Pub Date : 2025-12-01DOI: 10.1016/j.hmedic.2025.100393
Dennis Poon , Hilary Kok
Described here is a case of small bowel obstruction secondary to ileo-ileal intussusception of a rare aetiology in a 34-year-old female presented with acute abdominal pain and vomiting. Ultrasound scan of her hepatobiliary system only showed two small gallbladder polyps with no biliary ductal dilatation, gastroscopy showed mild oesophagitis and gastritis in the antrum and endoscopic ultrasound confirmed the two gallbladder polyps and a normal common bile duct. Computed tomography was performed in view of her persistent symptoms and revealed small bowel obstruction. An intraluminal lesion at 110 cm from the ileocaecal valve was palpable intra-operatively and ileal resection was performed. Histological features of the resected lesion confirmed an inflammatory fibroid polyp. A small number of cases reports on adult patients presented with bowel obstruction can be found in the literature and this rare aetiology should be considered as one of the differentials in the diagnostic process in managing this patient cohort.
{"title":"A rare case of intussusception in an adult caused by a small intestinal inflammatory fibroid polyp","authors":"Dennis Poon , Hilary Kok","doi":"10.1016/j.hmedic.2025.100393","DOIUrl":"10.1016/j.hmedic.2025.100393","url":null,"abstract":"<div><div>Described here is a case of small bowel obstruction secondary to ileo-ileal intussusception of a rare aetiology in a 34-year-old female presented with acute abdominal pain and vomiting. Ultrasound scan of her hepatobiliary system only showed two small gallbladder polyps with no biliary ductal dilatation, gastroscopy showed mild oesophagitis and gastritis in the antrum and endoscopic ultrasound confirmed the two gallbladder polyps and a normal common bile duct. Computed tomography was performed in view of her persistent symptoms and revealed small bowel obstruction. An intraluminal lesion at 110 cm from the ileocaecal valve was palpable intra-operatively and ileal resection was performed. Histological features of the resected lesion confirmed an inflammatory fibroid polyp. A small number of cases reports on adult patients presented with bowel obstruction can be found in the literature and this rare aetiology should be considered as one of the differentials in the diagnostic process in managing this patient cohort.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617143","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}
Pub Date : 2025-12-01DOI: 10.1016/j.hmedic.2025.100388
Zoungrana Jacques , Somé Dogbèponé , Da Léa , Lankoande Diagniagou , Kabore D. Odilon , Sougue Yaya , Diallo Ismaël , Ouédraogo Abdoul Salam , Poda Armel
Tetanus is a disease characterized by generalized muscle contractures and can be potentially serious, especially in tropical environments where it requires specialized care. Mortality is often associated with neurovegetative and infectious complications. Thrombotic and bacteremic complications are exceedingly rare in this disease, and to our knowledge, their association with generalized tetanus has not been previously described. We present a case of generalized tetanus complicated by venous thrombosis of the left leg and E. coli bacteremia.
