Hyperinflammatory responses due to cytokine storms involve multiple systems in hemophagocytic lymphohistiocytosis (HLH) leading to morbidities. Multiple bacterial etiologies have been suggested as a cause of secondary HLH but streptococcal infection has only been reported in pediatric cases. Streptococcus has been considered a notorious pathogen due to its ability to interfere with host immunity through the phenomenon of molecular mimicry. This case report shows the sequence of events post-streptococcal pharyngitis in a 28-year-old male, which lead to HLH and fatality to life, and how a timely intervention of steroids salvaged the patient.
{"title":"A rare case of streptococcal pharyngitis in an adult male causing hemophagocytic lymphohistiocytosis","authors":"Shubhank Narula, Pankaj Kumar Agarwal, Ambuj Garg","doi":"10.32677/ijcr.v9i9.4169","DOIUrl":"https://doi.org/10.32677/ijcr.v9i9.4169","url":null,"abstract":"Hyperinflammatory responses due to cytokine storms involve multiple systems in hemophagocytic lymphohistiocytosis (HLH) leading to morbidities. Multiple bacterial etiologies have been suggested as a cause of secondary HLH but streptococcal infection has only been reported in pediatric cases. Streptococcus has been considered a notorious pathogen due to its ability to interfere with host immunity through the phenomenon of molecular mimicry. This case report shows the sequence of events post-streptococcal pharyngitis in a 28-year-old male, which lead to HLH and fatality to life, and how a timely intervention of steroids salvaged the patient.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"1149 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139831248","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}
Carcinoid tumor of the ovary is a rare neoplasm that may present as a solid mass or combined with mucinous tumors or teratomas. Primary ovarian carcinoid represents <0.1% of ovarian malignancies. These tumors are often unilateral presenting as a solid mass and vary from microscopic to very large tumors. Metastatic ovarian carcinoid tumors are seen to be bilateral in most cases. Involvement of the ovary from gastrointestinal carcinoid is rare with no hepatic or peritoneal seedlings. Ovarian carcinoid tumors commonly occur in perimenopausal and postmenopausal women. Surgical removal of the tumor is the standard treatment modality. Tumor size and the presence of metastasis are necessary to plan the treatment modality. We herein report a case of carcinoid tumor of the ovary in a 55-year-old female, which we thought was a dermoid cyst of the ovary and turned out to be carcinoid after detailed immunohistochemical analysis.
{"title":"Carcinoid tumor of the ovary: A mysterious puzzle","authors":"Thilagarani, Sowmya Devi Ajith Prasad","doi":"10.32677/ijcr.v9i9.4157","DOIUrl":"https://doi.org/10.32677/ijcr.v9i9.4157","url":null,"abstract":"Carcinoid tumor of the ovary is a rare neoplasm that may present as a solid mass or combined with mucinous tumors or teratomas. Primary ovarian carcinoid represents <0.1% of ovarian malignancies. These tumors are often unilateral presenting as a solid mass and vary from microscopic to very large tumors. Metastatic ovarian carcinoid tumors are seen to be bilateral in most cases. Involvement of the ovary from gastrointestinal carcinoid is rare with no hepatic or peritoneal seedlings. Ovarian carcinoid tumors commonly occur in perimenopausal and postmenopausal women. Surgical removal of the tumor is the standard treatment modality. Tumor size and the presence of metastasis are necessary to plan the treatment modality. We herein report a case of carcinoid tumor of the ovary in a 55-year-old female, which we thought was a dermoid cyst of the ovary and turned out to be carcinoid after detailed immunohistochemical analysis.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"58 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139882063","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}
Jagannath Dev Sharma, Asreen Suhana, A. P. Beso, B. Bharadwaj, Muktanjalee Deka, Upasana Kalita, B. Goswami
Rectal mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) are rare tumors with two components, neuroendocrine and non-neuroendocrine, each comprising 30% of all tumors. There have been limited studies on the epidemiology, clinical and prognostic characteristics of these tumors. Here, we report a case series of two cases of rectal MiNEN from a tertiary care center in North East India. These tumors are known to be aggressive and often with poor prognosis.
