Journal of Medical Case Reports最新文献

{"title":"Evans syndrome as a presentation in systemic lupus erythematous, coexisting with Hashimoto's thyroiditis and pernicious anemia: a case report.","authors":"Maryam Mansour, Arwa Shamasnah, Deema Alsaadi, Saja Abu Saif, Akram Krama","doi":"10.1186/s13256-024-05002-3","DOIUrl":"10.1186/s13256-024-05002-3","url":null,"abstract":"<p><strong>Background: </strong>Evans syndrome is a rare disorder characterized by the simultaneous or sequential combination of autoimmune hemolytic anemia and immunological thrombocytopenia, together with a positive direct antiglobulin test. This syndrome, which can be primary or secondary, is a rare initial manifestation of autoimmune diseases, notably systemic lupus erythematosus, with 1.7-2.7% of patients with systemic lupus erythematosus developing secondary Evans syndrome, sometimes preceding the onset of systemic lupus erythematosus symptoms.</p><p><strong>Case presentation: </strong>A 47-year-old Middle Eastern female presented with symptoms including shortness of breath, chest pain, and weakness. Physical examination revealed pallor, pale conjunctiva, icteric sclera, tachycardia, and tachypnea. She was diagnosed with Evans syndrome owing to hemolytic anemia, thrombocytopenia, and a positive Coombs test, where initial resistance to treatment prompted intensive therapy with methylprednisolone, intravenous immunoglobulin, and rituximab. Subsequent identification of systemic lupus erythematosus on the basis of positive anti-nuclear antibodies and anti-double-stranded deoxyribonucleic acid antibodies led to treatment with mycophenolate mofetil and hydroxychloroquine. Further evaluations uncovered Hashimoto's thyroiditis and pernicious anemia, necessitating thyroxine supplementation and vitamin B12 injections.</p><p><strong>Conclusion: </strong>Hematologic abnormalities play a crucial role in the diagnostic framework of systemic lupus erythematosus. This case highlights a patient initially diagnosed with Evans syndrome, revealing an underlying systemic lupus erythematosus. The presentation underscores the significance of hematologic manifestations as integral components of the diagnostic framework for autoimmune diseases, emphasizing the intricate relationship between Evans syndrome and systemic lupus erythematosus.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"643"},"PeriodicalIF":0.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895363","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 staged approach to managing a combination of a terrible triad injury and an Essex-Lopresti fracture dislocation: an open forearm crush injury-a case report.","authors":"Abdulla Abdelwahab, Ahmed Khairy Farahat Elsayed, Hamed Badawi","doi":"10.1186/s13256-024-04974-6","DOIUrl":"10.1186/s13256-024-04974-6","url":null,"abstract":"<p><strong>Background: </strong>Open and crushed forearm injury is a complex and rare injury affecting the upper extremity. It results in damage to various structures, including bones, soft tissues, and neurovascular bundles, ultimately leading to functional impairment. Typically, these injuries occur owing to high-energy trauma.</p><p><strong>Case presentation: </strong>A 19-year-old South Asian male was seen at our trauma center emergency department following an accident where his arm got entangled in a machine belt. He sustained a serious open injury on his left forearm, spanning from the elbow to the wrist, affecting the proximal radio-ulnar joint, ulna bone, interosseous membrane, and distal radio-ulnar joint. The initial plan of care involved stabilizing the injury using an external fixator, while reconstructive surgery was scheduled for a later date.</p><p><strong>Conclusion: </strong>Timely intervention for wound debridement and joint stabilization plays a crucial role in the restoration of a crushed forearm. Following this, a collaborative effort from a multidisciplinary team becomes essential. Planning multiple surgeries is important, with the primary goal of achieving early range of motion of the elbow and wrist to prevent stiffness. This comprehensive approach aims at optimizing the recovery and functionality of the affected limb. The combination of early intervention, damage control surgeries, and carefully planned procedures sets the foundation for successful management of a crushed and open forearm injury. Furthermore, early range of motion and physiotherapy rehabilitation has a key role in stiffness prevention and the restoration of function.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"642"},"PeriodicalIF":0.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895353","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":"Pulmonary infection caused by Tropheryma whipplei: a case report and review of the literature.","authors":"Jianglong Shi, Ren Liu, Jiehui Qiu, Chunping Wei, Dejin Pan, Tianxin Xiang, Na Cheng","doi":"10.1186/s13256-024-04936-y","DOIUrl":"10.1186/s13256-024-04936-y","url":null,"abstract":"<p><strong>Background: </strong>Tropheryma whipplei pneumonia is an infrequent medical condition. The clinical symptoms associated with this disease are nonspecific, often resulting in misdiagnosis or missed diagnosis. Therefore, sharing and summarizing the experiences in the diagnosis and treatment of this disease can deepen global understanding and awareness of it.