Medical Reports最新文献

{"title":"Acute hemorrhagic leukoencephalitis (AHLE): An exceptional clinical presentation with the association of scrub typhus and opercular syndrome","authors":"Arpan Mitra , Niraj Kumar Srivastava , Subhraneel Paul , Anand Kumar , Deepika Joshi","doi":"10.1016/j.hmedic.2025.100166","DOIUrl":"10.1016/j.hmedic.2025.100166","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute hemorrhagic leukoencephalitis (AHLE) is a rare and severe form of acute disseminated encephalomyelitis (ADEM), characterized by rapid progression and inflammation of the brain's white matter. It's often preceded by an upper respiratory infection, bacterial or viral illness, or even vaccination. An opercular syndrome is characterized by the triad of facial weakness, dysarthria, and difficulty in swallowing due to lesions in the operculum, the part of the brain that covers the insula. When AHLE is associated with opercular syndrome and scrub typhus, it presents a unique and challenging clinical condition. Here, we are presenting a case of AHLE (a subtype of ADEM), which is very rare but is also associated with scrub typhus and opercular syndrome (a rare syndrome). In this way, the presenting case becomes the rarest of rare or most exceptional.</div></div><div><h3>Case report</h3><div>A complex clinical case involving a 12-year-old girl, who had the symptoms of fever, vomiting, headache, focal seizure, and altered sensorium for the last 25 days, she was initially diagnosed as tuberculous meningitis (TBM) in an outside hospital, but there was no significant improvement with standard anti-tubercular therapy (ATT). Due to no notable improvement, she was brought to our institute (IMS, BHU) for further evaluation suggests a need for a comprehensive approach to uncover any underlying conditions that may be contributing to her symptoms. The additional and necessary investigations, such as fever workup, repeat CSF analysis, routine blood tests, and MRI brain, were crucial steps in this process. The serum of the patient was positive for IgM scrub typhus suggesting an active infection. The presence of lymphocytic pleocytosis, elevated protein, and reduced sugar in the CSF indicate inflammation and dysfunction within the central nervous system (CNS). The MRI findings of extensive subcortical and white matter changes with haemorrhage further suggest AHLE. Symptoms and MRI features also projected the diagnosis of opercular syndrome. CSF neuro-infection panel was negative. Stopping ATT and initiating pulse steroid therapy along with doxycycline was a prudent decision. Doxycycline is the treatment of choice for scrub typhus, and the addition of pulse steroid therapy aims to reduce inflammation and prevent further neurological damage.</div></div><div><h3>Conclusion</h3><div>AHLE (Acute Hemorrhagic Leukoencephalitis) is indeed a severe and often fatal condition, and its association with scrub typhus and opercular syndrome presents a unique and challenging clinical scenario. Given its rarity and the potential for misdiagnosis or lack of recognition, highlighting such cases can be crucial in increasing awareness among healthcare professionals. Moreover, documenting such rare occurrences can contribute significantly to the medical literature, providing valuable insights into the clinical features, pathophysiology, and management str","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"10 ","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spondylodiscitis by Streptococcus Gordonii in an immunocompetent adult: A case report","authors":"Abdul Qadir ,&nbsp;Amal Wael Abdellatif ,&nbsp;Jamal Sajid ,&nbsp;Mamunul Islam ,&nbsp;Dana Al-Sayegh","doi":"10.1016/j.hmedic.2024.100152","DOIUrl":"10.1016/j.hmedic.2024.100152","url":null,"abstract":"<div><div><em>Streptococcus gordonii</em>, a Gram-positive bacterium found in the human oral cavity, skin, intestines, and respiratory tract, can occasionally cause serious infections, including periodontitis, bacteremia, and infective endocarditis. Rarely, it can lead to infectious spondylitis, a severe spinal infection. We report a case of a 49-year-old male presenting with neck pain and fever. Examination revealed cervical spine tenderness and elevated inflammatory markers. MRI indicated spondylitic changes and cervical disc degeneration with mild disc bulge at C4-C5. Blood cultures identified <em>S. gordonii</em>. Hence, making a definitive diagnosis of <em>S. gordonii</em> causing infectious spondylodiscitis. A 6-week course of ceftriaxone resolved his symptoms and normalized inflammatory markers. Previous literature reports only few similar cases, mainly linked to dental or spinal surgeries. This is the only case reported unusual as the patient had no recent dental or spinal procedures yet predisposing to infectious spondylitis. This highlights the need for spinal imaging in patients with <em>S. gordonii</em> bacteremia and neck or back pain to ensure proper diagnosis and treatment.