Medical Reports最新文献

{"title":"Ictal whistling as the first clinical sign of amygdala onset seizure on sEEG, a review of the literature and case report","authors":"Ahmad Yusuf Solaiman ,&nbsp;Mohammad Alkhoujah ,&nbsp;Mo'men K. Kahhaleh","doi":"10.1016/j.hmedic.2025.100348","DOIUrl":"10.1016/j.hmedic.2025.100348","url":null,"abstract":"<div><div>Ictal whistling (IW) is a rare type of mimic musical automatisms, which is usually reported in temporal lobe epilepsy. Accurate localization is crucial for the diagnosis and appropriate epilepsy treatment planning. In this report, we are describing a case of precise localization of ictal whistling seizures using intracranial stereo-EEG (sEEG). Clinically, symptoms were consistent with loss of awareness and mimic automatisms: whistling and blowing air, time-locked to an ictal pattern over the deep contacts of the left amygdala spreading promptly to the entire mesial hippocampal area. Although there was a structural abnormality (bilateral occipital horn heterotopia), it was not involved in the ictal pattern during the sEEG, which was crucial in determining our surgical options. We hypothesize that ictal whistling may be considered as an oroalimentary automatism, given that such symptoms are typically associated with seizure activity originating in the amygdala and peri-amygdaloid region.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907206","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}

{"title":"Triple attack: Cytomegalovirus, mycobacterium avium complex and aspergillus co-infection presenting as a cavitary pulmonary lesion in a patient with human immunodeficiency virus","authors":"Ryan Njeim ,&nbsp;Michel Al-Achkar ,&nbsp;Wei Xue ,&nbsp;Allison Glaser","doi":"10.1016/j.hmedic.2025.100350","DOIUrl":"10.1016/j.hmedic.2025.100350","url":null,"abstract":"<div><h3>Background</h3><div>Opportunistic infections are a significant concern in immunocompromised patients, particularly those with human immunodeficiency virus (HIV). The diagnosis of these infections can be challenging due to overlapping clinical and radiological findings.</div></div><div><h3>Case description</h3><div>We report a rare case of triple co-infection by cytomegalovirus (CMV), Mycobacterium chimaera, and Aspergillus fumigatus causing pneumonia with a cavitary lesion in a 43-year-old HIV-infected female, non-adherent to antiretroviral therapy. Chest imaging revealed a left upper lobe cavitary lesion with ground-glass opacities. Serum CMV PCR was strongly positive. Bronchoscopic biopsy showed Aspergillus and focal CMV pneumonia, while post-discharge culture grew Aspergillus and Mycobacterium chimaera. The patient was treated with intravenous ganciclovir and voriconazole, then discharged on oral medications with plans for MAC treatment.</div></div><div><h3>Conclusion</h3><div>This case represents the first reported triple co-infection of its kind, particularly noteworthy given the patient's CD4 count above 50 cells/mm³ . It underscores the importance of comprehensive diagnostic workup and highlights the challenges in managing multiple opportunistic infections in severely immunocompromised individuals.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896264","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}

{"title":"Kawasaki disease as a rare cause of suppurative sterile lymphadenitis in pediatrics","authors":"Sarah Magdy Abdelmohsen ,&nbsp;Walid Hussein ,&nbsp;Marwa T. Hussien","doi":"10.1016/j.hmedic.2025.100351","DOIUrl":"10.1016/j.hmedic.2025.100351","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric surgeons frequently encounter pediatric patients with various differential diagnoses for neck lymph node swelling. Kawasaki disease is a rare cause of neck lymph node swelling in children.</div></div><div><h3>Case reports</h3><div>A nine-year-old boy presented with a right-sided neck lymph node mass and fever for two days. Inflammatory markers were elevated. An abscess or liquefactive necrosis developed within the enlarged lymph nodes. An intraoperative swab tested negative for pathogens, and the blood culture was unremarkable. The child was diagnosed with Kawasaki disease.</div></div><div><h3>Discussion</h3><div>The number of children diagnosed with Kawasaki disease has increased over the past two years, particularly during the COVID-19 pandemic. In this case, the sterile abscess resulted from the vascular necrosis of significantly enlarged lymph nodes and vasculitis affecting the supplying blood vessels.</div></div><div><h3>Conclusion</h3><div>Kawasaki disease is a rare cause of suppurative sterile neck lymphadenitis in children. Early diagnosis and timely treatment with intravenous immunoglobulin (IVIG) significantly improve the prognosis of Kawasaki disease.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100351"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026608","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}

