Pub Date : 2025-08-30DOI: 10.1016/j.hmedic.2025.100357
Y. Mouhcine , S. Beyyato , H. Ouazzani , I. Chaouche , A. Akammar , N. EL Bouardi , B. Alami , Y.Alaoui Lamrani , M. Maaroufi , M. Boubbou
Septo-optic dysplasia, also referred to as ‘De-Morsier syndrome’, is a rare congenital disorder characterized by a combination of midline brain abnormalities, optic nerve hypoplasia (ONH), and hypothalamic pituitary dysfunction. In this paper, we present typical magnetic resonance imaging (MRI) findings and clinical manifestations of septo-optic dysplasia in a 3-year-old male patient, followed up by a literature review to highlight the crucial role of imaging, especially MRI, in the early diagnosis of this condition. Early clinical suspicion, along with radiological imaging, is crucial for a prompt diagnosis and effective management of patients with this condition.
{"title":"Septo-optic dysplasia: A case report and systematic literature review","authors":"Y. Mouhcine , S. Beyyato , H. Ouazzani , I. Chaouche , A. Akammar , N. EL Bouardi , B. Alami , Y.Alaoui Lamrani , M. Maaroufi , M. Boubbou","doi":"10.1016/j.hmedic.2025.100357","DOIUrl":"10.1016/j.hmedic.2025.100357","url":null,"abstract":"<div><div>Septo-optic dysplasia, also referred to as ‘De-Morsier syndrome’, is a rare congenital disorder characterized by a combination of midline brain abnormalities, optic nerve hypoplasia (ONH), and hypothalamic pituitary dysfunction. In this paper, we present typical magnetic resonance imaging (MRI) findings and clinical manifestations of septo-optic dysplasia in a 3-year-old male patient, followed up by a literature review to highlight the crucial role of imaging, especially MRI, in the early diagnosis of this condition. Early clinical suspicion, along with radiological imaging, is crucial for a prompt diagnosis and effective management of patients with this condition.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100357"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922114","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}
Haemophilus influenzae type b (Hib) vaccine has significantly reduced invasive Haemophilus influenzae disease (IHD) in Japan, but it has no effect on nontypeable Haemophilus influenzae (NTHi). IHD caused by NTHi remains a common issue among neonates. This report presents a case of neonatal late-onset bacteremia caused by NTHi without typical symptoms such as fever and elevated serum C-reactive protein (CRP) levels. A Japanese girl, born prematurely as the first twin, was hospitalized for lip cyanosis and a cough. Initial hematological and radiological investigations revealed no significant abnormalities except for hypocomplementemia. However, she experienced frequent apneic attacks with bradycardia and cyanosis on the first night. NTHi bacteremia, diagnosed by blood culture was identified in subsequent diagnostic procedures. Clinical improvement was observed with antibiotic treatment, despite afebrile and no elevated CRP levels during hospitalization. Previous reports indicate that late-onset IHD at > 48 h of age is rare with unclear clinical course. This case underscores the importance of considering NTHi as a potential pathogen in neonatal bacteremia, even without typical symptoms like fever and elevated CRP levels. blood samples for culture remain crucial for diagnosing bacteremia, particularly in atypical presentations.