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A coinfection of Delftia acidovorans and Stenotrophomonas maltophilia as an atypical cause of necrotizing pneumonia: A case report","authors":"John Peters ,&nbsp;Tyler Lackland ,&nbsp;Mohamed M.G. Mohamed ,&nbsp;Christopher Barrios","doi":"10.1016/j.hmedic.2025.100160","DOIUrl":"10.1016/j.hmedic.2025.100160","url":null,"abstract":"<div><div>Necrotizing pneumonia is a relatively rare complication of bacterial pneumonia. It is characterized by pulmonary inflammation associated with vascular compromise causing necrosis and is mostly triggered by common respiratory pathogens. Atypical pathogens might cause necrotizing pneumonia in immunocompromised hosts. We are presenting an atypical case of necrotizing pneumonia caused by <em>Delftia acidovorans</em> and <em>Stenotrophomonas maltophilia</em> in an immunocompetent host. We aim to highlight the potential role of these bacteria as causative pathogens of necrotizing pneumonia and to facilitate early consideration and recognition by health care providers.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “From shattered to restored: overcoming challenges in management of fractured tooth” [Med. Rep. 7 (2024) 100107]","authors":"Aakash Gupta ,&nbsp;Ramandeep Singh","doi":"10.1016/j.hmedic.2024.100154","DOIUrl":"10.1016/j.hmedic.2024.100154","url":null,"abstract":"","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in management and postoperative complications of total uterine procidentia at term: Case report","authors":"Thomas Solomon ,&nbsp;Dereje Dageme ,&nbsp;Abdela Aliyi ,&nbsp;Ibsa Mohammed ,&nbsp;Bekalu Yirga ,&nbsp;Chalachew Bizuye ,&nbsp;Astawus Alemayehu","doi":"10.1016/j.hmedic.2025.100163","DOIUrl":"10.1016/j.hmedic.2025.100163","url":null,"abstract":"<div><h3>Background</h3><div>Total procidentia, or complete uterine prolapse, at term pregnancy is an exceptionally rare and severe obstetric condition. This condition, when accompanied by intrauterine fetal demise (IUFD), significantly increases the risks of obstructed labor, maternal morbidity, and poor fetal outcomes. Early recognition and a comprehensive management approach are critical to minimizing adverse outcomes. This case highlights the challenges and importance of multidisciplinary care in managing such a rare and complex presentation.</div></div><div><h3>Case presentation</h3><div>A 30-year-old gravida 7, para 6 woman at 39 weeks and 5 days of gestation, with no antenatal care, presented with labor symptoms, including a protruding vaginal mass and a two-day history of absent fetal movements. Physical examination confirmed total uterine prolapse and absent fetal heart tones. Ultrasound revealed a third-trimester intrauterine pregnancy complicated by IUFD. Following informed consent, an emergency cesarean section was performed, delivering a 3000 g macerated male stillborn. The surgery also included a bilateral salpingectomy per the patient’s request.</div></div><div><h3>Outcome</h3><div>The patient’s postoperative course was complicated by partial bowel obstruction on the 2nd postoperative day, managed conservatively. By the 6th postoperative day, she developed wound dehiscence and intra-abdominal infection, necessitating a re-laparotomy and hysterectomy. Multidisciplinary coordination between surgical and anesthesiology teams was essential in managing these severe complications.</div></div><div><h3>Conclusion</h3><div>This case underscores the critical importance of prompt surgical intervention and rigorous postoperative care in managing total procidentia at term with IUFD. The significant complications encountered highlight the necessity of a multidisciplinary approach and This rare condition also highlight the importance of innovative surgical techniques and rigorous postoperative monitoring to minimize maternal morbidity and improve outcomes in life-threatening obstetric emergencies.