{"title":"A comprehensive analysis of aberrant immunophenotypes in T-ALL","authors":"Chintamani Pathak,&nbsp;Neha Aggarwal,&nbsp;Smriti Sharan,&nbsp;Siddhartha Sankar Samanta","doi":"10.1016/j.hmedic.2025.100347","DOIUrl":"10.1016/j.hmedic.2025.100347","url":null,"abstract":"<div><div>T cell Acute Lymphoblastic Leukemia (T-ALL) is an aggressive hematologic malignancy characterized by the clonal proliferation of immature T lymphocytes. It accounts for approximately 15 % of childhood ALL cases. Aberrant expression of immunophenotype markers is not uncommon in Acute leukemia, especially T-ALL. Aberrant phenotype in T ALL previously are CD10, CD19,CD79a, CD13, CD33, CD117, CD15 and CD11b. In this case series, we describe clinicopathological profile of 7 T ALL cases with aberrant immunophenotype. All cases diagnosed as T ALL on flow cytometry over a period of 2.5 years were included in this study with emphasis on cases expressing aberrant immunophenotype.Among 29 diagnosed cases T ALL, 8 cases exhibited expression of aberrant markers CD10 (6 cases, paediatric), CD33 (1 case, paediatric),CD117 (1 case, paediatric)co expression of CD10 and CD33 (1 case, paediatric), co expression of CD10, CD79a and CD13 (1 case, adult). The detection of aberrant immunophenotypic markers in T-ALL poses considerable diagnostic challenges. The study underscores the importance of comprehensive diagnostic workup including flowcytometry in managing atypical presentations of T-ALL. It highlights the diagnostic complexity of common &amp; uncommon aberrant immunophenotypes in T-ALL, emphasizing the need for detailed molecular and immunophenotypic profiling to guide treatment planning.In our study, CD10 was found to be the most common aberrant immunophenotype as reported previously. The only adult patient with aberrant immunophenotype had coexpression of 3 CD markers and 1 paediatric case coexpressed 2 CD markers which is rare. None of our cases showed aberrant expression of CD19, CD15 and CD11b.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896288","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}

{"title":"Mucinous carcinoma of the breast: A case report and comprehensive literature review","authors":"A. Khallaf ,&nbsp;M. Oussafi ,&nbsp;H. Ouazzani ,&nbsp;I. Chaouche ,&nbsp;A. Akammar ,&nbsp;N. EL Bouardi ,&nbsp;B. Alami ,&nbsp;MY. Alaoui Lamrani ,&nbsp;M. Maaroufi ,&nbsp;M. Boubbou","doi":"10.1016/j.hmedic.2025.100346","DOIUrl":"10.1016/j.hmedic.2025.100346","url":null,"abstract":"<div><h3>Background</h3><div>Mucinous carcinoma is a rare histologic subtype of breast cancer, accounting for 1–4 % of all cases. It predominantly affects older women and generally presents a favorable prognosis compared to other invasive breast cancers.</div></div><div><h3>Case summary</h3><div>We report the case of a 54-year-old woman presenting with a slowly enlarging right breast mass. Clinical and imaging examinations revealed a lobulated lesion in the lower outer quadrant of the right breast. Core needle biopsy confirmed the diagnosis of grade II mucinous carcinoma. The patient underwent mastectomy with sentinel lymph node biopsy, which was negative for metastasis. Histopathological examination confirmed a pure mucinous carcinoma. Postoperatively, the patient was referred for adjuvant radiotherapy.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of correlating imaging and histological features to ensure timely diagnosis of mucinous carcinoma and underscores its generally favorable outcome when appropriately managed.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100346"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865319","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}