{"title":"Late-onset afebrile neonatal bacteremia due to nontypeable Haemophilus influenzae: A case report","authors":"Wataru Anzai, Yoshitaka Watanabe, Naomi Yagi, Masaki Yamaguchi, Nobuhiro Kawai, Hirokazu Ikeda","doi":"10.1016/j.hmedic.2025.100356","DOIUrl":"10.1016/j.hmedic.2025.100356","url":null,"abstract":"<div><div><em>Haemophilus influenzae</em> type b (Hib) vaccine has significantly reduced invasive <em>Haemophilus influenzae</em> disease (IHD) in Japan, but it has no effect on nontypeable <em>Haemophilus influenzae</em> (NTHi). IHD caused by NTHi remains a common issue among neonates. This report presents a case of neonatal late-onset bacteremia caused by NTHi without typical symptoms such as fever and elevated serum C-reactive protein (CRP) levels. A Japanese girl, born prematurely as the first twin, was hospitalized for lip cyanosis and a cough. Initial hematological and radiological investigations revealed no significant abnormalities except for hypocomplementemia. However, she experienced frequent apneic attacks with bradycardia and cyanosis on the first night. NTHi bacteremia, diagnosed by blood culture was identified in subsequent diagnostic procedures. Clinical improvement was observed with antibiotic treatment, despite afebrile and no elevated CRP levels during hospitalization. Previous reports indicate that late-onset IHD at > 48 h of age is rare with unclear clinical course. This case underscores the importance of considering NTHi as a potential pathogen in neonatal bacteremia, even without typical symptoms like fever and elevated CRP levels. blood samples for culture remain crucial for diagnosing bacteremia, particularly in atypical presentations.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925303","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 : 2025-08-28DOI: 10.1016/j.hmedic.2025.100355
Ramesh Yelanati , Dharanindra Moturu , Ramesh Babu Potineni , Supriya Rayana , Kondaveeti Devaki , Mohammad Noor Shaik
Glyphosate is a commonly used herbicide, and its toxicity is primarily due to the uncoupling of oxidative phosphorylation and polyoxymethylene amine (POEA) mediated cardiotoxicity. A 64-year-old was brought to the hospital with an alleged history of consumption of glyphosate. The patient has a known history of ischemic heart disease with a ejection fraction. ECG showed QT prolongation. Given the risk of metabolic acidosis and hyperkalemia, in the background of low cardiac output, continuous renal replacement therapy (CRRT) was initiated. The patient was hemodynamically stable after CRRT sessions and was discharged from the ICU. This case highlights the potential role of CRRT in managing glyphosate poisoning, particularly in patients with significant cardiac comorbidities.
{"title":"Management of glyphosate poisoning with continuous renal replacement therapy (CRRT): A case report","authors":"Ramesh Yelanati , Dharanindra Moturu , Ramesh Babu Potineni , Supriya Rayana , Kondaveeti Devaki , Mohammad Noor Shaik","doi":"10.1016/j.hmedic.2025.100355","DOIUrl":"10.1016/j.hmedic.2025.100355","url":null,"abstract":"<div><div>Glyphosate is a commonly used herbicide, and its toxicity is primarily due to the uncoupling of oxidative phosphorylation and polyoxymethylene amine (POEA) mediated cardiotoxicity. A 64-year-old was brought to the hospital with an alleged history of consumption of glyphosate. The patient has a known history of ischemic heart disease with a ejection fraction. ECG showed QT prolongation. Given the risk of metabolic acidosis and hyperkalemia, in the background of low cardiac output, continuous renal replacement therapy (CRRT) was initiated. The patient was hemodynamically stable after CRRT sessions and was discharged from the ICU. This case highlights the potential role of CRRT in managing glyphosate poisoning, particularly in patients with significant cardiac comorbidities.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100355"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932298","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}
Significant developmental difficulties are frequently caused by neurodevelopmental diseases, which are frequently brought on by environmental causes and genetic mutations. The DEAF1 gene is associated with serious neurological disorders and is essential for brain development. The purpose of this study is to investigate the potential effects of a homozygous mutation in the DEAF1 gene on developmental delays, specifically in consanguineous families, using the example of a 1.5-year-old boy.
Methods and results
A harmful mutation in the DEAF1 gene (c.1051C>T p.(Arg351Ter)) was discovered by genetic research. The child had generalized epileptic activity, optic atrophy, microcephaly, and global developmental delay. There was no discernible developmental improvement even after getting antiepileptic medication, occupational therapy, and physical therapy. Similar developmental difficulties were also shown by a first cousin, suggesting a close genetic connection. Genetic testing and thorough neurological examinations were among the evaluations.
Conclusions
The difficulties in treating neurodevelopmental abnormalities linked to the DEAF1 gene are highlighted by this example. The particular mutation emphasizes how important it is for developmental outcomes. The results highlight the value of preventive testing and genetic counseling in consanguineous relationships. Because of the severity of the mutation, the prognosis is still unknown even after intensive multidisciplinary care. All things considered, this instance highlights the need for more research in this field and offers insightful information on how DEAF1 mutations affect neurodevelopmental diseases.
