European journal of case reports in internal medicine最新文献

{"title":"One Haemolytic Anaemia May Hide Another: Paroxysmal Nocturnal Haemoglobinuria Masquerading As <i>Plasmodium Falciparum</i> Infection.","authors":"Alexandre-Raphael Wery, Coline Mortier, Quentin Cabrera, Mohamadou Niang, Moumini Kone, Sarah Permal","doi":"10.12890/2024_004749","DOIUrl":"10.12890/2024_004749","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, genetic and acquired haematologic disease that causes complement-mediated intravascular haemolytic anaemia, thrombosis and bone marrow failure.</p><p><strong>Case description: </strong>A 27-year-old migrant patient attended the emergency department in a context of fever and chills over the previous few days as well as chronic fatigue, dyspnoea and chest pain. His medical history included chronic anaemia and erectile dysfunction. Initial biology showed a haemoglobin of 6.3 g/dl, platelets of 25,000/μl, total leucocytes of 3,500/μl with 1,500 neutrophils. B12 vitamin, folic acid, ferritin and thyroid stimulating hormone were normal. Lactate dehydrogenase levels were high and haptoglobin was non-measurable. C-reactive protein was 46.1 mg/l. A thick blood smear revealed <i>Plasmodium falciparum</i> infection with 0.1% parasitaemia. The patient was treated with an oral combination of artemether and lumefantrine. Three weeks later, the patient consulted the infectious disease department given the lack of clinical improvement. The cytopenias worsened, and lactate dehydrogenase (LDH) and reticulocytes increased. Tests for schistocytes, a thick blood smear for malaria and a direct Coombs test were negative; a myelogram was reassuring. An abdominal, pelvic and thoracic CT scan showed a mild hepatomegaly with no focal lesion and no splenomegaly or adenomegaly. A 12-colour flow cytometry unveiled a PNH clone on 90.9545% of neutrophils and 80.7371% of monocytes.</p><p><strong>Discussion: </strong>PNH patients can be vulnerable to parasites infection (such as <i>P. falciparum</i>) as it may trigger breakthrough haemolysis through uncontrolled resurgence of activity of the complement system. In our patient, <i>P. falciparum</i> infection was a confounding factor, as it commonly causes haemolytic anaemia and thrombocytopenia, and patients living in malaria-endemic regions can carry low parasitaemia while being slightly symptomatic or asymptomatic.</p><p><strong>Learning points: </strong><i>Plasmodium falciparum</i> infection can cause breakthrough haemolysis in patients with paroxysmal nocturnal haemoglobinuria.Low <i>P. falciparum</i> parasitemia in patients living in malaria-endemic regions is not always significant as these patients often carry acquired immunity.Patients from malaria-endemic regions presenting with severe sickness and low <i>P. falciparum</i> parasitemia must be assessed for other diseases, as it cannot explain heavy illness.Patients presenting with haemolytic anaemia, no schistocytes, a negative direct Coombs test and other unexplained cytopenia such as thrombocytopenia/neutropenia and other unexplained clinical manifestations such as dyspnoea, chest pain or erectile dysfunction should be assessed for paroxysmal nocturnal haemoglobinuria.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153436","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 Inflammatory Myofibroblastic Tumour Presenting with Limited Mouth-Opening, Hypoesthaesia of The Left Chin and Infraorbital Area, Intermittent Left Eye Ptosis and Converging Strabismus.","authors":"Imen Ben Hassine, Wiem Romdhane, Raouaa Belkacem, Jihed Anoun, Wafa Baya, Anis Mzabi, Fatma Ben Fredj","doi":"10.12890/2024_004568","DOIUrl":"10.12890/2024_004568","url":null,"abstract":"<p><p>An inflammatory myofibroblastic tumour (IMT) is a rare neoplasm of mesenchymal origin, defined by myofibroblastic spindle cells accompanied by inflammatory cells, lymphocytes and eosinophils. Its symptomatology depends on the involved site and tends to mimic a malignant tumour clinically and radiologically. The head and neck region accounts for 5% of all IMTs. Here, we report a case of a 35-year-old woman, with no medical history, who presented with a mouth-opening limitation of 8 mm evolving for three years and occurring six months after of a wisdom tooth extraction. She also experienced a recent occurrence of left eye ptosis and a converging strabismus. On examination, the patient had a body temperature at 37°C, with hypoesthaesia of the left chin and infraorbital area, without any other abnormality. Laboratory examinations did not reveal a biological inflammatory syndrome or rhabdomyolysis. The infectious investigations were all negative, as well as the immunological tests, in particular negative for anti-AChR and anti-MuSK antibodies. On the facial computed tomography (CT) scan, we noted an active reshuffle in the left mandible ascending branch with a thickening of the ipsilateral pterygoid muscles and the left temporal meningeal tissue. After corticosteroid therapy 0.7 mg/kg/j, we obtained an improvement in the patient's mouth-opening, thus a biopsy of the lesion was performed under local anaesthesia, revealing IMT. The patient continued the corticosteroids therapy with a progressive tapering resulting in a marked clinical improvement of the mouth-opening limitation and her ptosis.