Pub Date : 2025-09-05DOI: 10.1016/j.hmedic.2025.100365
Maher Salloum , Batoul Abbas , Michael Khoury , Zaki Samia , Mona Youssef , Karam Karam , Maroun Abou-Jawde
Angiosarcoma is a rare and aggressive malignant neoplasm that originates from the endothelial cells lining blood vessels. It can occasionally arise as a complication of both functional and nonfunctional arteriovenous fistulas. This paper will present a documented case of angiosarcoma developing from a nonfunctioning fistula in a 36-year-old male who underwent kidney transplantation and was on immunosuppressive therapies. The clinical manifestations, management strategies, and a comprehensive review of the literature on this uncommon disease will be discussed.
{"title":"Angiosarcoma unveiled: A rare case of arteriovenous fistula post kidney transplantation","authors":"Maher Salloum , Batoul Abbas , Michael Khoury , Zaki Samia , Mona Youssef , Karam Karam , Maroun Abou-Jawde","doi":"10.1016/j.hmedic.2025.100365","DOIUrl":"10.1016/j.hmedic.2025.100365","url":null,"abstract":"<div><div>Angiosarcoma is a rare and aggressive malignant neoplasm that originates from the endothelial cells lining blood vessels. It can occasionally arise as a complication of both functional and nonfunctional arteriovenous fistulas. This paper will present a documented case of angiosarcoma developing from a nonfunctioning fistula in a 36-year-old male who underwent kidney transplantation and was on immunosuppressive therapies. The clinical manifestations, management strategies, and a comprehensive review of the literature on this uncommon disease will be discussed.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100365"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019250","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}
Langerhans cell histiocytosis (LCH) is a rare neoplasm of myeloid dendritic cells that often presents diagnostic challenges due to its variable clinical manifestations. It is most commonly seen in the first three years of life. LCH with isolated scalp involvement in children, particularly adolescents, remains underreported.
Case presentation
We report a case of a 12-year-old boy who presented with a painless swelling on the left frontal scalp. Imaging revealed a lytic bone lesion in the frontal bone. Fine needle aspiration cytology of the mass suggested a benign histiocytic lesion consistent with Langerhans cell histiocytosis. The mass was completely excised, and subsequent histopathologic examination confirmed the diagnosis of LCH. Immunohistochemistry showed that the neoplastic cells were diffusely positive for Langerin and CD1a, further supporting the diagnosis.
Conclusion
LCH should be considered as a differential diagnosis in children presenting with a lytic scalp mass. Histopathology combined with immunohistochemistry is crucial for definitive diagnosis.
{"title":"Unifocal scalp langerhans cell histiocytosis in an adolescent child: A case report","authors":"Sisay Abush Mulisa , Tsion Haile Woldemariam , Birhanu Kassie Reta , Robel Tibebu Kasaye , Asonya Abera Akuma , Adem Reshid Abdella , Fadil Nuredin Abrar , Hidaya Yahya Mohammed , Yemane Leake Gebremichael","doi":"10.1016/j.hmedic.2025.100362","DOIUrl":"10.1016/j.hmedic.2025.100362","url":null,"abstract":"<div><h3>Introduction</h3><div>Langerhans cell histiocytosis (LCH) is a rare neoplasm of myeloid dendritic cells that often presents diagnostic challenges due to its variable clinical manifestations. It is most commonly seen in the first three years of life. LCH with isolated scalp involvement in children, particularly adolescents, remains underreported.</div></div><div><h3>Case presentation</h3><div>We report a case of a 12-year-old boy who presented with a painless swelling on the left frontal scalp. Imaging revealed a lytic bone lesion in the frontal bone. Fine needle aspiration cytology of the mass suggested a benign histiocytic lesion consistent with Langerhans cell histiocytosis. The mass was completely excised, and subsequent histopathologic examination confirmed the diagnosis of LCH. Immunohistochemistry showed that the neoplastic cells were diffusely positive for Langerin and CD1a, further supporting the diagnosis.</div></div><div><h3>Conclusion</h3><div>LCH should be considered as a differential diagnosis in children presenting with a lytic scalp mass. Histopathology combined with immunohistochemistry is crucial for definitive diagnosis.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100362"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010428","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 : 2025-09-04DOI: 10.1016/j.hmedic.2025.100358
Mia van der Kop , Anna Mia Ekström , Eman Al-Raddadi
Creatine is a naturally occurring compound that is synthesized endogenously and obtained through dietary consumption. Oral supplementation with creatine monohydrate (CM) is commonly used to enhance exercise performance. There is increasing interest in the use of creatine supplementation to improve cognitive processing and in neurodegenerative disorders. Epilepsy is one of the most common, serious neurological conditions, and one-third of patients continue to have seizures despite treatment. Pre-clinical studies suggest that creatine may have a potential role as an anticonvulsant, however no studies in adult humans have been done. Here, we present a case in which a patient with drug-resistant epilepsy had a marked reduction in seizure frequency after supplementing with 5 g/day of creatine monohydrate. This case, together with pre-clinical evidence, provides preliminary clinical support for further exploration of creatine as a low-risk, adjunctive therapy in epilepsy, particularly for patients with drug-resistant forms.