{"title":"Homozygous DEAF1 mutation with developmental delay, microcephaly, and optic atrophy – A case report","authors":"Aisha Shahid , Umer Shahid , Reet Ramani , Zubaid Moazzam Sheikh , Ubaid Shahid , Saba Safdar","doi":"10.1016/j.hmedic.2025.100349","DOIUrl":"10.1016/j.hmedic.2025.100349","url":null,"abstract":"<div><h3>Background</h3><div>Significant developmental difficulties are frequently caused by neurodevelopmental diseases, which are frequently brought on by environmental causes and genetic mutations. The DEAF1 gene is associated with serious neurological disorders and is essential for brain development. The purpose of this study is to investigate the potential effects of a homozygous mutation in the DEAF1 gene on developmental delays, specifically in consanguineous families, using the example of a 1.5-year-old boy.</div></div><div><h3>Methods and results</h3><div>A harmful mutation in the DEAF1 gene (c.1051C>T p.(Arg351Ter)) was discovered by genetic research. The child had generalized epileptic activity, optic atrophy, microcephaly, and global developmental delay. There was no discernible developmental improvement even after getting antiepileptic medication, occupational therapy, and physical therapy. Similar developmental difficulties were also shown by a first cousin, suggesting a close genetic connection. Genetic testing and thorough neurological examinations were among the evaluations.</div></div><div><h3>Conclusions</h3><div>The difficulties in treating neurodevelopmental abnormalities linked to the DEAF1 gene are highlighted by this example. The particular mutation emphasizes how important it is for developmental outcomes. The results highlight the value of preventive testing and genetic counseling in consanguineous relationships. Because of the severity of the mutation, the prognosis is still unknown even after intensive multidisciplinary care. All things considered, this instance highlights the need for more research in this field and offers insightful information on how DEAF1 mutations affect neurodevelopmental diseases.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913139","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 : 2025-08-28DOI: 10.1016/j.hmedic.2025.100353
Maria Emilia Adenike V. Adedoja , Lovell B. Gatchalian
Celecoxib is a widely prescribed drug for symptomatic pain control. Data regarding its potential to cause deleterious hepatotoxicity is limited. This case report presents a 42-year old man who developed jaundice within 24 h after intake of one tablet of celecoxib (200 mg) for a tooth extraction. He did not have signs of hepatic encephalopathy, fever or rash. There was no previous drug allergy, herbal medicine or alcohol intake. Laboratory workup showed ALT 699, AST 631 U/L, Total bilirubin 5.17 mg/dL, alkaline phosphatase was elevated at 195 U/L and INR 1.2 with an R factor of 9 indicating a hepatocellular pattern of injury. Serologic tests for Hepatitis A, B & C were non-reactive. Antinuclear Antibody (ANA), anti-smooth muscle antibody (anti-SMA), serum immunoglobulin G, anti-mitochondrial antibody (AMA), and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) were all negative. Imaging tests of the liver such as triphasic CT scan and Magnetic Resonance Cholangiopancreatography (MRCP) showed no evidence of biliary obstruction and dilatation. His cholestasis and course of liver disease were prolonged, and ultimately he underwent liver biopsy which showed portal and lobular inflammation and hepatocanalicular cholestasis favoring drug-induced liver injury. Celecoxib was withdrawn, ursodeoxycholic acid 300 mg/tab twice times daily and cetirizine 10 mg/tab OD were started to address his persistent pruritus. His liver biochemical and function tests gradually normalized with symptom resolution after 4 months. Conventional non-steroidal anti-inflammatory drugs like celecoxib may still be associated with significant hepatotoxicity. Swift recognition and cessation of the drug's use are crucial. This case highlights the potential for severe hepatotoxicity even with minimal exposure to celecoxib, underscoring the importance of recognizing this rare but serious adverse reaction.
