Clinical Case Reports最新文献

Key Clinical Message

Brucellosis, especially with osteoarticular involvement, is uncommon and difficult to diagnose, but it should be considered in a case presenting with prolonged fever, joint pain, and back pain. The diagnosis requires a combination of history, serological examinations, and radiographic studies. When the condition is detected and treated early, the prognosis is good.

Brucella exploits host immune defenses to establish the chronic infection brucellosis, an endemic zoonotic disease. While human brucellosis affects multiple organs, osteo articular involvement is rare. We report the case of a 41-year-old woman with a history of goat farming who presented with fewer associated with low back pain and multiple joint pain for 4 months. Brucellosis was documented by positive serological tests (ELISA). Radiological findings suggested of right sacroiliitis and fracture line on the right sacral ala though had no history of trauma. Treatment consisted of NSAIDs and multiple antibiotic therapy. At follow-up, her low back pain, joint pain, and fever had subsided. After 4 weeks of follow-up, her symptoms were completely relieved with no recurrence. Brucellosis with atypical localization should be considered with a high index of suspicion based on detailed history and physical examination to ensure timely diagnosis and treatment.

Key Clinical Message

Chin augmentation by hyaluronic acid filler injection rarely causes abnormal bone resorption in the mentum. Thus, when taking the history of a patient with jaw deformity, it is imperative to check the history of treatment of the mentum.

Hyaluronic acid (HA) filler injection is a common procedure in nonsurgical cosmetic chin augmentation. Due to its high biocompatibility and simple injection technique, HA filler injection is a popular procedure. However, adverse events such as allergic reactions and foreign body reactions have been reported in some cases. In this study, we report a case of skeletal Class II jaw deformity in which bone resorption was observed in the mentum after HA filler injection. The purpose of this study is to discuss the indications for HA filler injection in skeletal Class II cases that require orthognathic surgery. The patient was a 30-year-old woman. To improve retrusion of the mentum, she has been receiving HA filler injections in the mentum three times every 6 months in the cosmetic surgery clinic since 2015. However, the retrusion of the mentum did not improve, which prompted here to visit the orthodontic clinic. Radiographs and CT revealed bowl-shaped bone resorption surrounding the foreign bodies in the mentum. She was diagnosed with maxillary protrusion, vertical maxillary excess, mandibular retrusion, and bilateral condylar resorption. Bimaxillary orthognathic surgery (BOGS) and removal of residual HA fillers were planned after completion of the preoperative orthodontic treatment. After BOGS, the foreign bodies were completely removed, and the resorption cavities were filled with excess bone segments from the surgical sites. X-ray photoelectron spectroscopy analysis of the foreign bodies suggested the presence of HA. One year after the BOGS, no progression of condylar resorption occurred, and bone healing at the mentum had a good prognosis. Therefore, the patient underwent reduction and advancement genioplasty. She was satisfied with her facial profile and occlusal function. Unexpected bone resorption in the mentum caused by HA filler injection is often discovered incidentally. Although, patients may feel hesitant to confess their history of treatment of the mentum, it is important to ensure that they are carefully interviewed.

Key Clinical Message

Screening for parasitic infections among displaced populations including migrants, refugees, and internally displaced persons is crucial to prevent long-term complications associated with untreated infections. Additionally, prompt treatment with appropriate medications like praziquantel and albendazole can lead to significant improvement and successful patient outcomes. This case highlights the necessity of heightened awareness, early detection, and effective management of parasitic infections to enhance public health efforts and minimize the spread of these diseases. Implementing multisectoral One Health will improve human, animal, and environmental health globally using limited resources.

Parasitic infections including Schistosoma spp., hookworm, and Strongyloides spp. are commonly co-existing diseases in underdeveloped countries including South Sudan and Sudan. These infections are often presented with no specific symptoms, therefore they remain undetected and eventually leading to long-term complications. Latent parasitic infections among adults particularly displaced population like migrants and refugees have recently gained global attention. In this case report, we present the case of a young male immigrant from South Sudan with multi-parasitic infections. The patient was admitted to a hospital complaining of gastrointestinal symptoms of hematemesis and melena, which were accompanied by signs of liver and spleen enlargement, coupled with low blood cell counts. While liver function tests showed no abnormalities, stool examinations confirmed the presence of S. mansoni, hook worm eggs, and Rhabditiform first-stage larvae of S. stercoralis. The patient was treated with medications such as praziquantel and albendazole, which resulted in full recovery and discharge from the hospital. This case highlights the importance of considering multiple infections among patients with gastrointestinal symptoms, especially in endemic areas. Cost-effective prevention and control strategy require the implementation of a multisectoral One Health strategy for the surveillance, prevention, and control of parasitic infections in human, animals, and the environment.

Key Clinical Message

We report three cases of IMN from our center, where patients received a single dose of telitacicept after showing no response to conventional treatments. Although one case did not respond, the other two cases achieved complete or partial remission of proteinuria. These cases illustrates the telitacicept may offer new hope for the treatment of IMN.

Despite the variety of treatment options available, effective therapies for refractory membranous nephropathy remain lacking. Recently, some reports have suggested that telitacicept is a new therapeutic option. However, only a few published studies have documented the use of telitacicept for treating idiopathic membranous nephropathy (IMN). We present three cases of IMN from our center, where patients received a single dose of telitacicept after showing no response to conventional treatments, including glucocorticoids, tacrolimus, mycophenolate mofetil, cyclophosphamide, cyclosporine, and rituximab. Although one case did not respond, the other two cases achieved complete or partial remission of proteinuria. Thus, telitacicept may offer new hope for the treatment of refractory membranous nephropathy.

Key Clinical Message

A 26-year-old patient with swelling on the lingual surface of the mandible in the incisors area was referred to the Faculty of Dentistry at Mashhad University of Medical Sciences. After conducting clinical, radiographic, and pathological examinations, the patient was diagnosed with capillary hemangioma. This study explores the clinical manifestation and unusual behavior of intraoral hemangioma.

Hemangioma is a tumor that occurs due to the proliferation of endothelial cells in 4%–5% of infants and affects the head and neck region in almost 70% of cases. The tumor in the mouth can appear as a soft, smooth, or lobulated mass with or without a base and varying in size from a few millimeters to a few centimeters. This article reports a case of hemangioma with unusual clinical features in a 26-year-old male patient.