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief insight regarding Nasopalatine duct cyst – Report of a case with a review of literature","authors":"Snehanjan Sarangi,&nbsp;Debarati Ray,&nbsp;Basudev Mahato,&nbsp;Tathagata Bhattacharjee,&nbsp;Rudra Pyne","doi":"10.1016/j.hmedic.2025.100156","DOIUrl":"10.1016/j.hmedic.2025.100156","url":null,"abstract":"<div><div>Nasopalatine duct cysts (NPDCs) are among the most common non-odontogenic cysts, typically located in the midline of the anterior hard palate. They arise from the embryonic epithelial remnants of the nasopalatine duct. NPDCs are more frequently seen in adult males, usually during the fourth decade of life. Clinically, they present as an asymptomatic or occasionally painful, fluctuant, or discharging swelling in the hard palate. Radiographically, NPDCs appear as well-defined, corticated, inverted pear-shaped or heart-shaped radiolucencies situated between the roots of the maxillary incisors. Histologically, the epithelial lining shows considerable variation, ranging from stratified squamous to pseudostratified ciliated columnar, columnar, or cuboidal epithelium, with transitions often observed between these types. The cyst wall is fibrocollagenous and may include distinctive features such as neurovascular bundles, mucous glands, or cartilaginous remnants. Management typically involves surgical enucleation, with a low risk of recurrence. Here, we present a case of NPDC along with a brief overview of its origin, diagnostic characteristics, and treatment approach.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary hepatic neuroendocrine tumor: A rare neuroendocrine tumor","authors":"Muhammad Naveed Ur Rehman ,&nbsp;Muhammad Arslan Mumtaz ,&nbsp;Najum Fatima ,&nbsp;Khalid Shahzad","doi":"10.1016/j.hmedic.2024.100155","DOIUrl":"10.1016/j.hmedic.2024.100155","url":null,"abstract":"<div><div>Primary hepatic neuroendocrine tumors (PHNETs) account for only 0.3 % of all the primary neuroendocrine tumors(NETs). Since, liver is the most frequent site of metastasis of NETs from other sites in the body; a distinction between metastatic liver mass and primary NET is extremely necessary. This report describes the case of a 54-year-old male who presented with right hypochondrial pain and had a space occupying lesion in the left lobe of liver and multiple small lesions in both the lobes of liver. USG guided tru-cut biopsy showed malignant neoplasm of grade III comprising of sheets and nests of atypical plasmacytoid looking cells with brisk mitosis. Immunohistochemically, synaptophysin and cytokeratin were positive with Ki-67 index of 30 %. Hormonal studies were normal; hence, a diagnosis of non-functioning PHNET was made. Patient was treated stepwise with cisplatin/etoposide based chemotherapy, Everolimus, capecitabine and temozolomide; but, all the therapies failed to produce response and ultimately, patient was put on pembrolizumab as a palliative measure. This case illustrates that PHNET should be amongst the differentials of a liver mass and a comprehensive research is needed to devise successful management strategies.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An uncommon case of thrombosis of ascending aorta diagnosed by transesophageal echocardiography","authors":"Anshuman Srivastava ,&nbsp;Sandhya J. Kadam ,&nbsp;Rishika Sharma ,&nbsp;Archana Reddy Bongurala","doi":"10.1016/j.hmedic.2024.100147","DOIUrl":"10.1016/j.hmedic.2024.100147","url":null,"abstract":"<div><div>The most common sites for arterial thrombosis depend on the patient’s age and the type of thrombosis. The coronary artery is the commonest site, which can lead to a heart attack, and the middle cerebral, internal carotid artery, which can lead to stroke. Atherosclerosis is the most common cause of arterial thrombosis. Other risk factors are old age, smoking, obesity, overweight, an unhealthy diet, lack of exercise, high blood pressure, high cholesterol, diabetes, COVID-19 infection, and inherited factors. Risk factors in adults less than 60 years of age and old adults could be different. Thrombosis of other arteries can occur due to underlying systemic diseases. Aortic thrombosis is less common, and ascending aorta thrombosis is the least common because of the high velocity and caliber of blood flowing through it. We present a case of a patient, less than 60 years of age, with arterial thrombosis at an uncommon site in the ascending aorta, who needed Transesophageal echocardiography (TEE) for diagnosis as CT angiogram(CTA) and transthoracic echocardiography(TTE) were negative. The case highlights the importance of paying more attention to uncommon sites of thrombosis and using more conventional modalities to diagnose aortic thrombosis.