuroectodermal neoplasms include epithelial and non-epithelial types. Small cell neuroendocrine carcinoma (SNEC), primarily a lung cancer, can also appear in the head and neck region. Extra-pulmonary SNECs are rare, with a significant smoking history being a common factor.
Case report
A 60-year-old female presented with a six-month history of painful swelling in the lower right jaw. Examination revealed a firm, tender swelling with tooth mobility and right submandibular lymphadenopathy. Imaging showed a diffuse radiolucent lesion with root resorption. Biopsy and immunohistochemistry confirmed poorly differentiated neuroendocrine carcinoma. The patient underwent partial mandibulectomy and radical neck dissection, followed by adjuvant chemotherapy. A 16-month follow-up showed no recurrence.
Conclusion
Oral cavity SNEC is rare and aggressive, necessitating thorough differential diagnosis. A combination of surgery and chemotherapy is a viable treatment for localized lesions, though standardized protocols are lacking. Enhanced awareness and further research are essential for better diagnostic and therapeutic strategies.
{"title":"Primary Neuro-endocrine Carcinoma of the oral cavity – Report of a rare case","authors":"Pyne Rudra , Sil Shiladitya , Ghosh Subhankar , Saha Nilanjana","doi":"10.1016/j.hmedic.2024.100140","DOIUrl":"10.1016/j.hmedic.2024.100140","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuroectodermal neoplasms include epithelial and non-epithelial types. Small cell neuroendocrine carcinoma (SNEC), primarily a lung cancer, can also appear in the head and neck region. Extra-pulmonary SNECs are rare, with a significant smoking history being a common factor.</div></div><div><h3>Case report</h3><div>A 60-year-old female presented with a six-month history of painful swelling in the lower right jaw. Examination revealed a firm, tender swelling with tooth mobility and right submandibular lymphadenopathy. Imaging showed a diffuse radiolucent lesion with root resorption. Biopsy and immunohistochemistry confirmed poorly differentiated neuroendocrine carcinoma. The patient underwent partial mandibulectomy and radical neck dissection, followed by adjuvant chemotherapy. A 16-month follow-up showed no recurrence.</div></div><div><h3>Conclusion</h3><div>Oral cavity SNEC is rare and aggressive, necessitating thorough differential diagnosis. A combination of surgery and chemotherapy is a viable treatment for localized lesions, though standardized protocols are lacking. Enhanced awareness and further research are essential for better diagnostic and therapeutic strategies.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2025.100169
Mohammad Ashraful Amin , Ishtiakul Islam Khan , Ridwana Maher Manna , Sumyta Rahman , Nomaan Hassan Khan , Sabrina Nahin , Mohammad Delwer Hossain Hawlader
Adult-onset Still's disease (AOSD) is a rare autoimmune disorder with a challenging diagnosis due to its overlapping symptoms with other inflammatory and infectious conditions. This case study describes a 54-year-old man with type 2 diabetes mellitus who presented with persistent fever, weight loss, and multiple organ involvement. Initial investigations, including imaging and laboratory tests, suggested a granulomatous disease, but a definitive diagnosis remained elusive despite extensive workup. The patient's clinical course, marked by fluctuating symptoms and poor response to conventional treatments, eventually pointed towards an underlying autoimmune disorder. A provisional diagnosis of connective tissue disease with a differential diagnosis of AOSD was made, and corticosteroid therapy was initiated. Complications arose with the development of hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS), a severe, life-threatening condition associated with AOSD. The patient exhibited high ferritin levels, pancytopenia, and multi-organ dysfunction, indicating HLH. Despite aggressive management, including broad-spectrum antibiotics, antifungal therapy, and high-dose corticosteroids, the patient's condition deteriorated, leading to respiratory distress and arrhythmia. He was transferred to the intensive care unit but unfortunately expired. This case highlights the diagnostic challenges of AOSD and its potential to progress to severe complications like HLH. It underscores the need for a multidisciplinary approach in managing such complex cases and the importance of early recognition and aggressive treatment to improve outcomes. The limitations of conventional therapies and the need for targeted treatments and advanced diagnostic tools are also emphasized for better management of AOSD and associated complications.