</p><p><strong>Case presentation: </strong>The patient is a 78-year-old married Han Chinese female who was admitted to the hospital after experiencing fever, dry cough, and fatigue for 4 days. A lung computed tomography scan revealed inflammatory exudation in the lower left lung, accompanied by pleural effusion. The bronchoalveolar lavage fluid was subjected to further analysis using metagenomic next-generation sequencing, which identified 41 genetic sequences associated with Tropheryma whipplei. Consequently, she was diagnosed with Tropheryma whipplei pneumonia. After initiating treatment with doxycycline and biapenem, the patient's symptoms showed significant improvement. Upon discharge, the patient continued treatment with a combination of doxycycline and hydroxychloroquine, which was discontinued after 4 days. At 12-month follow-up, the patient reported overall good health, with no symptoms of fever, cough, or any other discomfort.</p><p><strong>Conclusion: </strong>Tropheryma whipplei pneumonia is a rare condition with nonspecific symptoms. The application of metagenomic next-generation sequencing technology in pulmonary infections helps to rapidly identify rare pathogens, providing a solid foundation for precise and effective antibacterial treatment for patients.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"613"},"PeriodicalIF":0.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895391","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":"Immune checkpoint inhibitor-associated diabetic ketoacidosis and insulin-dependent diabetes: a case report.","authors":"Yungee Jung, Anthony Lau, Joseph Bednarczyk","doi":"10.1186/s13256-024-04852-1","DOIUrl":"10.1186/s13256-024-04852-1","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy, including the use of immune checkpoint inhibitors such as nivolumab, is increasingly common in cancer treatment and can lead to various immune-related adverse effects, including rare cases of diabetic ketoacidosis. This case report highlights an unique instance of nivolumab-induced diabetic ketoacidosis in a patient without prior history of diabetes, emphasizing the importance of careful monitoring even in those without traditional risk factors.</p><p><strong>Case presentation: </strong>We report a case of a 70-year-old Caucasian male with metastatic esophageal adenocarcinoma who developed diabetic ketoacidosis 3 weeks after stopping nivolumab therapy. The patient had no previous history of diabetes, nor had he used sodium-glucose transport protein 2 inhibitors or corticosteroids. Diagnostic tests confirmed diabetic ketoacidosis, and while he was initially treated following the institutional protocol, he continued to require insulin therapy indefinitely.</p><p><strong>Conclusions: </strong>This case report underscores the risk of diabetic ketoacidosis linked to nivolumab, even in patients without predisposing factors, emphasizing the need for increased vigilance among both oncologists and physicians. It highlights the importance of monitoring for new-onset diabetes and diabetic ketoacidosis, whether immunotherapy is active or discontinued, and ensuring comprehensive care including hospitalization, insulin management, and diabetes education if diabetic ketoacidosis is diagnosed.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"611"},"PeriodicalIF":0.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895376","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":"Cholecystectomy-induced thrombotic microangiopathy (TMA) in a postpartum patient successfully treated with eculizumab: a case report.","authors":"Ashley Meyer, Kathryn Uchida, Matthew Nguyen, Kenny Vongbunyong, Dong Ren, Ramy Hanna, Minh-Ha Tran, Omar Darwish","doi":"10.1186/s13256-024-04804-9","DOIUrl":"10.1186/s13256-024-04804-9","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic microangiopathy (TMA) is a rare, life-threatening disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage. Atypical hemolytic uremic syndrome (aHUS) is even less common, comprising less than 10% of hemolytic uremic syndrome (HUS) cases. aHUS in postpartum is associated with poor maternal outcomes, with the majority of cases resulting in end-stage renal disease. aHUS, unlike other types of TMA, is related to complement dysregulation. Thus, the current treatment of choice for aHUS is complement blockade, which limits unregulated activation of complement and complement-mediated end organ damage.</p><p><strong>Case presentation: </strong>We present a rare case of a previously healthy, postpartum, 20-year-old Hispanic female patient who underwent a laparoscopic cholecystectomy and subsequently developed complement-mediated TMA, successfully treated with eculizumab. Unique to our case was renal failure owing to multiple insults and partial resolution of hematologic TMA findings prior to initiation of eculizumab.</p><p><strong>Conclusion: </strong>Our case emphasizes the importance of clinicians possessing a high degree of clinical awareness and judgement surrounding complement-mediated TMA, aHUS and its subsets, and surgery as a precipitator, regardless of safety, particularly during the postpartum period.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"610"},"PeriodicalIF":0.