Medical Reports最新文献

{"title":"Recurrent dyspnea on exertion: Hypersensitivity pneumonitis caused by exposure to household birds","authors":"Elena Stekolchik , David Saul , Aaron Chidekel","doi":"10.1016/j.hmedic.2025.100403","DOIUrl":"10.1016/j.hmedic.2025.100403","url":null,"abstract":"","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100403"},"PeriodicalIF":0.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptococcus pyogenes presenting as infrarenal abdominal aortic mycotic aneurysm: Exploring the potential for conservative management","authors":"Carmen Pérez-Valencia ,&nbsp;Antonio Bedmar Pérez ,&nbsp;Francisco Javier Torre-Gomar ,&nbsp;Andrés Ruiz-Sancho","doi":"10.1016/j.hmedic.2025.100402","DOIUrl":"10.1016/j.hmedic.2025.100402","url":null,"abstract":"<div><h3>Introduction</h3><div>Infrarenal abdominal aortic mycotic aneurysm (MAA) is an uncommon and life-threatening condition caused by septic emboli that degrade the arterial wall. Standard treatment involves antibiotic therapy, aneurysm resection, and reconstruction of the affected area. However, in patients with significant comorbidities, surgery presents substantial risks, raising the question of whether conservative treatment might be a viable therapeutic option.</div></div><div><h3>Case presentation</h3><div>An 80-year-old male with a history of aorto-monoiliac prosthesis placement for an infrarenal abdominal aortic aneurysm presented with fever, malaise, and lower back pain. Initially diagnosed with pyelonephritis, imaging CT scan revealed a dilated aorta with suspicious infected collections but no active bleeding. PET-CT demonstrated hypermetabolism confirming an active infectious focus. The patient was diagnosed with Szilagyi Grade III MAA. Blood cultures revealed an infection by Streptococcus pyogenes, a microorganism that is extremely infrequently associated with mycotic aneurysms. Due to comorbidities, conservative management with suppressive antimicrobial therapy was chosen. After 12 months of follow-up, the patient remains asymptomatic with negative blood cultures and disappearance of perianeurysmal soft tissue mass on follow-up CTA.</div></div><div><h3>Conclusion</h3><div>MAA is a rare and fatal condition requiring early detection to prevent severe complications. Diagnosis relies on imaging studies. Standard treatment involves antibiotics and surgery, but in elderly patients with comorbidities, a conservative approach is a viable option. Treatment should be individualized and discussed by a multidisciplinary team.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A common drug, an uncommon reaction: The combination of amoxicillin-clavulanic acid induced acute allergic reaction with urticaria and angioedema—A case study","authors":"Aruna Kale ,&nbsp;Avinash Khairnar ,&nbsp;Anil Pardeshi ,&nbsp;Vaishali Agrawal ,&nbsp;Shweta Bora","doi":"10.1016/j.hmedic.2025.100401","DOIUrl":"10.1016/j.hmedic.2025.100401","url":null,"abstract":"<div><h3>Background</h3><div>Amoxicillin-clavulanic acid is a commonly prescribed β-lactam antibiotic combination known for its broad-spectrum activity and general tolerability. However, it can rarely cause severe immediate hypersensitivity reactions, including urticaria, angioedema, and life-threatening anaphylaxis. Early identification and management are crucial, especially in perioperative settings.</div></div><div><h3>Case presentation</h3><div>The patient who was a 38-year-old female gynaecologist, developed an acute allergic reaction with urticaria, angioedema, and anaphylaxis shortly after intravenous administration of amoxicillin-clavulanic acid during an elective caesarean section. Despite previous uneventful exposures and no known allergy history, she experienced rapid cardiovascular collapse requiring advanced resuscitation. The patient recovered fully after timely intervention with corticosteroids, vasopressors, and supportive care.</div></div><div><h3>Pathogenesis</h3><div>The hypersensitivity was likely IgE-mediated, involving mast cell activation triggered by both amoxicillin and clavulanic acid sensitization. Proposed mechanisms include drug-induced hapten formation and disruption of skin cell adhesion proteins, leading to immune activation and the characteristic skin manifestations.</div></div><div><h3>Diagnosis and management</h3><div>Diagnosis relied on clinical correlation of symptoms with drug exposure. Immediate cessation of the drug and initiation of corticosteroids, antihistamines, vasopressors, and cardiopulmonary resuscitation were critical to patient survival. Close monitoring post-event ensured recovery and prevented complications.