{"title":"Reduced seizure frequency with oral creatine supplementation: A case report","authors":"Mia van der Kop , Anna Mia Ekström , Eman Al-Raddadi","doi":"10.1016/j.hmedic.2025.100358","DOIUrl":"10.1016/j.hmedic.2025.100358","url":null,"abstract":"<div><div>Creatine is a naturally occurring compound that is synthesized endogenously and obtained through dietary consumption. Oral supplementation with creatine monohydrate (CM) is commonly used to enhance exercise performance. There is increasing interest in the use of creatine supplementation to improve cognitive processing and in neurodegenerative disorders. Epilepsy is one of the most common, serious neurological conditions, and one-third of patients continue to have seizures despite treatment. Pre-clinical studies suggest that creatine may have a potential role as an anticonvulsant, however no studies in adult humans have been done. Here, we present a case in which a patient with drug-resistant epilepsy had a marked reduction in seizure frequency after supplementing with 5 g/day of creatine monohydrate. This case, together with pre-clinical evidence, provides preliminary clinical support for further exploration of creatine as a low-risk, adjunctive therapy in epilepsy, particularly for patients with drug-resistant forms.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100358"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019249","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 : 2025-09-04DOI: 10.1016/j.hmedic.2025.100363
Farah Tarek Shaalan , Israa Ahmed Qutob
Background
Breast cancer is the most common malignancy in women and is known to metastasize to distant organs, including the lungs, liver, bone, and brain. However, metastasis to the parotid glands is an exceedingly rare occurrence, often posing a diagnostic challenge. Parotid metastasis can mimic primary salivary gland tumors, inflammatory conditions, or neurological disorders such as Bell's palsy, leading to delays in diagnosis and treatment. This case report presents an unusual instance of bilateral parotid metastasis from breast cancer and highlights the diagnostic and management challenges associated with this rare phenomenon.
Case presentation
A 46-year-old premenopausal woman with a history of invasive ductal carcinoma (IDC) of the right breast, diagnosed in 2018, presented in January 2021 with progressive bilateral parotid swelling, peripheral facial paralysis, and difficulty closing her left eye. She had previously undergone mastectomy, chemotherapy, radiotherapy, and endocrine therapy. Imaging, including ultrasound-guided biopsy and CT scans, confirmed metastatic ductal carcinoma in both parotid glands. Immunohistochemistry results were consistent with the patient's original breast cancer diagnosis, demonstrating estrogen receptor (ER)-positive, progesterone receptor (PR)-positive, and HER2-negative tumors. Despite receiving palliative chemotherapy and radiotherapy, the patient's condition worsened, and she passed away one year after the diagnosis of parotid metastasis.
Conclusion
Parotid gland metastasis from breast cancer is a rare but clinically significant manifestation. Due to its rarity, it is often under-recognized, and early diagnosis can be challenging. Advanced imaging techniques such as PET/CT and MRI play a critical role in detecting these rare metastases, though they require careful interpretation. While treatment remains primarily palliative due to the poor prognosis, early recognition and timely palliative care can improve patient quality of life. This case investigates the importance of heightened clinical awareness and advanced imaging in the management of metastatic parotid lesions in breast cancer patients.
