A 62 year old female patient, with no previous history, consulted in emergency department for a sudden decrease in visual acuity of the right eye with a feeling of uneasiness and vertigo. The Best Corrected Visual Acuity (BCVA) was measured at 10/10 according to the Snellen scale in the left eye and “counting fingers” in the right eye.
Issue 4 (Apr)
Bipartite medial cuneiform is a rare congenital normal variant at the Lisfranc joint that is a potential trap for isolated medial cuneiform fracture or midfoot injury. Misinterpretation of imaging may lead to unnecessary surgical intervention. The morphology of the bipartite medial cuneiform is further subdivided into completely or partially bipartite. The “E-sign” is a useful imaging sign that is present in all cases of the complete bipartite medial cuneiform.
Epulis fissuratum is a condition where the tissues in the mouth become overgrown due to long-term irritation caused by poorly fitting dentures. The cause of this condition is ongoing irritation and damage to the tissue, which is most commonly seen in the areas surrounding the labial vestibule. In this report, a 57-year-old man had an excessive growth of soft tissue in the lower premolar region.
Recto-Urethral Fistula (RUF) is a relatively uncommon surgical condition requiring complex and precise surgery that is often challenging for surgeons. There is no firm consensus on the surgical method. Therefore, it is important to know the best surgical method. Therefore, the purpose of this study is to introduce a case of recto-urethral fistula and a new surgical method in a 25-year-old man.
Cancer is characterized as the highest clinical burden throughout the world. It is the second cause of death behind ischemic heart disease and will be expected to be the first in 2060 . The statistical review showed about 18 million new cancer patients and 9.5 million cancer deaths in 2018.
Diffuse osteosclerosis of axial and appendicular skeleton is an unusual manifestation of renal osteodystrophy. Symmetrical involvement of multiple bones is the finding. The more common encountered feature is rugger jersey appearance of spine due to affected vertebral end plates. We present a case with chronic kidney disease and renal osteodystrophy manifesting in the form of diffuse osteosclerosis.
First described by Albert Schonberg in 1904, osteopetrosis is a group of sclerosing bone dysplasias characterized by generalized skeletal densification due to decreased osteoclast mediated resorption. The management of fractures in this patient population is unique. Centromedullary nailing cannot be used in the vast majority of cases because of a narrow canal.
Combined Central and Peripheral Demyelination (CCPD) is a rare neurological disorder in which demyelination occurs in the central as well as peripheral nervous systems, either sequentially or simultaneously. While neurological complications have been reported anecdotally after COVID vaccination, this report highlights the rare occurrence of CCPD in three patients during this period with stress on variations in their presentation, course of progression and response to treatment and outcome.
Angiotensin-Converting Enzyme Inhibitors (ACEI) are commonly used to prevent cardiac remodeling in patients with ST-Segment Elevation Myocardial Infarction (STEMI). Life-threatening ACEI side effects, such as angiodema, are rare; unilateral tongue swelling is even rarer. Early recognition and diagnosis of angioedema can often be life-saving.
In this case we report a 42-year-old woman who presented to Syrian Heart Lung Center (SHLC) with recurrent syncope attacks, general fatigue and weight loss. During the diagnostic approach, many investigations were performed including laboratory analysis, ECG, Echocardiography, Computed Tomography (CT), and biopsies. However, immunostaining was the decisive investigation.
Invasive surgery may be required to resect the area of the seizure in approximately one third of epilepsy patients. A combination of diagnostic tests is used to ascertain the resection area, including nuclear imaging (PET/SPECT) techniques that can accurately localize areas of seizures. Limited data is available on ictal PET-CT imaging, because PET-CT images are usually obtained in interictal phases and cannot be routinely obtained in the ictal phase because of logistic issues.
Takayasu’s Arteritis (TA) is a rare granulomatous vasculitis affecting large vessels, mainly the aorta and its branches as well as the pulmonary arteries. Although it occurs most often in young women of childbearing age, it is also considered among the main causes of aortic occlusive disease and pediatric renovascular hypertension. The diagnosis of Takayasu’s arteritis during childhood remains difficult due to non-specific symptoms and biomarkers, a source of delayed diagnosis and vascular complications.
The development of bronchial hemangioma in adults is rare, and massive hemoptysis due to diffuse vascular proliferation of bronchial hemangioma is fatal. We report a case of a 29-year-old woman who underwent repeated interventional embolization for recurrent massive hemoptysis due to bronchial hemangioma, and eventually massive hemoptysis even after interventional embolization.