{"title":"Acute liver injury following a single dose of celecoxib: A rare case of rapid-onset hepatotoxicity","authors":"Maria Emilia Adenike V. Adedoja , Lovell B. Gatchalian","doi":"10.1016/j.hmedic.2025.100353","DOIUrl":"10.1016/j.hmedic.2025.100353","url":null,"abstract":"<div><div>Celecoxib is a widely prescribed drug for symptomatic pain control. Data regarding its potential to cause deleterious hepatotoxicity is limited. This case report presents a 42-year old man who developed jaundice within 24 h after intake of one tablet of celecoxib (200 mg) for a tooth extraction. He did not have signs of hepatic encephalopathy, fever or rash. There was no previous drug allergy, herbal medicine or alcohol intake. Laboratory workup showed ALT 699, AST 631 U/L, Total bilirubin 5.17 mg/dL, alkaline phosphatase was elevated at 195 U/L and INR 1.2 with an R factor of 9 indicating a hepatocellular pattern of injury. Serologic tests for Hepatitis A, B & C were non-reactive. Antinuclear Antibody (ANA), anti-smooth muscle antibody (anti-SMA), serum immunoglobulin G, anti-mitochondrial antibody (AMA), and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) were all negative. Imaging tests of the liver such as triphasic CT scan and Magnetic Resonance Cholangiopancreatography (MRCP) showed no evidence of biliary obstruction and dilatation. His cholestasis and course of liver disease were prolonged, and ultimately he underwent liver biopsy which showed portal and lobular inflammation and hepatocanalicular cholestasis favoring drug-induced liver injury. Celecoxib was withdrawn, ursodeoxycholic acid 300 mg/tab twice times daily and cetirizine 10 mg/tab OD were started to address his persistent pruritus. His liver biochemical and function tests gradually normalized with symptom resolution after 4 months. Conventional non-steroidal anti-inflammatory drugs like celecoxib may still be associated with significant hepatotoxicity. Swift recognition and cessation of the drug's use are crucial. This case highlights the potential for severe hepatotoxicity even with minimal exposure to celecoxib, underscoring the importance of recognizing this rare but serious adverse reaction.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100353"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988503","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 : 2025-08-26DOI: 10.1016/j.hmedic.2025.100354
Yali Qiu , Xiwei Zhang , Ying Feng , Lifei Wang
Parvimonas Micra, a Gram-positive anaerobic coccus, has been implicated in a range of infectious conditions affecting immunocompromised individuals, particularly those with diabetes or malignancies. It is considered a key pathogen associated with chronic apical periodontitis and has been identified in several non-oral infections, including purulent spondylitis, infective endocarditis, and discitis. However, there is a paucity of comprehensive and systematic research on the pathogenesis of Parvimonas micra-induced empyema. This case report aims to elucidate the mechanisms underlying empyema development in patients with type 2 diabetes mellitus, to enhance clinical diagnostic accuracy and therapeutic strategies for such cases.
{"title":"Empyema caused by Parvimonas micra: A case report","authors":"Yali Qiu , Xiwei Zhang , Ying Feng , Lifei Wang","doi":"10.1016/j.hmedic.2025.100354","DOIUrl":"10.1016/j.hmedic.2025.100354","url":null,"abstract":"<div><div><em>Parvimonas Micra</em>, a Gram-positive anaerobic coccus, has been implicated in a range of infectious conditions affecting immunocompromised individuals, particularly those with diabetes or malignancies. It is considered a key pathogen associated with chronic apical periodontitis and has been identified in several non-oral infections, including purulent spondylitis, infective endocarditis, and discitis. However, there is a paucity of comprehensive and systematic research on the pathogenesis of <em>Parvimonas micra</em>-induced empyema. This case report aims to elucidate the mechanisms underlying empyema development in patients with type 2 diabetes mellitus, to enhance clinical diagnostic accuracy and therapeutic strategies for such cases.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100354"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157645","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 : 2025-08-26DOI: 10.1016/j.hmedic.2025.100352
Babatope O. Adebiyi , Ferdinand C. Mukumbang
Fetal Alcohol Spectrum Disorder (FASD) represents a critical public health challenge in South Africa (SA), where the prevalence is among the highest worldwide. This commentary highlights the urgent need for coordinated, multifaceted approaches to address FASD, with prevalence rates as high as 310 per 1000 individuals, particularly in rural communities. Factors contributing to this high prevalence include historical practices like the "dop system," pervasive poverty, limited healthcare access, and social norms around alcohol use. The consequences of FASD are profound, leading to lifelong impairments and significant economic impacts. Alcohol-related harms cost SA around 65–104 billion Rand annually. Despite the magnitude of the issue, SA lacks a comprehensive national strategy, resulting in fragmented services and care gaps. To mitigate this crisis, a combination of prevention, early diagnosis, and community-based interventions is essential. Suggested strategies include public awareness campaigns, integration of FASD prevention into primary healthcare, enhanced diagnostic services, and community empowerment initiatives. A national response involving government agencies, healthcare providers, educational institutions, community organizations, and private sector stakeholders is imperative. With sustained commitment, South Africa can substantially reduce the burden of FASD, ensuring a healthier future for its communities.