{"title":"Unusual bilateral parotid metastasis from breast cancer: A case report","authors":"Farah Tarek Shaalan , Israa Ahmed Qutob","doi":"10.1016/j.hmedic.2025.100363","DOIUrl":"10.1016/j.hmedic.2025.100363","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most common malignancy in women and is known to metastasize to distant organs, including the lungs, liver, bone, and brain. However, metastasis to the parotid glands is an exceedingly rare occurrence, often posing a diagnostic challenge. Parotid metastasis can mimic primary salivary gland tumors, inflammatory conditions, or neurological disorders such as Bell's palsy, leading to delays in diagnosis and treatment. This case report presents an unusual instance of bilateral parotid metastasis from breast cancer and highlights the diagnostic and management challenges associated with this rare phenomenon.</div></div><div><h3>Case presentation</h3><div>A 46-year-old premenopausal woman with a history of invasive ductal carcinoma (IDC) of the right breast, diagnosed in 2018, presented in January 2021 with progressive bilateral parotid swelling, peripheral facial paralysis, and difficulty closing her left eye. She had previously undergone mastectomy, chemotherapy, radiotherapy, and endocrine therapy. Imaging, including ultrasound-guided biopsy and CT scans, confirmed metastatic ductal carcinoma in both parotid glands. Immunohistochemistry results were consistent with the patient's original breast cancer diagnosis, demonstrating estrogen receptor (ER)-positive, progesterone receptor (PR)-positive, and HER2-negative tumors. Despite receiving palliative chemotherapy and radiotherapy, the patient's condition worsened, and she passed away one year after the diagnosis of parotid metastasis.</div></div><div><h3>Conclusion</h3><div>Parotid gland metastasis from breast cancer is a rare but clinically significant manifestation. Due to its rarity, it is often under-recognized, and early diagnosis can be challenging. Advanced imaging techniques such as PET/CT and MRI play a critical role in detecting these rare metastases, though they require careful interpretation. While treatment remains primarily palliative due to the poor prognosis, early recognition and timely palliative care can improve patient quality of life. This case investigates the importance of heightened clinical awareness and advanced imaging in the management of metastatic parotid lesions in breast cancer patients.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010427","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 : 2025-09-03DOI: 10.1016/j.hmedic.2025.100360
Naqiuddin Mohd Fazali , Zaitul Azra Mohd Nasir , Mohamed Ashraf Mohamed Daud , Wan Fatihah Wan Sohaimi , Nur Asma Sapiai
Background
Double-J ureteral stents are often utilised in urology and have become an essential component of urologic practice. The primary function is to facilitate urine outflow from the kidney to the urinary bladder. As the usage of stent grows, so do the number of issues.
Case presentation
We present a case of a 54-year-old man with neglected right double J stent for thirteen years after right pyelolithotomy. He skipped follow up and then later, presented with painless haematuria. Abdominal radiograph revealed bilateral nephrolithiasis and vesicolithiasis with broken right double J stent.
Conclusion
To avoid this circumstance, patients should be taught about the difficulties that might occur if the stent is not removed within a short period of time. This instance highlights the need of giving enough information and understanding about the insertion of a ureteral stent.
{"title":"The forgotten double J ureteral stent complicated with large urinary bladder calculus formation: A case report","authors":"Naqiuddin Mohd Fazali , Zaitul Azra Mohd Nasir , Mohamed Ashraf Mohamed Daud , Wan Fatihah Wan Sohaimi , Nur Asma Sapiai","doi":"10.1016/j.hmedic.2025.100360","DOIUrl":"10.1016/j.hmedic.2025.100360","url":null,"abstract":"<div><h3>Background</h3><div>Double-J ureteral stents are often utilised in urology and have become an essential component of urologic practice. The primary function is to facilitate urine outflow from the kidney to the urinary bladder. As the usage of stent grows, so do the number of issues.</div></div><div><h3>Case presentation</h3><div>We present a case of a 54-year-old man with neglected right double J stent for thirteen years after right pyelolithotomy. He skipped follow up and then later, presented with painless haematuria. Abdominal radiograph revealed bilateral nephrolithiasis and vesicolithiasis with broken right double J stent.</div></div><div><h3>Conclusion</h3><div>To avoid this circumstance, patients should be taught about the difficulties that might occur if the stent is not removed within a short period of time. This instance highlights the need of giving enough information and understanding about the insertion of a ureteral stent.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100360"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060231","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 : 2025-09-03DOI: 10.1016/j.hmedic.2025.100361
Farah Ghanim , Sari Zraiq , Nizar Abu Hamdeh , Mohammed Sweilih , Haitham Abu Khadija , Mohammad Alnees
Sarcoidosis is a rare but complex multisystem granulomatous disease that can mimic common respiratory conditions, leading to delayed diagnosis. We present a 75-year-old female with type 2 diabetes and hypertension who experienced persistent cough, fatigue, and occasional unconsciousness for months. Initial workups, including chest X-rays and tuberculosis screening, were inconclusive, and empirical treatments for pneumonia failed to provide relief. Her condition progressed to significant weight loss, night sweats, and lymphadenopathy. High-resolution computed tomography (HRCT) later revealed mediastinal lymphadenopathy, bilateral infiltrates, and pulmonary nodules, strongly suggesting sarcoidosis. Due to biopsy refusal, histological confirmation was unavailable, yet her dramatic response to corticosteroids and methotrexate solidified the diagnosis. This case highlights the importance of early suspicion, serial imaging, and clinical response in diagnosing sarcoidosis, especially in elderly patients, where histopathological confirmation may not be feasible.