Neural tube defects (NTD) are one of the most common congenital malformations, second only to congenital heart disease (CHD). The most common types of NTDs are anencephaly and spina bifida. NTDs can be open or closed. Unlike some other congenital defects, NTDs can usually be prevented. When women take the recommended amounts of folic acid (FA) during the periconceptional period and the first trimester, they can significantly lower the risk of NTDs.
A 74-year-old man was referred to hospital for condylomatous lesions of left inguinal fold. Clinical examination highlighted multiple budding lesions, fixed to the skin with subcutaneous induration; scrotal and penis edema, and edema of both lower limbs (Figure 1). CT scan showed multiple dense nodular skin lesions of the left inguinal fold with diffuse infiltration of the subcutaneous fat but also suspicious budding lesion.
We report a case of encapsulated papillary carcinoma arising de novo in an axillary lymph node. This rare diagnosis is thought to occur via epithelial rest. Our case is suggestive of epithelial rest playing a role in our patient’s pathogenesis
A 5-year-old child with no particular history consulted for tonic-clinical generalized seizures of recent onset, all evolving in a febrile context. The clinical examination revealed a slight disorientation, but there was no localized neurological deficit. An MRI was performed 72 h after the onset of the symptomatology. Cerebral masses were highlighted on this MRI in relation to cerebral abscesses.
Cervical spondylodiscitis is a rare condition, but it is usually associated with rapid neurological deterioration so urgent surgical intervention mostly is indicated. We are presenting a case of cervical spondylodiscitis in patient with history of cancer hypopharynx. The patient had lateral pharyngotomy wide excision followed by radiotherapy, but the presence of epidural abscess made surgical intervention inevitable.
Dysplasia Epiphysealis Hemimelica (DEH) or Trevor disease is a condition that affects skeletal development characterized by asymmetric abnormal growth in epiphyses cartilage. Clinical signs are uncommon and variable; resulting in a non standardized treatment approach. We reported a case of a 13-year-old child complaining from left knee pain and swelling of the medial side.
The article discusses a case report of a 49-year-old patient who presented with an isolated pigment epithelium detachment. Multimodal imaging revealed the presence of a pachychoroid, leading to the diagnosis of a pachychoroid pigment epitheliopathy. Pachychoroidopathies are a recent description that includes choroidal thickening, choroidal hyperpermeability, and pigment epithelium alterations without a retinal serous detachment.
Spinal Muscular Atrophy (SMA), is defined as a set of hereditary neurodegenerative disorders causing a high phenotypic and genotypic variability that generate an impact on quality of life, psychosocial, emotional and functional development, considered in Colombia orphan disease in relation to its low prevalence, chronicity and high complexity.
A 30-year-old woman with no prior medical history reported left knee pain and swelling evolving for 4 years. The swelling had progressively worsened over the past 4 months, becoming resistant to analgesics and non steroidal anti-inflammatory drugs. Physical examination showed only a positive patellar shock on the left without local inflammatory signs.
Emphysematous pyelonephritis (EPN) is a rare, severe, necrotizing renal parenchymal infection that is characterized by the production of intra-parenchymal gas and is most common in diabetics and in females. We describe a 30 year old woman with poorly controlled type 1 diabetes mellitus who presented with CT-confirmed left emphysematous pyelonephritis with concomitant emphysematous cystitis.
MS is a devastating disease of the Central Nervous System (CNS) caused by autoimmune responses to CNS antigens such as myelin basic protein, leading to the neuronal damage and formation of demyelinating plaques in the brain, spinal cord and optic nerves. As the miRNAs play a significant role in the regulation of the cellular procedures, this study aims to predict the miRNAs, targeting the CYBRD1, SMAD1 and GNG12 genes using bioinformatics tools.
Malignant transformation of Giant Cell Tumor (GCT) is not common. We report a case of GCT transformation after radiation and denosumab with iliac lymph node metastasis. A 31-year-old man received surgery for his lesion in the left femur in 2010, without histological diagnosis.
CAR T cell therapy is a promising immunotherapy that can target and eradicate leukemia cells with high specificity. While CD19, CD20, and CD22 CAR T cells have shown impressive responses in ALL patients, AML-specific CAR T cells are still being investigated. However, CAR T cell therapy can lead to serious adverse effects. Further research is necessary to optimize the efficacy and safety of CAR T cell therapy in AML and ALL.
A 57-year old male presented with generalized weakness, fatigue, upper abdominal pain, anorexia, and a 30-pound weight loss in 6 months. He was found to have severe pancytopenia and low Vitamin B12 levels with elevated Parietal Cell Antibodies and antibodies against Intrinsic Factor. The following images depict his upper endoscopy findings and gastric tissue biopsy.