{"title":"Persistent crisis of fetal alcohol spectrum disorder in South Africa: Time for decisive action","authors":"Babatope O. Adebiyi , Ferdinand C. Mukumbang","doi":"10.1016/j.hmedic.2025.100352","DOIUrl":"10.1016/j.hmedic.2025.100352","url":null,"abstract":"<div><div>Fetal Alcohol Spectrum Disorder (FASD) represents a critical public health challenge in South Africa (SA), where the prevalence is among the highest worldwide. This commentary highlights the urgent need for coordinated, multifaceted approaches to address FASD, with prevalence rates as high as 310 per 1000 individuals, particularly in rural communities. Factors contributing to this high prevalence include historical practices like the \"dop system,\" pervasive poverty, limited healthcare access, and social norms around alcohol use. The consequences of FASD are profound, leading to lifelong impairments and significant economic impacts. Alcohol-related harms cost SA around 65–104 billion Rand annually. Despite the magnitude of the issue, SA lacks a comprehensive national strategy, resulting in fragmented services and care gaps. To mitigate this crisis, a combination of prevention, early diagnosis, and community-based interventions is essential. Suggested strategies include public awareness campaigns, integration of FASD prevention into primary healthcare, enhanced diagnostic services, and community empowerment initiatives. A national response involving government agencies, healthcare providers, educational institutions, community organizations, and private sector stakeholders is imperative. With sustained commitment, South Africa can substantially reduce the burden of FASD, ensuring a healthier future for its communities.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100352"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916311","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 : 2025-08-25DOI: 10.1016/j.hmedic.2025.100348
Ahmad Yusuf Solaiman , Mohammad Alkhoujah , Mo'men K. Kahhaleh
Ictal whistling (IW) is a rare type of mimic musical automatisms, which is usually reported in temporal lobe epilepsy. Accurate localization is crucial for the diagnosis and appropriate epilepsy treatment planning. In this report, we are describing a case of precise localization of ictal whistling seizures using intracranial stereo-EEG (sEEG). Clinically, symptoms were consistent with loss of awareness and mimic automatisms: whistling and blowing air, time-locked to an ictal pattern over the deep contacts of the left amygdala spreading promptly to the entire mesial hippocampal area. Although there was a structural abnormality (bilateral occipital horn heterotopia), it was not involved in the ictal pattern during the sEEG, which was crucial in determining our surgical options. We hypothesize that ictal whistling may be considered as an oroalimentary automatism, given that such symptoms are typically associated with seizure activity originating in the amygdala and peri-amygdaloid region.
{"title":"Ictal whistling as the first clinical sign of amygdala onset seizure on sEEG, a review of the literature and case report","authors":"Ahmad Yusuf Solaiman , Mohammad Alkhoujah , Mo'men K. Kahhaleh","doi":"10.1016/j.hmedic.2025.100348","DOIUrl":"10.1016/j.hmedic.2025.100348","url":null,"abstract":"<div><div>Ictal whistling (IW) is a rare type of mimic musical automatisms, which is usually reported in temporal lobe epilepsy. Accurate localization is crucial for the diagnosis and appropriate epilepsy treatment planning. In this report, we are describing a case of precise localization of ictal whistling seizures using intracranial stereo-EEG (sEEG). Clinically, symptoms were consistent with loss of awareness and mimic automatisms: whistling and blowing air, time-locked to an ictal pattern over the deep contacts of the left amygdala spreading promptly to the entire mesial hippocampal area. Although there was a structural abnormality (bilateral occipital horn heterotopia), it was not involved in the ictal pattern during the sEEG, which was crucial in determining our surgical options. We hypothesize that ictal whistling may be considered as an oroalimentary automatism, given that such symptoms are typically associated with seizure activity originating in the amygdala and peri-amygdaloid region.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907206","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 : 2025-08-24DOI: 10.1016/j.hmedic.2025.100350
Ryan Njeim , Michel Al-Achkar , Wei Xue , Allison Glaser
Background
Opportunistic infections are a significant concern in immunocompromised patients, particularly those with human immunodeficiency virus (HIV). The diagnosis of these infections can be challenging due to overlapping clinical and radiological findings.
Case description
We report a rare case of triple co-infection by cytomegalovirus (CMV), Mycobacterium chimaera, and Aspergillus fumigatus causing pneumonia with a cavitary lesion in a 43-year-old HIV-infected female, non-adherent to antiretroviral therapy. Chest imaging revealed a left upper lobe cavitary lesion with ground-glass opacities. Serum CMV PCR was strongly positive. Bronchoscopic biopsy showed Aspergillus and focal CMV pneumonia, while post-discharge culture grew Aspergillus and Mycobacterium chimaera. The patient was treated with intravenous ganciclovir and voriconazole, then discharged on oral medications with plans for MAC treatment.