{"title":"The Chameleon of rheumatology: A case of adult-onset Still’s disease","authors":"Mohammad Ashraful Amin , Ishtiakul Islam Khan , Ridwana Maher Manna , Sumyta Rahman , Nomaan Hassan Khan , Sabrina Nahin , Mohammad Delwer Hossain Hawlader","doi":"10.1016/j.hmedic.2025.100169","DOIUrl":"10.1016/j.hmedic.2025.100169","url":null,"abstract":"<div><div>Adult-onset Still's disease (AOSD) is a rare autoimmune disorder with a challenging diagnosis due to its overlapping symptoms with other inflammatory and infectious conditions. This case study describes a 54-year-old man with type 2 diabetes mellitus who presented with persistent fever, weight loss, and multiple organ involvement. Initial investigations, including imaging and laboratory tests, suggested a granulomatous disease, but a definitive diagnosis remained elusive despite extensive workup. The patient's clinical course, marked by fluctuating symptoms and poor response to conventional treatments, eventually pointed towards an underlying autoimmune disorder. A provisional diagnosis of connective tissue disease with a differential diagnosis of AOSD was made, and corticosteroid therapy was initiated. Complications arose with the development of hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS), a severe, life-threatening condition associated with AOSD. The patient exhibited high ferritin levels, pancytopenia, and multi-organ dysfunction, indicating HLH. Despite aggressive management, including broad-spectrum antibiotics, antifungal therapy, and high-dose corticosteroids, the patient's condition deteriorated, leading to respiratory distress and arrhythmia. He was transferred to the intensive care unit but unfortunately expired. This case highlights the diagnostic challenges of AOSD and its potential to progress to severe complications like HLH. It underscores the need for a multidisciplinary approach in managing such complex cases and the importance of early recognition and aggressive treatment to improve outcomes. The limitations of conventional therapies and the need for targeted treatments and advanced diagnostic tools are also emphasized for better management of AOSD and associated complications.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2025.100167
Amina Hameed, Ranam Akhtar, Khurram Khaliq Bhinder, Ahmad Talha Tariq
Persistent hypoglossal artery (PHA) is a rare vascular variant of carotid-basilar anastomosis, with persistent trigeminal artery being the more common one. It is even rarer in patients with tetralogy of Fallot (TOF) with very few cases reported in the literature. We present a case of a 9-year-old boy diagnosed with Tetralogy of Fallot who presented to the Pediatrics department of Shifa International Hospital with complaints of headache, vomiting and fits. His MRI and serial CT brain imaging were performed, and a diagnosis of brain abscess was made. An incidental note was made of the persistent right hypoglossal artery. He was given IV antibiotics, and significant improvement was seen radiologically as well as clinically. The patient is a potential candidate for Surgical repair of TOF.
{"title":"Enigmatic vessel: The persistent hypoglossal artery in a tetralogy of fallot patient with brain abscess – Report of a rare case","authors":"Amina Hameed, Ranam Akhtar, Khurram Khaliq Bhinder, Ahmad Talha Tariq","doi":"10.1016/j.hmedic.2025.100167","DOIUrl":"10.1016/j.hmedic.2025.100167","url":null,"abstract":"<div><div>Persistent hypoglossal artery (PHA) is a rare vascular variant of carotid-basilar anastomosis, with persistent trigeminal artery being the more common one. It is even rarer in patients with tetralogy of Fallot (TOF) with very few cases reported in the literature. We present a case of a 9-year-old boy diagnosed with Tetralogy of Fallot who presented to the Pediatrics department of Shifa International Hospital with complaints of headache, vomiting and fits. His MRI and serial CT brain imaging were performed, and a diagnosis of brain abscess was made. An incidental note was made of the persistent right hypoglossal artery. He was given IV antibiotics, and significant improvement was seen radiologically as well as clinically. The patient is a potential candidate for Surgical repair of TOF.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.hmedic.2024.100146
Vivek Manohar Kavila , Jerusha P , Stella Spurthi G , Komali Paruvada
Pregnancy tumor is a reactive hyperplasia of the connective tissue in response to local irritants. Hormonal changes have also been attributed as a likely cause of pregnancy tumors which is frequently seen during pregnancy. Increased levels of sex hormones during pregnancy affect the subgingival microflora, the immune system, the vasculature, and specific cells of the periodontium. This, combined with local irritants, can exacerbate the lesion. Clinically, these lesions appear as tumor-like, non-neoplastic growths in the oral cavity. Pregnancy tumor, typically does not recur after careful surgical excision and the correction of contributing factors. Histopathology plays a crucial role in the diagnosis of the pregnancy tumors. This report presents a case of pregnancy tumor which reoccurred twice in a span of one year postpartum. The patient was followed up for one year after surgical excision, and no recurrence was detected. Recurrence is seldom when local factors are promptly addressed and with thorough surgical excision.
{"title":"Recurrent post-partum pregnancy tumor: A case report","authors":"Vivek Manohar Kavila , Jerusha P , Stella Spurthi G , Komali Paruvada","doi":"10.1016/j.hmedic.2024.100146","DOIUrl":"10.1016/j.hmedic.2024.100146","url":null,"abstract":"<div><div>Pregnancy tumor is a reactive hyperplasia of the connective tissue in response to local irritants. Hormonal changes have also been attributed as a likely cause of pregnancy tumors which is frequently seen during pregnancy. Increased levels of sex hormones during pregnancy affect the subgingival microflora, the immune system, the vasculature, and specific cells of the periodontium. This, combined with local irritants, can exacerbate the lesion. Clinically, these lesions appear as tumor-like, non-neoplastic growths in the oral cavity. Pregnancy tumor, typically does not recur after careful surgical excision and the correction of contributing factors. Histopathology plays a crucial role in the diagnosis of the pregnancy tumors. This report presents a case of pregnancy tumor which reoccurred twice in a span of one year postpartum. The patient was followed up for one year after surgical excision, and no recurrence was detected. Recurrence is seldom when local factors are promptly addressed and with thorough surgical excision.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号