{"title":"Bacteremia and venous thrombosis of the lower limb complicating a case of acute generalized tetanus","authors":"Zoungrana Jacques , Somé Dogbèponé , Da Léa , Lankoande Diagniagou , Kabore D. Odilon , Sougue Yaya , Diallo Ismaël , Ouédraogo Abdoul Salam , Poda Armel","doi":"10.1016/j.hmedic.2025.100388","DOIUrl":"10.1016/j.hmedic.2025.100388","url":null,"abstract":"<div><div>Tetanus is a disease characterized by generalized muscle contractures and can be potentially serious, especially in tropical environments where it requires specialized care. Mortality is often associated with neurovegetative and infectious complications. Thrombotic and bacteremic complications are exceedingly rare in this disease, and to our knowledge, their association with generalized tetanus has not been previously described. We present a case of generalized tetanus complicated by venous thrombosis of the left leg and <em>E. coli</em> bacteremia.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100388"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617145","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}
Pub Date : 2025-11-28DOI: 10.1016/j.hmedic.2025.100404
Mohammad Qureshi , Jamie Sloan , Sunpreet Rakhra , Gurpreet Gandhoke , Stephanie A. Kolakowsky-Hayner
Intracranial germ cell tumors, in locations other than the suprasellar and pineal area, are rare and typically present in children and adolescents. There is a dearth of literature regarding the presentation and treatment of germ cell tumors, particularly in adults. We present the case history, management, and 2-year follow up imaging of a 33-year-old male presenting with headaches and diabetes insipidus. On investigation, multiple tumors were found in the pineal, sellar region, posterior falcine area, and the frontal lobe on enhanced MRI. Stereotactic biopsy of the most accessible lesion was performed. Immunological analysis revealed tumor cells positive for OCT 3/4, CD117, CD10, D2–40 and dot-like CAM5.2. The patient was treated with BEP (Bleomycin + Etoposide + Cisplatin) chemotherapy and cranio-spinal proton beam radiation with significant reduction of tumor burden and no local recurrence or distant metastasis at 24 months. Timely diagnosis and excellent response to chemo-radiation helped avoid invasive and morbid surgical interventions. This case enhances the understanding of timely diagnosis and initiation of treatment for central nervous system germ cell tumors.
{"title":"Multicentric intracranial germinomas – Case report","authors":"Mohammad Qureshi , Jamie Sloan , Sunpreet Rakhra , Gurpreet Gandhoke , Stephanie A. Kolakowsky-Hayner","doi":"10.1016/j.hmedic.2025.100404","DOIUrl":"10.1016/j.hmedic.2025.100404","url":null,"abstract":"<div><div>Intracranial germ cell tumors, in locations other than the suprasellar and pineal area, are rare and typically present in children and adolescents. There is a dearth of literature regarding the presentation and treatment of germ cell tumors, particularly in adults. We present the case history, management, and 2-year follow up imaging of a 33-year-old male presenting with headaches and diabetes insipidus. On investigation, multiple tumors were found in the pineal, sellar region, posterior falcine area, and the frontal lobe on enhanced MRI. Stereotactic biopsy of the most accessible lesion was performed. Immunological analysis revealed tumor cells positive for OCT 3/4, CD117, CD10, D2–40 and dot-like CAM5.2. The patient was treated with BEP (Bleomycin + Etoposide + Cisplatin) chemotherapy and cranio-spinal proton beam radiation with significant reduction of tumor burden and no local recurrence or distant metastasis at 24 months. Timely diagnosis and excellent response to chemo-radiation helped avoid invasive and morbid surgical interventions. This case enhances the understanding of timely diagnosis and initiation of treatment for central nervous system germ cell tumors.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738015","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}
Pub Date : 2025-11-27DOI: 10.1016/j.hmedic.2025.100406
Joelle Milan , Bashir Bassile , Bachir Elias
Introduction
Chordomas are rare bone neoplasms that arise from the remnants of the embryonic notochord. Although chordomas are rare, slow to grow and have low metastatic potential, they can be fatal if diagnosed late or misdiagnosed.
Case report
We present the case of a 65 years old male patient who presented for pain and discomfort in his buttocks area mainly upon sitting. He had previously undergone three surgeries for resection of what was diagnosed as a pilonidal sinus from the buttock area in a different hospital. After a CT scan being in favor of a developmental cyst, once again surgical resection was done.
Postoperative immunohistopathological studies identified the mass as a differentiated conventional type chordoma. In light of these findings, our patient was referred for metastatic workup, radiotherapy and chemotherapy.
Discussion
Their vague symptomatology can lead to frequent misdiagnosis of chordomas. CT scan can easily cause confusion between a benign pilonidal/developmental cyst and a slow growing chordoma. To date, total resection of chordomas is the gold standard of treatment, however, pre-operative biopsy and MRI should be implemented whenever chordoma is among the differentials. Determining the presence of metastasis and assessing local invasions are needed to decide on an appropriate surgical resection (total or partial) and assess the need of chemical (i.e. imatinib mesylate) or radiological treatment.