</div></div><div><h3>Contribution of this study</h3><div>This case underscores the unpredictable nature of severe β-lactam allergies, highlighting the necessity for vigilant allergy assessment and pharmacovigilance. It supports the implementation of penicillin skin testing and awareness of clavulanate-specific hypersensitivity. Additionally, pharmacogenomic insights may enhance personalized antibiotic therapy and reduce adverse reactions.</div></div><div><h3>Conclusion</h3><div>Anaphylaxis to amoxicillin-clavulanate may occur despite prior tolerance, indicating delayed sensitization. Early drug withdrawal and epinephrine use are lifesaving. Pregnancy at advanced maternal age may heighten immune reactivity. Post-resuscitation pulmonary complications warrant monitoring. Confirmatory allergic testing for β-lactam and clavulanate determinants is crucial for guiding future antibiotic safety and prophylaxis.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendiceal mucinous adenocarcinoma presenting as cecal intussusception: A rare case report","authors":"Lamia Azizi ,&nbsp;Philippe Attieh ,&nbsp;Noura Chamchoum ,&nbsp;Elie Chamchoum ,&nbsp;George Ghaleb ,&nbsp;Mehsen Azizi ,&nbsp;Karam Karam","doi":"10.1016/j.hmedic.2025.100400","DOIUrl":"10.1016/j.hmedic.2025.100400","url":null,"abstract":"<div><h3>Background</h3><div>Appendiceal mucinous adenocarcinoma (MACA) is an uncommon malignancy, representing less than 0.5 % of gastrointestinal cancers. Clinical presentation is often nonspecific, which can delay diagnosis. Intussusception as an initial manifestation is exceptionally rare in adults.</div></div><div><h3>Case Presentation</h3><div>We report the case of a 63-year-old man with no significant medical history who presented with acute abdominal pain, vomiting, and diarrhea. Examination revealed a periumbilical mass, and inflammatory markers were elevated. Contrast-enhanced CT demonstrated a large cecal intussusception extending to the transverse colon with a few right iliac fossa lymph nodes. The patient underwent laparotomy with partial cecectomy, which revealed indurated cecal tissue. Histopathology confirmed mucinous adenocarcinoma of the appendix measuring 3.5 cm, low-grade, invading the subserosa/mesoappendix (pT3), with negative margins and no nodal metastasis (0/12). The final stage was pT3N0M0 (AJCC stage IIA). Given the absence of nodal involvement, adjuvant chemotherapy was not administered, and the patient was managed with structured surveillance including periodic imaging and tumor marker assessment.</div></div><div><h3>Conclusion</h3><div>This case illustrates a rare presentation of MACA as the lead point for cecal intussusception in an adult. It underscores the importance of considering appendiceal tumors in the differential diagnosis of bowel obstruction and highlights the role of prompt surgical resection for diagnosis and management.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer metastasis to gallbladder and urinary bladder: A rare case report","authors":"Farah Tarek Shaalan ,&nbsp;Israa Ahmed Qutob","doi":"10.1016/j.hmedic.2025.100398","DOIUrl":"10.1016/j.hmedic.2025.100398","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is among the most frequently diagnosed malignancies worldwide, with metastases significantly impacting prognosis and treatment strategies. While the bones, lungs, liver, and brain are common metastatic sites, the involvement of the gallbladder and urinary bladder is exceedingly rare. These atypical metastatic sites pose considerable diagnostic challenges, often mimicking primary malignancies or benign conditions, thereby complicating timely diagnosis and appropriate management.</div></div><div><h3>Case Presentation</h3><div>We present the case of a 59-year-old female with a history of invasive lobular carcinoma of the right breast, diagnosed in 2018. Following a modified radical mastectomy, she underwent adjuvant chemotherapy, radiotherapy, and hormonal therapy, achieving an initial disease-free period. In June 2021, she presented with persistent vomiting, epigastric pain, and hematuria. Further evaluation revealed gastric outlet obstruction, prompting an exploratory laparotomy revealed a thickened gallbladder and pyloric narrowing. She underwent gastrojejunostomy (bypass surgery) with cholecystectomy, which confirmed metastatic carcinoma of lobular breast cancer origin in the gallbladder. Additional metastatic workup identified metastases to the bone and urinary bladder. Immunohistochemical analysis of metastatic lesions demonstrated estrogen receptor positivity, progesterone receptor positivity, and human epidermal growth factor receptor-2 negativity, consistent with the primary breast malignancy. Given her deteriorating condition, she commenced palliative chemotherapy with paclitaxel and zoledronic acid, subsequently transitioning to anastrozole and zoledronic acid.