</p><p><strong>Learning points: </strong>An inflammatory myofibroblastic tumour (IMT) is a challenging disease.Given the variable clinical and radiological presentation of the disease, it is of paramount importance to know it, to be swiftly recognised so diagnosis can be promptly made.The adapted treatment should be immediately started to prevent possible life-threatening outcomes.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153420","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":"Oxaliplatin-Induced Immune Thrombocytopenia in a Patient with Pancreatic Cancer.","authors":"Mustafa Şentürk, Özden Altundağ","doi":"10.12890/2024_004782","DOIUrl":"10.12890/2024_004782","url":null,"abstract":"<p><p>Oxaliplatin-induced immune thrombocytopenia is a rare but potentially serious complication of chemotherapy. We present the case of a 55-year-old man with stage 4 pancreatic carcinoma who developed immune thrombocytopenia during the 18^th cycle of folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) chemotherapy, immediately after oxaliplatin infusion. Despite treatment with methylprednisolone and platelet infusion, the patient's platelet count remained low. Subsequent plasmapheresis and continued steroid therapy resulted in a gradual improvement in platelet count and resolution of symptoms. This case highlights the importance of considering immune thrombocytopenia in patients receiving oxaliplatin-based chemotherapy, and the potential role of plasmapheresis in refractory cases. Further research is needed to elucidate the optimal management of this rare complication.</p><p><strong>Learning points: </strong>Oxaliplatin-induced immune thrombocytopenia is a rare but potentially life-threatening side effect of chemotherapy.Management of drug-induced immune thrombocytopenia involves discontinuation of the offending drug and the use of steroids.Monitoring and follow-up are crucial in patients receiving oxaliplatin-based chemotherapy to promptly detect and manage potential hematologic emergencies, including immune thrombocytopenia.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153461","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":"Facial Venous Tumour Thrombus from Submandibular Gland Mucoepidermoid Carcinoma: An Atypical Tumour Spread in Head and Neck Cancer.","authors":"Mariam Malik, Rana Bilal Idrees, Zeeshan Rashid Mirza, Sharifa Sikandar, Saba Nawaz, Maham Khalid, Muhammad Hamid Chaudhary","doi":"10.12890/2024_004762","DOIUrl":"10.12890/2024_004762","url":null,"abstract":"<p><strong>Background: </strong>Tumour thrombus of the facial vein is an exceedingly rare complication arising from mucoepidermoid carcinoma of the salivary glands. Early detection is pivotal for appropriate management, as delays can lead to metastatic disease, worsening the prognosis.</p><p><strong>Case description: </strong>We present a case involving a 76-year-old male with a history of mucoepidermoid carcinoma of the right submandibular gland, previously treated with surgical resection and radiotherapy. The patient, a long-term worker in a rubber factory, presented with a painless, firm swelling in the right cheek, persisting for three months. Contrast-enhanced computed tomography (CECT) showed distended facial vein with enhancing thrombus confirmed by sonographic correlation demonstrating intralesional vascularity. Cannon ball pulmonary nodules were also noted. Radiological findings led to a core biopsy, confirming tumor thrombosis of the facial vein due to mucoepidermoid carcinoma. However, the patient declined a biopsy of the pulmonary nodules, and has been referred to oncology for further management.</p><p><strong>Conclusions: </strong>This case highlights the critical importance of considering venous tumour thrombus in patients with previous salivary gland malignancies presenting with new or persistent facial swellings. It emphasises the role of advanced imaging techniques in the early identification of this rare entity. Additionally, it stresses the need for healthcare providers to engage in thorough discussions with patients about the potential consequences of forgoing recommended treatments, reinforcing the need for vigilance in monitoring such patients.</p><p><strong>Learning points: </strong>Tumours of head and neck may cause thrombosis of veins by direct invasion resulting in a tumour thrombus, or indirectly by exerting a mass effect and vein compression.These can be distinguished by contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI).Doppler ultrasound may show patchy neovascularisation in a tumour thrombus, which would be absent if thrombosis was caused by compression.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153423","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":"Small Intestinal Obstruction Secondary to Migrated Intragastric Balloon Retrieved Endoscopically from the Jejunum.","authors":"Khaled Bamakhrama, Suhana Riyaz, Mizna Musthafa","doi":"10.12890/2024_004743","DOIUrl":"10.12890/2024_004743","url":null,"abstract":"<p><strong>Introduction: </strong>The intragastric balloon is a medical device inserted into the stomach endoscopically and filled with either air or more commonly, saline. Widely utilised since the 1980s, numerous studies have affirmed its safety and effectiveness as a temporary treatment for weight loss. Despite this, there have been reports of rare but severe complications associated with its usage.