Conclusion
This case represents the first reported triple co-infection of its kind, particularly noteworthy given the patient's CD4 count above 50 cells/mm³ . It underscores the importance of comprehensive diagnostic workup and highlights the challenges in managing multiple opportunistic infections in severely immunocompromised individuals.
{"title":"Triple attack: Cytomegalovirus, mycobacterium avium complex and aspergillus co-infection presenting as a cavitary pulmonary lesion in a patient with human immunodeficiency virus","authors":"Ryan Njeim , Michel Al-Achkar , Wei Xue , Allison Glaser","doi":"10.1016/j.hmedic.2025.100350","DOIUrl":"10.1016/j.hmedic.2025.100350","url":null,"abstract":"<div><h3>Background</h3><div>Opportunistic infections are a significant concern in immunocompromised patients, particularly those with human immunodeficiency virus (HIV). The diagnosis of these infections can be challenging due to overlapping clinical and radiological findings.</div></div><div><h3>Case description</h3><div>We report a rare case of triple co-infection by cytomegalovirus (CMV), Mycobacterium chimaera, and Aspergillus fumigatus causing pneumonia with a cavitary lesion in a 43-year-old HIV-infected female, non-adherent to antiretroviral therapy. Chest imaging revealed a left upper lobe cavitary lesion with ground-glass opacities. Serum CMV PCR was strongly positive. Bronchoscopic biopsy showed Aspergillus and focal CMV pneumonia, while post-discharge culture grew Aspergillus and Mycobacterium chimaera. The patient was treated with intravenous ganciclovir and voriconazole, then discharged on oral medications with plans for MAC treatment.</div></div><div><h3>Conclusion</h3><div>This case represents the first reported triple co-infection of its kind, particularly noteworthy given the patient's CD4 count above 50 cells/mm³ . It underscores the importance of comprehensive diagnostic workup and highlights the challenges in managing multiple opportunistic infections in severely immunocompromised individuals.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896264","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 : 2025-08-22DOI: 10.1016/j.hmedic.2025.100351
Sarah Magdy Abdelmohsen , Walid Hussein , Marwa T. Hussien
Background
Pediatric surgeons frequently encounter pediatric patients with various differential diagnoses for neck lymph node swelling. Kawasaki disease is a rare cause of neck lymph node swelling in children.
Case reports
A nine-year-old boy presented with a right-sided neck lymph node mass and fever for two days. Inflammatory markers were elevated. An abscess or liquefactive necrosis developed within the enlarged lymph nodes. An intraoperative swab tested negative for pathogens, and the blood culture was unremarkable. The child was diagnosed with Kawasaki disease.
Discussion
The number of children diagnosed with Kawasaki disease has increased over the past two years, particularly during the COVID-19 pandemic. In this case, the sterile abscess resulted from the vascular necrosis of significantly enlarged lymph nodes and vasculitis affecting the supplying blood vessels.
Conclusion
Kawasaki disease is a rare cause of suppurative sterile neck lymphadenitis in children. Early diagnosis and timely treatment with intravenous immunoglobulin (IVIG) significantly improve the prognosis of Kawasaki disease.
{"title":"Kawasaki disease as a rare cause of suppurative sterile lymphadenitis in pediatrics","authors":"Sarah Magdy Abdelmohsen , Walid Hussein , Marwa T. Hussien","doi":"10.1016/j.hmedic.2025.100351","DOIUrl":"10.1016/j.hmedic.2025.100351","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric surgeons frequently encounter pediatric patients with various differential diagnoses for neck lymph node swelling. Kawasaki disease is a rare cause of neck lymph node swelling in children.</div></div><div><h3>Case reports</h3><div>A nine-year-old boy presented with a right-sided neck lymph node mass and fever for two days. Inflammatory markers were elevated. An abscess or liquefactive necrosis developed within the enlarged lymph nodes. An intraoperative swab tested negative for pathogens, and the blood culture was unremarkable. The child was diagnosed with Kawasaki disease.</div></div><div><h3>Discussion</h3><div>The number of children diagnosed with Kawasaki disease has increased over the past two years, particularly during the COVID-19 pandemic. In this case, the sterile abscess resulted from the vascular necrosis of significantly enlarged lymph nodes and vasculitis affecting the supplying blood vessels.</div></div><div><h3>Conclusion</h3><div>Kawasaki disease is a rare cause of suppurative sterile neck lymphadenitis in children. Early diagnosis and timely treatment with intravenous immunoglobulin (IVIG) significantly improve the prognosis of Kawasaki disease.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100351"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026608","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}
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