</div></div><div><h3>Conclusion</h3><div>This case underscores the importance of recognizing rare metastatic patterns in breast cancer. Comprehensive diagnostic evaluation, integrating imaging, histopathology, and molecular profiling, is crucial for accurate diagnosis and appropriate treatment. Further research is necessary to elucidate the mechanisms driving metastasis to uncommon sites and improve therapeutic approaches.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plexiform neurofibroma without neurofibromatosis type 1: A case report","authors":"Abdirahman Ahmed Mohamud ,&nbsp;Mohamed Rage Ahmed ,&nbsp;Abdirashid Abdullahi Dalmar ,&nbsp;Ismail Mohamoud Abdullahi ,&nbsp;Abdinasir Mohamed Elmi","doi":"10.1016/j.hmedic.2025.100399","DOIUrl":"10.1016/j.hmedic.2025.100399","url":null,"abstract":"<div><div>Plexiform neurofibromas are a less common type of tumor (occurring in 30 % of cases) associated with neurofibromatosis type 1 (NF-1). These tumors develop from multiple nerves, often appearing as bulging, disfiguring masses that can involve surrounding connective tissue and skin. We describe an unusual case of a 38-year-old male who presented with a painless swelling in the left preneal region that had been present since early childhood. A physical examination did not reveal the presence of multiple neurofibromas or café-au-lait macules on the trunk and arms. Cytological examination of biopsy samples obtained through ultrasound-guided fine needle aspiration revealed a spindle cell neoplasm. Subsequent pelvic magnetic resonance imaging (MRI) confirmed the presence of a solid, enhancing mass in the left perianal region. Following the patient's request for surgical intervention, an excisional biopsy was performed, which ultimately revealed the diagnosis of plexiform neurofibroma. Plexiform neurofibromas are typically diagnosed based on clinical findings, particularly when accompanied by other characteristic features of neurofibromatosis type 1. Treatment often involves surgery to remove disfiguring masses and any cancerous tissue that may have developed.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftriaxone-induced gallbladder pseudolithiasis in a child: A question of confirmation?","authors":"Abdulaziz Hussein","doi":"10.1016/j.hmedic.2025.100397","DOIUrl":"10.1016/j.hmedic.2025.100397","url":null,"abstract":"<div><h3>Background</h3><div>Ceftriaxone is a commonly prescribed antibiotic in pediatric medicine, but its association with gallbladder pseudolithiasis is not well-documented.</div></div><div><h3>Case presentation</h3><div>A four-year-old boy was admitted with lobar pneumonia presenting with fever, cough, and abdominal pain. Because of the severity of his pneumonia, which required inpatient management with parenteral antibiotics, the child was started on intravenous ceftriaxone. The patient had no significant past medical or family history and was not on any medications prior to admission. He was started on ceftriaxone, an injectable antibiotic, at a dosage of 60 mg/kg/day after a chest X-ray confirmed lobar pneumonia in the lower left lung. However, more than five days of treatment in hospital following developed gastrointestinal symptoms, including abdominal discomfort, nausea, and constipation, laboratory tests showed mildly elevated liver enzymes (ALT 45 U/L, AST 50 U/L, ALP 150 U/L, total bilirubin 1.5 mg/dL) and CBC of 14,000 cells/mm³ , while hemoglobin and platelets were normal. C-reactive protein was elevated, and electrolytes were within normal limits. An abdominal ultrasound conducted, revealed the presence of multiple echogenic foci in the gallbladder, which is indicative of pseudolithiasis, but no indicators of cholecystitis. Symptoms resolved after discontinued this antibiotic and replaced with another suitable one, with follow-up ultrasound confirming resolution.</div></div><div><h3>Conclusion</h3><div>This case underscores the need for awareness of ceftriaxone's potential side effects, including gallbladder pseudolithiasis in pediatric patients. Further investigation is warranted to elucidate the mechanisms behind this association and to guide clinical practice.