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895361","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":"Excellent response to levetiracetam for recurrent prolonged sleep attacks in an 18-year-old male: a case report.","authors":"Faisal Alfaksh, William Borghol, Saja Karaja, Mohammad Kasem, Naira Shaalan","doi":"10.1186/s13256-024-05007-y","DOIUrl":"10.1186/s13256-024-05007-y","url":null,"abstract":"<p><strong>Background: </strong>Sleep disorders are a common health problem that can be classified into many types that are distinguished by their history and characteristics. In this case report, we discuss a case of a patient suffering from recurrent unusual prolonged sleep attacks lasting up to 9 days that responded excellently to levetiracetam.</p><p><strong>Case presentation: </strong>An 18-year-old Syrian male patient presented to the neurology department complaining of recurrent prolonged sleep episodes lasting for 9 days. Although Kleine-Levin syndrome was suspected, the history and investigations ruled it out. The patient was then treated with levetiracetam as a trial, and the response was excellent.</p><p><strong>Conclusion: </strong>This case is a rare and unusual sleep disorder that does not match any of the known sleep disorders. What makes the case unique is the unexpected response to levetiracetam.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"641"},"PeriodicalIF":0.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895367","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":"Healing by secondary intention over NeoDura applicated on a craniectomy defect: a case report and literature review.","authors":"Axelle Stockmans, Quentin Dumont, Jos Velleman, Frank Van Calenbergh, Katarina Segers","doi":"10.1186/s13256-024-04975-5","DOIUrl":"10.1186/s13256-024-04975-5","url":null,"abstract":"<p><strong>Background: </strong>NeoDura (Medprin Biotech Gmbh) is an absorbable dural repair patch consisting of degradable poly-L-lactic acid and porcine gelatin that provides a hermetic closure of the dura mater (Medprin Biotech. Neodura. Dural Repair Patch [Brochure]. 2016. https://irp.cdn-website.com/762563d2/files/uploaded/a-NeoDura-Broschüre.pdf . Accessed 24 Sep 2022.). It can be used after resection of a meningioma. If overlying bone and skin structures are absent, an additional flap reconstruction is usually considered, resulting in extensive surgery. However, this study is the first to describe a case of healing by secondary intention over NeoDura as the most superficial layer.</p><p><strong>Case presentation: </strong>A 48-year-old Caucasian woman had been treated with surgery and whole brain radiotherapy for medulloblastoma in 1976. As radiotherapy-related consequences she developed blindness and multiple secondary tumors (meningioma, basal cell carcinoma). After resection of a large parasagittal meningioma, wound infection and healing problems occurred. The skull flap (10 cm in diameter) had to be removed, and two latissimus dorsi reconstructions failed. As the dura closure using NeoDura appeared watertight, it was decided to attempt healing by secondary intention using vacuum assisted closure, and later, with local wound dressings. This resulted in a complete skin closure after almost 1 year. No local or neurological complications occurred. The tissue was sufficiently resistant to avoid the \"syndrome of the trephined,\" a well-known complication in patients without bony reconstruction after craniectomy.</p><p><strong>Conclusion: </strong>This is the first description of healing by secondary intention over a craniectomy wound where the normal dura was also removed and replaced by NeoDura. This treatment could be an alternative for extensive reconstructions in patients who are not fit to undergo reconstructive surgery or after failure of reconstruction.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"622"},"PeriodicalIF":0.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895370","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":"Marginal zone lymphoma of mucosa associated lymphoid tissue-lymphoma of the lacrimal gland in a young patient with Klinefelter syndrome: a case report.","authors":"Askar K Alshaibani, Reem R Alanazi, Bedour Akif Aleid, Saad M Alosaimi","doi":"10.1186/s13256-024-04996-0","DOIUrl":"10.1186/s13256-024-04996-0","url":null,"abstract":"<p><strong>Background: </strong>Klinefelter syndrome is considered one of the most common sex chromosome disorders affecting males. The presence of an extra X chromosome can alter the tendency to develop various cancers, including lymphomas. Lacrimal gland lymphoma is a disease of the elderly, with a median age of presentation of 70 years.</p><p><strong>Case presentation: </strong>In this article, we report a case of a 35-year-old Arabian Saudi male with a known case of Klinefelter syndrome who presented to oculoplastic clinic complaining of progressively growing superior-temporal mass in the left eye. After evaluation and imaging, an incisional biopsy from the lacrimal gland mass was obtained and histopathological evaluation showed atypical lymphoproliferative infiltrate consistent with extranodal marginal zone lymphoma of mucosa associated lymphoid tissue. The mainstay treatment was external beam radiotherapy, which showed significant improvement in the case.