{"title":"Rectal MiNEN: A rare case report","authors":"Jagannath Dev Sharma, Asreen Suhana, A. P. Beso, B. Bharadwaj, Muktanjalee Deka, Upasana Kalita, B. Goswami","doi":"10.32677/ijcr.v9i9.4160","DOIUrl":"https://doi.org/10.32677/ijcr.v9i9.4160","url":null,"abstract":"Rectal mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) are rare tumors with two components, neuroendocrine and non-neuroendocrine, each comprising 30% of all tumors. There have been limited studies on the epidemiology, clinical and prognostic characteristics of these tumors. Here, we report a case series of two cases of rectal MiNEN from a tertiary care center in North East India. These tumors are known to be aggressive and often with poor prognosis.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"173 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139892247","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}
Small-cell lymphocytic lymphoma is a rare type of B-cell non-Hodgkin lymphoma. It is known as one of the indolent lymphomas. Moreover, sigmoid volvulus as an initial presentation is extremely uncommon. We encountered a unique case of mesenteric small cell lymphocytic lymphoma that presented with sigmoid volvulus as the initial clinical presentation. A 55-year-old male presented with 7-day history of abdominal pain, abdominal distension for 6 days, and non-passage of stool and flatus with recurrent vomiting for 3 days. Abdominopelvic computed tomography revealed a distended small bowel with volvulus of sigmoid colon with twisting of its mesentery with inter-ileal as well as free peritoneal collections of fluid. A manual untwisting counterclockwise of the volvulus followed by resection and anastomosis at a point where the bowel has apparent normal thickness and color along with excisional biopsy of the enlarged lymph node. Histopathology confirmed the diagnosis of small-cell lymphocytic lymphoma. Mesenteric lymphomas are less likely to present with sigmoid volvulus as the initial clinical presentation due to their extraluminal location and also they are indolent in course. Early diagnosis and its management reduce morbidity and mortality.
{"title":"Mesenteric small cell lymphocytic lymphoma presenting as acute intestinal obstruction: A rare case scenario","authors":"Anurag Singh, Puneet Sharma, Ayushya Gupta, Nancy Thakur","doi":"10.32677/ijcr.v9i10.4178","DOIUrl":"https://doi.org/10.32677/ijcr.v9i10.4178","url":null,"abstract":"Small-cell lymphocytic lymphoma is a rare type of B-cell non-Hodgkin lymphoma. It is known as one of the indolent lymphomas. Moreover, sigmoid volvulus as an initial presentation is extremely uncommon. We encountered a unique case of mesenteric small cell lymphocytic lymphoma that presented with sigmoid volvulus as the initial clinical presentation. A 55-year-old male presented with 7-day history of abdominal pain, abdominal distension for 6 days, and non-passage of stool and flatus with recurrent vomiting for 3 days. Abdominopelvic computed tomography revealed a distended small bowel with volvulus of sigmoid colon with twisting of its mesentery with inter-ileal as well as free peritoneal collections of fluid. A manual untwisting counterclockwise of the volvulus followed by resection and anastomosis at a point where the bowel has apparent normal thickness and color along with excisional biopsy of the enlarged lymph node. Histopathology confirmed the diagnosis of small-cell lymphocytic lymphoma. Mesenteric lymphomas are less likely to present with sigmoid volvulus as the initial clinical presentation due to their extraluminal location and also they are indolent in course. Early diagnosis and its management reduce morbidity and mortality.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139882737","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}
Jagannath Dev Sharma, Asreen Suhana, A. P. Beso, B. Bharadwaj, Muktanjalee Deka, Upasana Kalita, B. Goswami
Rectal mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) are rare tumors with two components, neuroendocrine and non-neuroendocrine, each comprising 30% of all tumors. There have been limited studies on the epidemiology, clinical and prognostic characteristics of these tumors. Here, we report a case series of two cases of rectal MiNEN from a tertiary care center in North East India. These tumors are known to be aggressive and often with poor prognosis.
{"title":"Rectal MiNEN: A rare case report","authors":"Jagannath Dev Sharma, Asreen Suhana, A. P. Beso, B. Bharadwaj, Muktanjalee Deka, Upasana Kalita, B. Goswami","doi":"10.32677/ijcr.v9i9.4160","DOIUrl":"https://doi.org/10.32677/ijcr.v9i9.4160","url":null,"abstract":"Rectal mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) are rare tumors with two components, neuroendocrine and non-neuroendocrine, each comprising 30% of all tumors. There have been limited studies on the epidemiology, clinical and prognostic characteristics of these tumors. Here, we report a case series of two cases of rectal MiNEN from a tertiary care center in North East India. These tumors are known to be aggressive and often with poor prognosis.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"697 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139832409","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}
Hemolacria (HL) is a rare condition characterized by the presence of blood in the tears. Bleeding associated with tears can occur in the context of infection, inflammation, trauma to the eye or surrounding structures, vascular tumors of the eye or surrounding structures, or retrograde epistaxis. We herein present a pediatric case with HL in the setting of epistaxis due to post-traumatic vessel injury without fracture, along with a literature review. Bleeding from the inferior lacrimal punctum was controlled by successful cauterization of damaged vessels and follow-up has remained uneventful for over a year. Bleeding from the eye is an alarming symptom, especially if it developed after facial trauma. However, physicians should be more aware that, in the absence of a fracture, HL due to retrograde epistaxis resulting from facial trauma can be a self-limited condition that is easily treated by controlling nasal hemorrhage.