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100397"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe multiarticular gouty tophi","authors":"Krislyn Cardoza ,&nbsp;Farzana Hoque","doi":"10.1016/j.hmedic.2025.100390","DOIUrl":"10.1016/j.hmedic.2025.100390","url":null,"abstract":"<div><div>Tophaceous gout is a chronic, advanced manifestation of gout, characterized by subcutaneous and periarticular deposition of monosodium urate crystals, leading to the formation of tophi. While modern urate-lowering therapies have reduced the incidence of tophaceous disease, it still occurs in patients with delayed diagnosis, nonadherence to treatment, or inadequate medical follow-up. We present the case of a 62-year-old male admitted with an acute ischemic stroke, which led to the incidental discovery of his advanced, untreated tophaceous disease. He was found to have extensive tophaceous involvement of multiple joints and soft tissues, including disfiguring nodules on the hands, elbows, and forearms. Management of tophaceous gout hinges on sustained urate-lowering therapy and careful monitoring to prevent irreversible joint damage. This report underscores the long-term consequences of untreated gout and the critical importance of early diagnosis and lifelong adherence to medical therapy.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100390"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of Mirizzi syndrome type I complicated by acute cholangitis and gallbladder perforation: A diagnostic and surgical challenge","authors":"Antonio Al Hazzouri ,&nbsp;Philippe Attieh ,&nbsp;Maya Ammoury ,&nbsp;Rose Mary Daou ,&nbsp;Lamia Azizi ,&nbsp;Karam Karam ,&nbsp;Elias Fiani","doi":"10.1016/j.hmedic.2025.100392","DOIUrl":"10.1016/j.hmedic.2025.100392","url":null,"abstract":"<div><div>Mirizzi syndrome (MS) is an uncommon complication of cholelithiasis involving gallstone impaction in the cystic duct or gallbladder neck, leading to compression of the common hepatic duct and potential biliary obstruction. We report a case of a middle aged male who presented with acute cholangitis.Imaging revealed two large gallstones: one at the gallbladder neck causing biliary compression, and another obstructing the common bile duct. The patient was diagnosed with Mirizzi Syndrome Type I complicated by cholangitis. Despite initial clinical improvement following antibiotic therapy, the patient rapidly deteriorated, developing gallbladder perforation. Urgent laparoscopic cholecystectomy was performed with a successful outcome. This case illustrates the diagnostic challenges associated with MS, especially when complicated by acute cholangitis and gallbladder perforation. It emphasizes the need for high clinical suspicion, early imaging with modalities such as CT and MRCP, and timely surgical intervention. The successful use of a minimally invasive approach in this high-risk scenario supports its viability even in complex biliary disease. To our knowledge, this is the first reported instance of gallbladder perforation complicating MS type I with concurrent cholangitis, highlighting an aggressive presentation of this rare syndrome.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melkersson–Rosenthal syndrome masquerading as mucocutaneous leishmaniasis in a high leishmaniasis-burden area: A case report","authors":"Mikias Woldetensay Woldemeleak ,&nbsp;Suleiman Ayalew Belay ,&nbsp;Ermias Teklehaimanot Yefter ,&nbsp;Zelallem Aniley Workneh","doi":"10.1016/j.hmedic.2025.100389","DOIUrl":"10.1016/j.hmedic.2025.100389","url":null,"abstract":"<div><div>Melkersson–Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disorder characterized by the classical triad of recurrent orofacial swelling, peripheral facial palsy, and fissured tongue, although the complete presentation is uncommon. In regions where infectious diseases with overlapping manifestations are endemic, such as mucocutaneous leishmaniasis (MCL), MRS may be easily misdiagnosed. We present the case of a 30-year-old Ethiopian man with a 16-year history of recurrent, painless lip swelling initially treated as MCL without clinical improvement. Examination revealed firm swelling of the upper and right lower lips, a geographic tongue, and right-sided peripheral facial palsy. A prior lip biopsy had been interpreted as pemphigus vulgaris, further contributing to diagnostic delay. The presence of the complete clinical triad ultimately led to a diagnosis of MRS. The patient was managed with systemic corticosteroids, doxycycline, and intralesional triamcinolone acetonide, achieving significant improvement after three months and sustained response at six months. This case underscores the diagnostic challenges of MRS in leishmaniasis-endemic regions and highlights the importance of recognizing the classical triad to avoid misdiagnosis and facilitate timely, effective treatment.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100389"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}