{"title":"When common diagnoses fail: The complexity of sarcoidosis in the elderly: Case report","authors":"Farah Ghanim , Sari Zraiq , Nizar Abu Hamdeh , Mohammed Sweilih , Haitham Abu Khadija , Mohammad Alnees","doi":"10.1016/j.hmedic.2025.100361","DOIUrl":"10.1016/j.hmedic.2025.100361","url":null,"abstract":"<div><div>Sarcoidosis is a rare but complex multisystem granulomatous disease that can mimic common respiratory conditions, leading to delayed diagnosis. We present a 75-year-old female with type 2 diabetes and hypertension who experienced persistent cough, fatigue, and occasional unconsciousness for months. Initial workups, including chest X-rays and tuberculosis screening, were inconclusive, and empirical treatments for pneumonia failed to provide relief. Her condition progressed to significant weight loss, night sweats, and lymphadenopathy. High-resolution computed tomography (HRCT) later revealed mediastinal lymphadenopathy, bilateral infiltrates, and pulmonary nodules, strongly suggesting sarcoidosis. Due to biopsy refusal, histological confirmation was unavailable, yet her dramatic response to corticosteroids and methotrexate solidified the diagnosis. This case highlights the importance of early suspicion, serial imaging, and clinical response in diagnosing sarcoidosis, especially in elderly patients, where histopathological confirmation may not be feasible.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100361"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010426","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}
Adult-onset Henoch-Schönlein Purpura (HSP), although much less common than in children, tends to display a much more sinister clinical course. This case is about a 35-year-old female who presented with polyarthritis, abdominal pain, and purpuric rash- symptoms aligning with those of IgA vasculitis. Furthermore, she had a history of a recent sore throat, an elevated antistreptolysin O (ASO) titer, and her skin biopsy demonstrated leuko-cytoclastic vasculitis-all suggestive of post-streptococcal origin. However, the Direct Immunofluorescence (DIF) test results were negative for the expected IgA deposits. Adult-onset HSP exhibits rather diverse clinical manifestations that often defy the textbook descriptions; noticeable patient improvement after initiation of corticosteroid therapy underscores the importance of its early recognition. Adult HSP, therefore, warrants a high degree of diagnostic scrutiny and an eye for the culprit infectious agents.
{"title":"Atypical adult-onset Henoch-Schönlein purpura in a female patient from Bangladesh: Post-streptococcal vasculitis without IgA deposition – A case report","authors":"Zahin Shahriar, Sakib Abrar , Soumik Roy, Shaimul Reza, Fabiha Rahman, Tushar Kanti Bhadra","doi":"10.1016/j.hmedic.2025.100359","DOIUrl":"10.1016/j.hmedic.2025.100359","url":null,"abstract":"<div><div>Adult-onset Henoch-Schönlein Purpura (HSP), although much less common than in children, tends to display a much more sinister clinical course. This case is about a 35-year-old female who presented with polyarthritis, abdominal pain, and purpuric rash- symptoms aligning with those of IgA vasculitis. Furthermore, she had a history of a recent sore throat, an elevated antistreptolysin O (ASO) titer, and her skin biopsy demonstrated leuko-cytoclastic vasculitis-all suggestive of post-streptococcal origin. However, the Direct Immunofluorescence (DIF) test results were negative for the expected IgA deposits. Adult-onset HSP exhibits rather diverse clinical manifestations that often defy the textbook descriptions; noticeable patient improvement after initiation of corticosteroid therapy underscores the importance of its early recognition. Adult HSP, therefore, warrants a high degree of diagnostic scrutiny and an eye for the culprit infectious agents.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100359"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931741","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 : 2025-08-30DOI: 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}
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