Conclusion
Sacrococcygeal chordomas are rare tumors that are usually misdiagnosed and mismanaged. Imaging can be very helpful in aiding the diagnosis with known suggestive findings especially on MRI. Wide surgical excision is still the ultimate treatment while the use of carbon/photon/hardon radiotherapy and imatinib mesylate is promising.
{"title":"Sacrococcygeal chondroma misdiagnosed as pilonidal sinus: A case report","authors":"Joelle Milan , Bashir Bassile , Bachir Elias","doi":"10.1016/j.hmedic.2025.100406","DOIUrl":"10.1016/j.hmedic.2025.100406","url":null,"abstract":"<div><h3>Introduction</h3><div>Chordomas are rare bone neoplasms that arise from the remnants of the embryonic notochord. Although chordomas are rare, slow to grow and have low metastatic potential, they can be fatal if diagnosed late or misdiagnosed.</div></div><div><h3>Case report</h3><div>We present the case of a 65 years old male patient who presented for pain and discomfort in his buttocks area mainly upon sitting. He had previously undergone three surgeries for resection of what was diagnosed as a pilonidal sinus from the buttock area in a different hospital. After a CT scan being in favor of a developmental cyst, once again surgical resection was done.</div><div>Postoperative immunohistopathological studies identified the mass as a differentiated conventional type chordoma. In light of these findings, our patient was referred for metastatic workup, radiotherapy and chemotherapy.</div></div><div><h3>Discussion</h3><div>Their vague symptomatology can lead to frequent misdiagnosis of chordomas. CT scan can easily cause confusion between a benign pilonidal/developmental cyst and a slow growing chordoma. To date, total resection of chordomas is the gold standard of treatment, however, pre-operative biopsy and MRI should be implemented whenever chordoma is among the differentials. Determining the presence of metastasis and assessing local invasions are needed to decide on an appropriate surgical resection (total or partial) and assess the need of chemical (i.e. imatinib mesylate) or radiological treatment.</div></div><div><h3>Conclusion</h3><div>Sacrococcygeal chordomas are rare tumors that are usually misdiagnosed and mismanaged. Imaging can be very helpful in aiding the diagnosis with known suggestive findings especially on MRI. Wide surgical excision is still the ultimate treatment while the use of carbon/photon/hardon radiotherapy and imatinib mesylate is promising.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100406"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685074","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}
Brucellosis is a zoonotic infection that can affect multiple organ systems, often presenting with non-specific symptoms such as fatigue, back pain, and low-grade fever. The musculoskeletal system is frequently involved, leading to conditions like arthritis, sacroiliitis, spondylitis, spondylodiscitis, and osteomyelitis. Among these, spondylodiscitis most commonly affects the lumbar vertebrae, followed by the thoracic vertebrae, with cervical involvement being rare. Brucellosis diagnosis is challenging due to slow, low-yield cultures and limitations of standard agglutination test (SAT) and Enzyme-linked immunosorbent assay (ELISA), which may show false negatives and cross-reactivity. Overlapping clinical and radiological features with tuberculosis often cause misdiagnosis, leading to delayed diagnosis.
Case description
We present a rare case of cervical brucellar spondylodiscitis with an epidural abscess, initially misdiagnosed as tuberculosis. A middle-aged patient presented with progressive quadriparesis, prompting clinical suspicion of tubercular spondylitis. The patient started on antitubercular therapy (ATT) but subsequently developed drug-induced hepatitis. Further investigation revealed Brucella was the causative agent. Treatment was adjusted accordingly, resulting in notable clinical recovery and radiological abscess resolution.
Conclusion
Brucellar spondylodiscitis should be considered in the differential diagnosis of infective spondylitis, especially in endemic regions. Misdiagnosis as tubercular spondylitis can result in unnecessary ATT exposure and its associated complications. Timely diagnosis with appropriate serological and microbiological investigations is crucial for initiating appropriate therapy and preventing adverse outcomes.