</p><p><strong>Conclusion: </strong>This is considered the first reported case of lacrimal gland lymphoma in young patient with Klinefelter syndrome, which increases the association between Klinefelter syndrome and lymphomas.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"640"},"PeriodicalIF":0.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895379","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":"Strongyloidiasis mimics duodenal lymphoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome: a case report.","authors":"Ayoub Basham, Sanaz Soleimani, Atash Ab Parvar, Arash Rahimi, Ebrahim Evazi, Seyed Hamid Moosavy","doi":"10.1186/s13256-024-04914-4","DOIUrl":"10.1186/s13256-024-04914-4","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus is a multi-organ autoimmune disorder that is treated by immunosuppressive agents that weaken the immune defense against opportunistic pathogens and latent infections such as strongyloidiasis. Herein, we report the case of a 43-year-old woman known to have systemic lupus erythematosus who presented with gastrointestinal symptoms, edema, and bone pain 2 months after receiving immunosuppressive treatment.</p><p><strong>Case presentation: </strong>A 43-year-old Iranian female known to have systemic lupus erythematosus and antiphospholipid syndrome presented with abdominal pain, nausea, vomiting, and generalized edema. She was on CellCept, prednisolone, and hydroxychloroquine. The vital signs were within the normal range. On physical examination, no rash was observed on the skin. There was only a mild tenderness in epigastric region. The results of blood analysis revealed hypochromic microcytic anemia, normal leukocyte count with mild eosinophilia. Liver enzymes as well as renal function tests were within the normal range. Stool examination was negative for trophozoites, ova, or cysts of parasites. Endoscopic findings included a generalized nodular appearance of duodenum with an infiltrative mucosa in the wall of duodenum, suggesting lymphoma. The pathology report determined the diagnosis of strongyloidiasis. Cap albendazole 400 mg was administered twice a day for 2 weeks. Abdominal pain was completely relieved 1 week after starting the treatment. The patient was eventually discharged after 10 days.</p><p><strong>Conclusion: </strong>The significance of this case report is the necessity to send complete blood count and serologic assays to screen latent strongyloidiasis before receiving immunosuppressive agents in patients with systemic lupus erythematosus.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"608"},"PeriodicalIF":0.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885461","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":"Angiosarcoma associated with Kasabach-Merritt syndrome presenting with typical signs and symptoms of pulmonary tuberculosis: a case report.","authors":"Ahmad Talha Tariq, Syed Murtaza Hassan Kazmi, Shahzad Riyaz, Zafar Ali","doi":"10.1186/s13256-024-04895-4","DOIUrl":"10.1186/s13256-024-04895-4","url":null,"abstract":"<p><strong>Background: </strong>Angiosarcoma is a rapidly proliferating vascular tumor that originates in endothelial cells of vessels. Rarely, it can be associated with consumptive coagulopathy due to disseminated intravascular coagulation eventually leading to thrombocytopenia and microangiopathic hemolytic anemia. This specific manifestation is termed Kasabach-Merritt syndrome. Patients usually present with manifestations related to the primary diagnosis of angiosarcoma depending on the organ it is involving. However, if Kasabach-Merritt syndrome has occurred, it will present with manifestations such as bleeding and thromboembolic phenomenon. To date, no favorable outcomes have been documented, and the overall prognosis remains grim.</p><p><strong>Case presentation: </strong>A 44-year-old male patient of Afghan origin developed typical signs and symptoms of pulmonary tuberculosis, that is, fever, cough, hemoptysis, weight loss, and night sweats. He was initially managed in an Afghan medical facility where workup for tuberculosis was done but came back negative. He empirically received anti-tuberculous therapy owing to typical presentation and tuberculosis being endemic in the area. The condition of the patient worsened, and he presented to our facility (Shifa International Hospital, Islamabad, Pakistan). Workup led to the diagnosis of a metastatic vascular neoplasm, which was further complicated with consumptive coagulopathy, and microangiopathic hemolytic anemia. This presentation is known as Kasabach-Merritt syndrome. Multidisciplinary team discussion was called, and it was decided to proceed with palliative chemotherapy with paclitaxel.</p><p><strong>Conclusion: </strong>Although a patient may present with typical signs and symptoms of, but negative workup for, TB, if there is a high index of suspicion and the patient is receiving empirical treatment for pulmonary tuberculosis, clinical worsening should alert to think about differential diagnosis. In our case, histopathological analysis of lymph node and radiological findings led us to the diagnosis.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"623"},"PeriodicalIF":0.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885356","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}