</p><p><strong>Case description: </strong>We report the case of a 33-year-old female presented with two-day history of epigastric pain, nausea and vomiting. This occurred after having a gastric balloon placed endoscopically two months earlier. A contrast-enhanced abdominal CT scan revealed a partially deflated and migrated intragastric balloon in the proximal jejunum, causing intestinal obstruction without any signs of bowel perforation. The diagnosis was established as intestinal obstruction due to the migrated intragastric balloon. An emergency endoscopic procedure was undertaken, successfully removing the balloon thus highlighting a unique attempt to endoscopically retrieve a migrated intragastric balloon from the jejunum.</p><p><strong>Conclusion: </strong>The efficacy of an intragastric balloon in reducing weight in a short time is gaining more popularity. The more common it becomes the more we must be vigilant about its complications. We advise regular follow-up of patients and emphasise patient education of possible signs and symptoms of intragastric balloon migration, which will avoid serious complications.</p><p><strong>Learning points: </strong>Endoscopic removal from the jejunum: Learn the procedure for endoscopic removal of a migrated gastric balloon from the jejunum, recognising it is possible without signs of perforation or leakage. Additionally, understand the importance of performing this procedure with surgical backup in a theatre to address any potential complications, such as perforation, during or after the procedure.The role of CT scans: Understand the crucial role of CT scans in diagnosing migrated gastric balloons or perforations related to gastric balloon procedures.Recognising and responding to balloon deflation: Identify signs of a deflated gastric balloon, such as methylene blue in the urine, and understand associated symptoms such as reduction in stomach fullness.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153463","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":"Mogad may not only Mimic Immune or Infectious Encephalitis, but can also be Triggered by Viral Infections.","authors":"Josef Finsterer","doi":"10.12890/2024_004764","DOIUrl":"10.12890/2024_004764","url":null,"abstract":"","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153426","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 Successful Laparoscopic Appendectomy for an Adult Male Patient with Osteogenesis Imperfecta.","authors":"Mohamed I Farid, Azza Baz, Mohamed Emad El-Dein Hemdan, Taghreed Abdelhamid, Diyaa Ebrahim, Fadl Fayed, Emad Abdel-Haleem","doi":"10.12890/2024_004738","DOIUrl":"10.12890/2024_004738","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a genetic connective tissue disease defined by the loss of bone mass and density, which makes the bones more brittle and more likely to fracture over time. Bone deformity and articular instability are the subsequent symptoms.</p><p><strong>Case report: </strong>This 25-year-old man had malformed lower limbs and trouble walking due to OI and dwarfism. He arrived complaining of fever, nausea, vomiting and diffuse peri-umbilical pain. During ultrasonography a blinded, oedematous lobe formation containing an appendicolith was discovered. Acute suppurative appendicitis was diagnosed, necessitating a laparoscopic appendectomy. Because the patient had previously undergone general anaesthesia, anaesthesia was thought to be attainable. Pneumoperitoneum and a 10 mm optical port inserted into the umbilicus were used in the surgical procedure. A diagnostic laparoscopy revealed faecolith obstruction and an acute suppurative appendicitis. After an hour, a laparoscopic appendectomy was performed effectively with little blood loss. Without experiencing any difficulties because of the surgery position, the patient was discharged.</p><p><strong>Conclusion: </strong>We present a case of an OI dwarf patient with acute suppurative appendicitis. It highlights the possibility of performing laparoscopic surgery in general and a laparoscopic appendectomy in particular on OI patients.</p><p><strong>Learning points: </strong>In rare instances involving OI, laparoscopic surgery in general and laparoscopic appendectomy in particular are practical and efficient options.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153419","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":"Mycophenolate Mofetil for the Treatment of Warm Autoimmune Haemolytic Anaemia Post-Rituximab Therapy: A Case Series.","authors":"Oscar F Borja-Montes, Alejandro Toro-Pedroza, Darrell D Horton, Leslie A Andritsos, Ala Ebaid","doi":"10.12890/2024_004780","DOIUrl":"10.12890/2024_004780","url":null,"abstract":"<p><strong>Background: </strong>Warm autoimmune haemolytic anaemia (wAIHA) is an acquired haemolytic disorder most commonly treated with a combination of corticosteroids, rituximab and/or splenectomy. Third-line therapies for refractory cases include immunosuppressive agents. Mycophenolate mofetil is frequently used in these scenarios, although its use is supported by small studies and anecdotal evidence rather than large-scale data.