{"title":"Recurrent ischemic strokes in a patient with ITP: A case report","authors":"Ahmad S. Ali ,&nbsp;Yaqian Xu ,&nbsp;Walter Husar","doi":"10.1016/j.hmedic.2025.100343","DOIUrl":"10.1016/j.hmedic.2025.100343","url":null,"abstract":"<div><h3>Background</h3><div>Primary Immune Thrombocytopenia (ITP) is typically associated with bleeding risks due to thrombocytopenia. However, paradoxical thrombotic events such as stroke may occur in rare cases, posing a clinical dilemma in management.</div></div><div><h3>Case presentation</h3><div>We present the case of a 65-year-old male with a history of ITP and recurrent venous thromboembolism who experienced multiple ischemic strokes despite therapeutic anticoagulation. The initial presentation revealed subacute bilateral frontal infarcts while on Rivaroxaban, with extensive workup suggesting a cryptogenic stroke etiology. The patient was subsequently switched to Warfarin and treated for ITP with steroids and Rituximab, resulting in improved platelet counts. Eight months later, he suffered a pontine infarct despite therapeutic INR. His anticoagulation goal was adjusted, and he remained stroke-free on close follow-up.</div></div><div><h3>Discussion:</h3><div>This case highlights the underrecognized thrombotic risk in ITP patients and the challenges in balancing anticoagulation with bleeding risk. Mechanisms may include increased platelet microparticles and immune-mediated endothelial injury. The individualized INR target and ITP treatment strategy led to improved clinical outcomes.</div></div><div><h3>Conclusion</h3><div>ITP can predispose patients to thrombotic complications such as stroke, even in the setting of thrombocytopenia. Personalized anticoagulation goals and multidisciplinary care are critical for optimal management. Further studies are needed to establish standardized treatment guidelines for this unique patient population.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157642","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}

{"title":"When immunotherapy strikes the heart: A multimodal approach to immune checkpoint inhibitors induced myocarditis: A case series and literature review","authors":"Ahmed Basuoni ,&nbsp;Marwa Makhlouf ,&nbsp;Waleed Dawelbeit ,&nbsp;Donia Ahmed ,&nbsp;Hadil Al-Sharqi ,&nbsp;Suhaila Al Farsi ,&nbsp;Khalid Al-Baimani","doi":"10.1016/j.hmedic.2025.100345","DOIUrl":"10.1016/j.hmedic.2025.100345","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICI) use is associated with potentially life-threatening cardiovascular complication including myocarditis. This case series aims to evaluate the different management approaches and outcomes of ICI-induced myocarditis with a comparative review with international benchmarks.</div></div><div><h3>Methods</h3><div>This retrospective case series analyzed patients diagnosed with ICI-induced myocarditis at Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC). The diagnosis of ICI-induced myocarditis was based on clinical presentation, cardiac biomarkers, and cardiac imaging after the exclusion of other differential diagnoses. Management strategies included corticosteroids and immunosuppressive therapy. Clinical outcomes and mortality were monitored longitudinally compared with a literature review of international benchmarks.</div></div><div><h3>Results</h3><div>A total of 6 cases were identified over 2 years, with a myocarditis prevalence of 1.8 %. Myocarditis onset occurred anytime between the first and the ninth cycle, with clinical presentations varying from mild symptoms to severe presentations with stroke, steroid resistance, and cardiogenic shock. Multimodality imaging, particularly cardiac magnetic resonance, was utilized; the mainstay therapy included corticosteroids, with one refractory case requiring mycophenolate mofetil (MMF). Complete recovery occurred in five patients.</div></div><div><h3>Conclusion</h3><div>The study outcome showed that the incidence of ICI-induced myocarditis may be under-reported due to underdiagnosis and the absence of risk stratification protocols in many cancer centers. For treatment of non-fulminant or Grade I/II cases, oral steroids should be considered, while steroid resistance may necessitate alternative immunosuppressive therapies. Multidisciplinary team discussions are essential to assess the continuation of ICI therapy in possible cases. Protocols enhancing early detection and timely steroid therapy initiation improve outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100345"},"PeriodicalIF":0.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865317","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}

{"title":"Atypical cutaneous manifestations in hyperimmunoglobulin D syndrome: A case report","authors":"Waad Alotaibi ,&nbsp;Aisha Mirza ,&nbsp;Hana Halabi ,&nbsp;Amer Khojah","doi":"10.1016/j.hmedic.2025.100344","DOIUrl":"10.1016/j.hmedic.2025.100344","url":null,"abstract":"<div><div>Hyperimmunoglobulin D syndrome (HIDS) is a rare autosomal recessive autoinflammatory disorder caused by mutations in the mevalonate kinase (MVK)gene. It is characterized by recurrent fever episodes, abdominal pain, elevated serum IgD levels, and systemic inflammation. We report a 5-year-old boy presenting with recurrent fever, abdominal pain, diarrhea, and hyperpigmented skin lesions. Physical examination revealed abdominal distension and multiple café-au-lait like spots on the lower extremities, with no lymphadenopathy or organomegaly. Whole-exome sequencing revealed a homozygous missense pathogenic variant (c.1129G&gt;A; p.Val377Ile) in MVK gene. Abdominal CT revealed colonic wall thickening with mucosal hyperenhancement. However, the lower GI endoscopy was unremarkable. Skin biopsy was consistent with café-au-lait spots. Despite the inadequate response to colchicine and anakinra, the patient showed significant clinical improvement with canakinumab. This case underscores the diagnostic complexity of HIDS and suggests a potential novel association with café-au-lait macules. Early genetic testing is crucial for timely diagnosis and targeted therapy.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100344"},"PeriodicalIF":0.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860304","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}