{"title":"Epistaxis-related hemolacria in a 6-year-old female after midfacial trauma: Epistaxis-related hemolacria","authors":"Merve Demirer Çelik, Deniz Aslan","doi":"10.32677/ijcr.v9i9.3952","DOIUrl":"https://doi.org/10.32677/ijcr.v9i9.3952","url":null,"abstract":"Hemolacria (HL) is a rare condition characterized by the presence of blood in the tears. Bleeding associated with tears can occur in the context of infection, inflammation, trauma to the eye or surrounding structures, vascular tumors of the eye or surrounding structures, or retrograde epistaxis. We herein present a pediatric case with HL in the setting of epistaxis due to post-traumatic vessel injury without fracture, along with a literature review. Bleeding from the inferior lacrimal punctum was controlled by successful cauterization of damaged vessels and follow-up has remained uneventful for over a year. Bleeding from the eye is an alarming symptom, especially if it developed after facial trauma. However, physicians should be more aware that, in the absence of a fracture, HL due to retrograde epistaxis resulting from facial trauma can be a self-limited condition that is easily treated by controlling nasal hemorrhage.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"8 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139826986","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}
Chronic hepatitis C (CHC) infection is one of the leading causes of liver disease worldwide and its early diagnosis is often considered a challenge because of its non-symptomatic presentation until late disease progression stages. We report the case of a 52-year-old, South-Indian male with CHC genotype 4c infection. We start with the patient’s initial presentation 12 weeks before the diagnosis with seemingly non-specific symptoms of pedal edema, purpura, peripheral neuropathy, arthralgia, and recent onset of diabetes mellitus (DM). We then present the employed direct-acting antiviral (DAA) management regimen and the patient’s response over the span of 48 weeks. Correlating with observations from recent literature highlighting CHC’s extra-hepatic role in inducing cryoglobulinemic vasculitis (CV) and pancreatic dysfunction, we discuss some educational perspectives on how CV and DM-related symptoms may sometimes become contextually specific in clinically suspecting, assessing risk, and warranting CHC screening and diagnostic confirmation.
{"title":"A case report of chronic hepatitis-C genotype 4c infection: Non-specific symptoms can become contextually relevant in clinical diagnosis","authors":"K. Mantha","doi":"10.32677/ijcr.v9i9.4148","DOIUrl":"https://doi.org/10.32677/ijcr.v9i9.4148","url":null,"abstract":"Chronic hepatitis C (CHC) infection is one of the leading causes of liver disease worldwide and its early diagnosis is often considered a challenge because of its non-symptomatic presentation until late disease progression stages. We report the case of a 52-year-old, South-Indian male with CHC genotype 4c infection. We start with the patient’s initial presentation 12 weeks before the diagnosis with seemingly non-specific symptoms of pedal edema, purpura, peripheral neuropathy, arthralgia, and recent onset of diabetes mellitus (DM). We then present the employed direct-acting antiviral (DAA) management regimen and the patient’s response over the span of 48 weeks. Correlating with observations from recent literature highlighting CHC’s extra-hepatic role in inducing cryoglobulinemic vasculitis (CV) and pancreatic dysfunction, we discuss some educational perspectives on how CV and DM-related symptoms may sometimes become contextually specific in clinically suspecting, assessing risk, and warranting CHC screening and diagnostic confirmation.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"6 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139882303","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 : 2024-02-01DOI: 10.32677/ijcr.v9i10.4188
Kumari Pritti, Vineet Mishra, R. Aggarwal, S. Choudhary
We report a case of circumvallate placenta which led to preterm premature rupture of membranes (PPROM) and leakage in a mother at 17 weeks of gestation. The mother underwent amniocentesis after the triple marker test showed an increased risk for trisomy 21. We encountered difficulty in aspirating amniotic fluid due to the abnormal placental structure, which was not known at the time of the invasive procedure. The mother experienced leaking 7 days post-procedure, followed by miscarriage. Autopsy examination revealed that the placenta was circumvallate, which not only caused difficulty in aspirating the amniotic fluid but also could be the cause of PPROM, a well-known complication of the circumvallate placenta. We emphasize that examining the placenta is very important to identify the cause of events in certain situations; circumvallate placenta or abnormal placenta can be suspected in cases where hindrance is encountered (not able to aspirate amniotic fluid even if the needle is visible in the amniotic sac) during amniocentesis.