</p><p><strong>Case description: </strong>We describe three cases of refractory warm autoimmune haemolytic anaemia successfully treated with mycophenolate mofetil. Case 1: A persistent case of autoimmune haemolytic anaemia in a 56-year-old was ultimately managed with mycophenolate mofetil, leading to successful steroid tapering and stable haemoglobin levels without relapse. Case 2: A woman with a complex oncological history, including lymphoma and breast cancer, achieved remission with mycophenolate therapy, maintaining stability post-steroid treatment. Case 3: Mycophenolate proved effective for a 63-year-old with cirrhosis after recurrent autoimmune anaemia and deep vein thrombosis, enabling cessation of steroids and maintaining remission.</p><p><strong>Conclusion: </strong>Management of this condition can be challenging and balancing the available treatments is crucial to reduce potential complications from long-term therapies that appear to be ineffective. Our case series demonstrates anecdotal experience on successful use of mycophenolate mofetil for complex refractory cases of wAIHA.</p><p><strong>Learning points: </strong>Warm autoimmune haemolytic anaemia can be a challenging condition to manage. Refractory cases that are steroid-dependent can benefit from trialling steroid-sparing agents such as mycophenolate.Anti-CD20 agents such as rituximab can be very effective in refractory cases, however there is a small percentage of patients that might not be responsive to this monoclonal antibody.Autoimmune haemolytic anaemias can be frequently complicated by thrombotic events, and part of the backbone treatment is establishing good thromboprophylaxis.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153427","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 Intimate Relationship Lies Between the Appendix and the Colon: A Case Report of Colitis Cystica Profunda Post-Laparoscopic Appendectomy.","authors":"Houssein Chebbo, Amer Yazbak, Sarah Saleh, Karam Karam, Lamia Azizi, Elias Fiani","doi":"10.12890/2024_004783","DOIUrl":"10.12890/2024_004783","url":null,"abstract":"<p><p>Cystica profunda is a rare benign finding of mucous-filled cysts in the submucosa of the gastrointestinal tract, more commonly found in the rectum and colon. Risk factors include rectal prolapse, inflammatory bowel diseases, pelvic radiation and being post-appendectomy. We present a case of a female patient presenting with rectorrhagia, found to have sigmoidal colitis cystica profunda (CCP) six months post-appendectomy. This case is one of the few in medical literature to highlight the direct association between laparoscopic appendectomy and CCP, previously discussed in the literature as a complication post-appendectomy in the American Journal of Gastroenterology.</p><p><strong>Learning points: </strong>Physicians should have a high index of suspicion to rule out colitis cystica profunda (CCP) when approaching a patient with rectorrhagia following laparoscopic appendectomy.It is pivotal to make a prompt diagnosis for CCP in the context of rectorrhagia and initiate timely management.It is important to differentiate CCP from other aetiologies of lower gastrointestinal tract bleed as it is coined 'the great imitator'.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153421","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":"Syphilis Should not be Overlooked in any Individual, Irrespective of their Condition.","authors":"Oriane Cellier, Juliette Jourdan, Lotfi Dahmane, Véronique Perronne, Aurélien Dinh, Karim Jaffal","doi":"10.12890/2024_004578","DOIUrl":"10.12890/2024_004578","url":null,"abstract":"<p><strong>Introduction: </strong>Syphilis remains a significant challenge in public health, largely because of its diverse clinical manifestations, often resulting in underdiagnosis especially among patients with neurogenic disability.</p><p><strong>Case description: </strong>We present a case of neurosyphilis in a 63-year-old patient with a spinal cord injury. Despite syphilis being a well-established sexually transmitted infection, the exacerbation of neurological and dermatological symptoms during physical examination prompted an investigation into alternative causes beyond the patient's pre-existing paraparesis, ultimately resulting in the diagnosis of neurosyphilis.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering syphilis as a potential diagnosis in individuals regardless of their medical history.</p><p><strong>Learning points: </strong>The incidence of syphilis cases is on the rise, presenting an ongoing challenge.Faced with atypical neurological symptomatology, it is necessary to know how to investigate and discuss tertiary syphilis.In the event of neurological worsening in a neuro-injured patient, it is necessary to know how to discuss a curable diagnosis.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153465","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}