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine device complications: Diagnosis and surgical management of migrated IUDs resulting in uterine and rectal perforation","authors":"Oussama lamzouri ,&nbsp;Reda Rhazi ,&nbsp;Hanae Benchaou ,&nbsp;Chatbi Zainab ,&nbsp;Hafsa Taheri ,&nbsp;Hanane Saadi ,&nbsp;Ahmed Mimouni","doi":"10.1016/j.hmedic.2025.100159","DOIUrl":"10.1016/j.hmedic.2025.100159","url":null,"abstract":"<div><div>Intrauterine devices (IUDs) are widely recognized as highly effective long-term contraceptive methods, providing significant flexibility in usage duration. Available in copper and hormonal variants, IUDs have become increasingly popular due to their convenience and high efficacy rates. Despite these benefits, IUDs can occasionally result in serious complications, including septic infections and uterine perforation, which occurs at an estimated rate of 0.5–1 per 1000 insertions. Uterine perforation, if misdiagnosed, can progress to severe complications such as peritonitis and septic shock. Migrated IUDs can be located in various abdominal regions, including the Douglas pouch, broad ligament, and omentum, with rectal migration being particularly rare and challenging to diagnose and treat. We report two cases of IUD migration resulting in significant clinical presentations. The first case involves a 26-year-old female with hypothyroidism, who presented with six months of cyclic rectal bleeding following the insertion of a copper IUD. Clinical and imaging assessments revealed the IUD had perforated the uterine wall and partially migrated into the rectum. Hysteroscopic removal of the IUD was performed successfully without complications, and the patient recovered uneventfully with prophylactic antibiotic therapy. The second case describes a 30-year-old multiparous female who experienced acute pelvic pain during IUD placement. Subsequent examinations indicated the IUD had migrated into the abdominal cavity. Laparoscopic surgery identified the IUD within the omentum, and it was carefully extracted without damage to surrounding organs. The patient’s recovery was uneventful post-procedure. These cases underscore the importance of recognizing risk factors associated with uterine perforation, such as postpartum insertion and clinician experience. Migrating IUDs can present with a range of symptoms or remain asymptomatic, with diagnosis supported by ultrasound, X-ray, and CT scans. Immediate removal of the displaced IUD is generally recommended to prevent severe complications, with laparoscopy being the preferred retrieval method. The absence of IUD strings during follow-up should prompt immediate suspicion of uterine perforation, necessitating prompt multidisciplinary intervention to mitigate serious outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic lacerated lung with diffuse corpora amylacea; the wasteosomes of protection -case report and review of literature","authors":"Aparna Ningombam ,&nbsp;Hemlata Jangir ,&nbsp;Arulselvi Subramanian ,&nbsp;Subodh Garg","doi":"10.1016/j.hmedic.2025.100162","DOIUrl":"10.1016/j.hmedic.2025.100162","url":null,"abstract":"<div><div>Corpora amylacea (CA) has been associated with ageing and various pathological disorders of different organs. Numerous hypotheses and postulates surrounding its origin and functions are available. We report here a case of a traumatic lacerated lung in a 49-year-old male with histopathological findings of diffuse corpora amylacea both intracellularly and extracellularly in the alveoli. The patient recuperated well post-surgical intervention. This case highlights corpora amylacea in the body’s defense and protective mechanism. It is unique as it is usually observed in autopsy findings, but we report these from a surgically resected lung as a management of trauma. It reiterates recent conjecture that these bodies are waste containers or wasteosomes, not only as a part of ageing but in various scenarios of oxidative stress, external factors which advertently activate the ubiquitin-proteasome degradation pathway.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"9 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}