{"title":"A case of circumvallate placenta causing preterm premature rupture of membranes post-amniocentesis","authors":"Kumari Pritti, Vineet Mishra, R. Aggarwal, S. Choudhary","doi":"10.32677/ijcr.v9i10.4188","DOIUrl":"https://doi.org/10.32677/ijcr.v9i10.4188","url":null,"abstract":"We report a case of circumvallate placenta which led to preterm premature rupture of membranes (PPROM) and leakage in a mother at 17 weeks of gestation. The mother underwent amniocentesis after the triple marker test showed an increased risk for trisomy 21. We encountered difficulty in aspirating amniotic fluid due to the abnormal placental structure, which was not known at the time of the invasive procedure. The mother experienced leaking 7 days post-procedure, followed by miscarriage. Autopsy examination revealed that the placenta was circumvallate, which not only caused difficulty in aspirating the amniotic fluid but also could be the cause of PPROM, a well-known complication of the circumvallate placenta. We emphasize that examining the placenta is very important to identify the cause of events in certain situations; circumvallate placenta or abnormal placenta can be suspected in cases where hindrance is encountered (not able to aspirate amniotic fluid even if the needle is visible in the amniotic sac) during amniocentesis.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"21 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887404","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 : 2024-02-01DOI: 10.32677/ijcr.v9i10.4190
Luiz Alberto Cerqueira Batista Filho, Mario Correa Netto Pacheco Junior, Alexandre Toledo Maciel, Larissa Seraphim Medeiros
A 42-year-old individual presented with a ruptured left patellar ligament after playing basketball. After undergoing reconstructive orthopedic surgery, he sustained a posterior shoulder dislocation while using crutches, necessitating additional surgery. This combination of orthopedic injuries rendered the patient immobile and bedridden for several months, and immobility-related complications began to develop. Immobilism is a condition that physicians typically associate with elderly and neuropathic patients; however, little is said about this pathology when young and healthy patients who have experienced acute diseases are considered. With a review of the relevant literature, this article describes a peculiar succession of immobility-related complications.
{"title":"Turning the young and healthy patient into an elderly faster: A cascade of complications related to immobility","authors":"Luiz Alberto Cerqueira Batista Filho, Mario Correa Netto Pacheco Junior, Alexandre Toledo Maciel, Larissa Seraphim Medeiros","doi":"10.32677/ijcr.v9i10.4190","DOIUrl":"https://doi.org/10.32677/ijcr.v9i10.4190","url":null,"abstract":"A 42-year-old individual presented with a ruptured left patellar ligament after playing basketball. After undergoing reconstructive orthopedic surgery, he sustained a posterior shoulder dislocation while using crutches, necessitating additional surgery. This combination of orthopedic injuries rendered the patient immobile and bedridden for several months, and immobility-related complications began to develop. Immobilism is a condition that physicians typically associate with elderly and neuropathic patients; however, little is said about this pathology when young and healthy patients who have experienced acute diseases are considered. With a review of the relevant literature, this article describes a peculiar succession of immobility-related complications.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"25 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139874873","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}
Children are prone to foreign body aspiration. Impaction of foreign bodies in the hard palate is a rare phenomenon. We present a case report where the infant’s palatal swelling was mistaken for a tumor or cyst and was planned for excision and later turned out to be an impacted pistachio shell. We emphasize considering the foreign body as a differential diagnosis in children who present with unusual hard palate mass.
{"title":"Unusual hard palate swelling in an infant: A case of impacted pistachio shell","authors":"Muppidi Shruthi, Santhosh Reddy Kantala, Satish Mandali, Pradeep Burli","doi":"10.32677/ijcr.v9i10.4218","DOIUrl":"https://doi.org/10.32677/ijcr.v9i10.4218","url":null,"abstract":"Children are prone to foreign body aspiration. Impaction of foreign bodies in the hard palate is a rare phenomenon. We present a case report where the infant’s palatal swelling was mistaken for a tumor or cyst and was planned for excision and later turned out to be an impacted pistachio shell. We emphasize considering the foreign body as a differential diagnosis in children who present with unusual hard palate mass.","PeriodicalId":13365,"journal":{"name":"Indian Journal of Case Reports","volume":"179 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139821769","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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