{"title":"Brucellosis or tuberculosis? A case of misdiagnosed cervical spondylodiscitis leading to ATT-induced hepatitis","authors":"Divya Tanwar , Naresh Kumar Midha , Suvinay Saxena , Monika Chaudhary , Deepak Kumar , Vibhor Tak","doi":"10.1016/j.hmedic.2025.100407","DOIUrl":"10.1016/j.hmedic.2025.100407","url":null,"abstract":"<div><h3>Background</h3><div>Brucellosis is a zoonotic infection that can affect multiple organ systems, often presenting with non-specific symptoms such as fatigue, back pain, and low-grade fever. The musculoskeletal system is frequently involved, leading to conditions like arthritis, sacroiliitis, spondylitis, spondylodiscitis, and osteomyelitis. Among these, spondylodiscitis most commonly affects the lumbar vertebrae, followed by the thoracic vertebrae, with cervical involvement being rare. Brucellosis diagnosis is challenging due to slow, low-yield cultures and limitations of standard agglutination test (SAT) and Enzyme-linked immunosorbent assay (ELISA), which may show false negatives and cross-reactivity. Overlapping clinical and radiological features with tuberculosis often cause misdiagnosis, leading to delayed diagnosis.</div></div><div><h3>Case description</h3><div>We present a rare case of cervical brucellar spondylodiscitis with an epidural abscess, initially misdiagnosed as tuberculosis. A middle-aged patient presented with progressive quadriparesis, prompting clinical suspicion of tubercular spondylitis. The patient started on antitubercular therapy (ATT) but subsequently developed drug-induced hepatitis. Further investigation revealed Brucella was the causative agent. Treatment was adjusted accordingly, resulting in notable clinical recovery and radiological abscess resolution.</div></div><div><h3>Conclusion</h3><div>Brucellar spondylodiscitis should be considered in the differential diagnosis of infective spondylitis, especially in endemic regions. Misdiagnosis as tubercular spondylitis can result in unnecessary ATT exposure and its associated complications. Timely diagnosis with appropriate serological and microbiological investigations is crucial for initiating appropriate therapy and preventing adverse outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"15 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624947","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}
Pub Date : 2025-11-21DOI: 10.1016/j.hmedic.2025.100402
Carmen Pérez-Valencia , Antonio Bedmar Pérez , Francisco Javier Torre-Gomar , Andrés Ruiz-Sancho
Introduction
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.
Case presentation
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.
Conclusion
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.
{"title":"Streptococcus pyogenes presenting as infrarenal abdominal aortic mycotic aneurysm: Exploring the potential for conservative management","authors":"Carmen Pérez-Valencia , Antonio Bedmar Pérez , Francisco Javier Torre-Gomar , 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}
Pub Date : 2025-11-21DOI: 10.1016/j.hmedic.2025.100401
Aruna Kale , Avinash Khairnar , Anil Pardeshi , Vaishali Agrawal , Shweta Bora
Background
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.
Case presentation
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.
Pathogenesis
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.
Diagnosis and management
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.
Contribution of this study
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.
Conclusion
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.
{"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 , Avinash Khairnar , Anil Pardeshi , Vaishali Agrawal , 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}
Pub Date : 2025-11-20DOI: 10.1016/j.hmedic.2025.100400
Lamia Azizi , Philippe Attieh , Noura Chamchoum , Elie Chamchoum , George Ghaleb , Mehsen Azizi , Karam Karam
Background
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.
Case Presentation
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.
Conclusion
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.
{"title":"Appendiceal mucinous adenocarcinoma presenting as cecal intussusception: A rare case report","authors":"Lamia Azizi , Philippe Attieh , Noura Chamchoum , Elie Chamchoum , George Ghaleb , Mehsen Azizi , 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}
Pub Date : 2025-11-20DOI: 10.1016/j.hmedic.2025.100398
Farah Tarek Shaalan , Israa Ahmed Qutob
Background
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.
Case Presentation
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.
Conclusion
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.
{"title":"Breast cancer metastasis to gallbladder and urinary bladder: A rare case report","authors":"Farah Tarek Shaalan , 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}
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