{"title":"Granulomatous mastitis: A 5-year single-center case series from North Africa","authors":"Regragui abdelmajide ,&nbsp;Marouane boukroute ,&nbsp;Hafsa Taheri ,&nbsp;Hanane Saadi ,&nbsp;Pr Ahmed Mimouni","doi":"10.1016/j.hmedic.2025.100341","DOIUrl":"10.1016/j.hmedic.2025.100341","url":null,"abstract":"<div><div>Granulomatous mastitis (GM) is a rare, benign, chronic inflammatory breast disease that clinically mimics malignancy. Despite increased recognition, GM remains difficult to diagnose and manage due to its nonspecific presentation and unclear etiology. To characterize the clinico-radiological and histopathological spectrum of granulomatous mastitis, identify factors associated with recurrence, and propose a context-specific diagnostic and therapeutic algorithm suitable for low-resource settings. A retrospective analysis of all histologically confirmed GM cases treated at CHU Mohammed VI Oujda from 2019 to 2024 was conducted. Demographic, clinical, imaging, histopathological, and therapeutic data were extracted and analyzed. Recurrence risk was assessed based on management strategies and clinical presentation. Forty-five cases of GM were identified. The mean age was 34 years; 78 % were multiparous and 91 % had a history of breastfeeding. The most frequent presentation was a unilateral breast mass (84 %), often painful (65 %) with inflammatory signs (47 %). Imaging findings were nonspecific; ultrasound showed irregular hypoechoic masses in 68 % of cases. Histopathology confirmed non-caseating lobulocentric granulomas in all cases. Corticosteroids were administered in 40 %, surgery in 35 %, while 15 % had spontaneous resolution. The recurrence rate was 18 %, predominantly among those managed conservatively or without corticosteroids. GM poses diagnostic and therapeutic challenges, particularly in resource-limited contexts. Accurate histopathological diagnosis is essential to avoid mismanagement. Recurrence appears more likely with conservative strategies, highlighting the need for standardized, individualized management. A diagnostic and therapeutic algorithm is proposed to guide clinical decision-making.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100341"},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827277","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}

{"title":"Takayasu Arteritis presenting with stroke: A case of lateral medullary syndrome in a 29-year-old female","authors":"Chowdhury Adnan Sami ,&nbsp;Mohammad Ferdous Ur Rahaman ,&nbsp;Rafsana ,&nbsp;Shohael Mahmud Arafat ,&nbsp;Md Nazmul Hasan","doi":"10.1016/j.hmedic.2025.100338","DOIUrl":"10.1016/j.hmedic.2025.100338","url":null,"abstract":"<div><div>Takayasu arteritis (TA) is a chronic large vessel vasculitis that typically targets the major vessels of our body, like the aorta and its branches. Infarction of the lateral medullatermed lateral medullary syndrome, is a rare presenting feature of TA. Our report presents a 29-year-old female who was diagnosed with TA, but her presentation was a rare early manifestation of TA, presenting with lateral medullary syndrome. She came to the hospital with gradually worsening vertigo, partial ptosis, dysphagia, contralateral sensory loss, and gait instability over a period of hours. On initial physical examination, her pulse and blood pressure were missing on the left upper limb. An Imaging test, which showed significant left vertebral artery stenosis and ischemic infarction in the lateral medulla. Further tests like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were raised, while the autoimmune panel and the coagulation panel results were negative. Diagnosis of TA was made, and treatment was started for TA with steroids and methotrexate and for stroke with aspirin and atorvastatin. Treatment showed significant improvement in symptoms within the two months of strict compliance. This case emphasizes the importance of early diagnosis and thorough treatment in young TA patients who present with rare ischemic events.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100338"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828957","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}