Von Hippel-Lindau Syndrome (VHL) is a rare genetic disease. The clinical and imaging data of one patient with VHL syndrome were retrospectively analyzed, and the clinical features and treatment of the disease were analyzed in combination with literature. The patient had multiple cysts of the pancreas, multiple cysts of both kidneys, left kidney tumor, right testicular tumor, and bilateral epididymal cystic lesions, and underwent surgery for right orchiectomy, and was discharged after surgery.
Mycetomas are slow growing pseudotumors, which develop after trauma with an infection caused by bacteria or fungi. This localized infection in the cutis and subcutis is identified as eumycetoma or “Madura foot” when caused by fungi. Without proper treatment, bulky and obstructive tumors develop. These tumors form fistulas from which pus oozes, sometimes granular. Eumycetomas may also lead to bone destruction, but usually do not show dissemination. In temperate zones, the diagnosis of eumycetoma is rare.
Niemann-Pick Diseases (NPD) is lysosomal storage diseases caused by Acid Sphingo Myelinase (ASM) deficiency, which catalyzes the hydrolysis of Sphingo Myelin (SM) to ceramide and phosphocholine. As a result, the SM and its precursor lipids accumulate in the lysosomes of the cells of the reticuloendothelial system, which produces an abnormal functioning, leading to the inability to degrade macromolecules, forming intracellular inclusions that are deposited in different organs such as the liver, spleen, lungs and brain.
A 49-year-old male Fijian soldier with no significant past medical history presented with a one-week history of fever (39.5oC) and dyspnea with hypoxemia. A complete blood count showed leukocytosis (25,120/ mm3) with neutrophilia (84%), and chest imaging revealed interstitial pneumonia. SARS-CoV-2 tests showed positive RT-PCR test and mono-IgG serology and negative Rapid Antigen test.
A 69-year-old woman with Hereditary Angioedema (HAE) due to deficient C1INH (Type I) was admitted to an orthopedic unit for a knee prosthesis infection. She subsequently developed angioedema in her eyelids, face, and hands, followed by a reduction in visual acuity that progressed to amaurosis within 48 hours.
A 66-year-old woman with type 2 diabetes, chronic sinusitis, chronic smoking, and a history of pneumococcal meningitis in 2019 presented to the hospital in October 2022 after being poorly responsive at home. On arrival, she was somnolent with a GCS of 5. CT head revealed mucosal thickening of the left maxillary sinus.
Since the start of the COVID-19 pandemic in December 2019, worldwide COVID-19 vaccination campaigns have been done to prevent the further spread of COVID-19. While COVID-19 infection has been found to have multiple neurological complications, an increased risk of Guillain-Barre’ Syndrome (GBS) has been attributed to COVID-19 vaccination. Here we report the first case of COVID-19 vaccine-related GBS in the Philippines.
Histoplasmosis is an infection due to a dimorphic fungus Histoplasma capsulatum. In Tunisia, there is no cases described among native Tunisians, but it is emerging as an exotic imported infection from Sub-Saharan Africa. We reported the case of an Ivorian woman living with HIV, hospitalized at infectious diseases department in 2020 for disseminated histoplasmosis.
Verruca is a benign proliferation of the skin and mucous membranes caused by the Human Papilloma Virus (HPV). The disease should be treated because it is contagious, causes cosmetic problems but often in the role of being part of an unresolved process. A total of 5 sessions of dry needle acupuncture treatment was applied to the patient. From the first session, the patient’s complaint decreased and disappeared.
Skin and Soft Tissue Infections (SSTI) resulting from cat bites most commonly occur due to Pasteurella infection. However, other pathogens such as Β-Hemolytic Streptococci (BHS) have been identified and tend to be highly virulent in diabetic patients. Here we present a case of a 59 year-old man presenting with left wrist osteomyelitis following a cat bite.
Porokeratosis is a specific disorder of keratinization whose diagnosis is based on clinical and histological findings. It presents in 5 clinical forms of which linear porokeratosis with nail dystrophy remains a rare entity. We report the sporadic case of a 23-year-old girl who presented since childhood with linear porokeratosis lesions with nail dystrophy in an acral, bilateral and symmetrical pattern.
The discovery of papilledema in children constitutes a neuroophthalmological emergency; the purpose of this report is to help differentiate MOGAD from other differential diagnosis of bilateral optic neuritis, especially in childhood. The 09 years old female came to our emergency department complaining about rapidly progressive visual decline in both eyes, with no other symptom.
Schwannoma of the lateral aspect of the Internal Carotid Plexus (ICP) is an unusual tumor, defined through its relationship with the Internal Carotid Artery (ICA). In literature, only 3 are certainly originated from this portion of that plexus. A 13-year-old male presented with 5 months of Peripheral Facial Paralysis (PFP) and hearing loss on the right.