American Journal of Case Reports最新文献

{"title":"Innovative Callus Release Technique for Closed Reduction in Old Fractures: Case Studies and Methodology.","authors":"Ahmed Mohamed Oun, Mansour M Aldhilan, Mohamed E Abdel-Wanis","doi":"10.12659/AJCR.946876","DOIUrl":"https://doi.org/10.12659/AJCR.946876","url":null,"abstract":"<p><p>BACKGROUND In modern limb fracture management, particularly in children, image-guided closed reduction and percutaneous fixation are commonly employed. However, for older, displaced fractures, achieving closed reduction may be challenging or even unfeasible, often necessitating open reduction, which carries a higher risk of complications. We utilized K wires to fragment the fibrous callus and facilitate callus fragmentation in 2 patients with old fractures. In both cases, successful fracture reduction was achieved using a closed technique, followed by percutaneous K wire fixation. CASE REPORT Patient 1 was a 10-year-old girl who presented 10 days after sustaining a fully displaced fracture of the left radial neck due to trauma. Closed reduction under general anesthesia was unsuccessful. We employed percutaneous K wires to fragment the fibrous callus at the fracture site, enabling successful reduction and subsequent fixation. Patient 2 was a 50-year-old woman who presented with a displaced fracture at the base of the proximal phalanx of the little finger, initially treated with closed reduction and cast immobilization. At a follow-up examination 2 weeks later, the fracture was found to be fully displaced. Attempts at closed reduction under ring block anesthesia were unsuccessful. A percutaneous K wire was utilized to fragment the fibrous callus, enabling successful reduction and fixation. CONCLUSIONS The technique of fibrous callus fragmentation and closed reduction, followed by percutaneous K wire fixation, offers an effective approach for managing neglected, displaced fractures of the radial neck and the proximal phalanx of the little finger. This method allows for closed reduction and internal fixation in these challenging peri-articular fracture locations.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946876"},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043685","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":"Diagnostic Challenges in Acute Fatty Liver of Pregnancy: Fever as a Key Symptom in Case Series from Indonesia.","authors":"Wahyudi Wirawan, Adhi Pribadi","doi":"10.12659/AJCR.946614","DOIUrl":"https://doi.org/10.12659/AJCR.946614","url":null,"abstract":"<p><p>BACKGROUND Acute fatty liver of pregnancy (AFLP) is a rare and catastrophic disease in pregnancy. It is important to distinguish between pathogenic diseases that cause abnormal liver function tests during pregnancy and typical physiological changes. An AFLP diagnosis can be established using Swansea criteria. AFLP typically occurs in the third trimester of pregnancy or postpartum, with a median presentation of 35-37 weeks of pregnancy. AFLP is also an obstetrical and medical emergency that is characterized by rapid deterioration of the patient's condition. CASE REPORT We present 3 cases from a tertiary hospital in Indonesia. The Swansea criteria were met in all 3 cases. Our cases were specifically characterized by complaints of fever. Fever complaints were not included in the Swansea criteria. The complaint of fever served to deceive and disorient the first treating clinician, resulting in a late referral. Delay of referral can lead to inappropriate treatment, prolonged duration of recovery, and the emergence of various complications, even death. In all of the cases reported here, the patients experienced detrimental effects and outcomes of the maternal and fetal condition. This case report also confirms that fever was the main symptom experienced by the patients who were hospitalized. Other common initial symptoms were nausea, vomiting, jaundice, and encephalopathy. CONCLUSIONS We propose that fever complaints be considered as criteria for AFLP diagnosis in Indonesia. However, more research is still needed with a larger number of cases. Prompt and appropriate treatment will result in a significantly more favorable outcome. Prompt identification, early diagnosis, immediate delivery, and comprehensive supportive treatment are important for maternal and infant outcomes in patients with AFLP.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946614"},"PeriodicalIF":1.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020323","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":"Middle-Lobe Bronchus Transection in Blunt Thoracic Trauma From a High-Speed Motor Vehicle Collision: A Case Report.","authors":"Killen H Briones-Claudett, Mónica H Briones-Claudett, Killen H Briones-Zamora, Jaime Galo Benites Solís, Carlos S Ronquillo-Barzola, William Johnny Jimenez Jimenez, Zully Stefania Cedeño Robalino, Maria Antonieta Touriz Bonifaz, Pedro Barberan-Torres, Michelle Grunauer Andrade","doi":"10.12659/AJCR.946488","DOIUrl":"https://doi.org/10.12659/AJCR.946488","url":null,"abstract":"<p><p>BACKGROUND Bronchial rupture following blunt thoracic trauma is an uncommon but potentially fatal injury that requires early recognition and appropriate intervention. Timely diagnosis and multidisciplinary trauma care are essential for improving outcomes and preventing complications. CASE REPORT A 52-year-old man with no prior medical history was admitted to the Emergency Department after a high-speed motor vehicle collision. He presented with multiple injuries, dyspnea, and thoracic and pelvic pain. His initial Glasgow Coma Scale (GCS) score was 15/15. Physical examination revealed subcutaneous emphysema in the cervical region, a distended right hemiabdomen, and absent breath sounds in the right lung. Multiple right-sided chest wall lacerations were noted. An extended focused assessment with sonography in trauma (eFAST) was suggestive of intra-abdominal free fluid, prompting further imaging. A chest CT confirmed the right pneumothorax. An exploratory laparotomy revealed 200 cc of hemoperitoneum, grade 1 liver trauma (segments II and IV), and a non-bleeding hepatic hilum hematoma. Additional procedures included cystostomy, left iliac vein clamping, and pelvic bone stabilization with external fixators. Due to worsening respiratory status on postoperative day 2, the patient underwent an emergency thoracotomy, which revealed a 200-mL clot hemothorax in the costodiaphragmatic recess, middle-lobe contusions, ischemia, and a complete transection of the middle-lobe bronchus extending to the intermediate bronchus. Rib fractures (5th and 6th) necessitated a middle lobectomy and rib fixation. CONCLUSIONS This case underscores the importance of a high index of suspicion for tracheobronchial injuries in blunt thoracic trauma. While eFAST aids in initial assessment, definitive diagnosis requires advanced imaging modalities such as CT and bronchoscopy. Timely surgical interventions and a coordinated multidisciplinary approach are essential for optimal patient outcomes. By sharing this case, we aim to contribute to the understanding and management of rare bronchial injuries.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946488"},"PeriodicalIF":1.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023437","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":"Epinephrine as a Therapeutic Agent for Hyperferritinemia in Diabetes Mellitus and Hypertension.","authors":"Ashraf M El-Molla, Fawzia Aboul Fetouh, Samir Bawazir, Yehya A Alwahby, Yasser A Ali, Abdullah A Basseet, Ahmed Hassan Albanna","doi":"10.12659/AJCR.947289","DOIUrl":"https://doi.org/10.12659/AJCR.947289","url":null,"abstract":"<p><p>BACKGROUND Diabetes mellitus was the first non-communicable disease to be recognized as a 21st century pandemic. Type 2 diabetes (T2DM) results from increased insulin resistance (IR) or relative insulin deficiency. IR impairs glucose disposal, leading to a compensatory hyper-insulinemic state. Increased iron stores as reflected by high serum ferritin (SF) have been associated with the development T2DM and affect glucose homeostasis by impairing tissue response to insulin. Iron overload (IO) is quite common in essential hypertension (HTN). The first clinical effect of epinephrine on SF was reported in 2024, showing that epinephrine resulted in normalization of SF and recovery from severe COVID-19 infection. CASE REPORT A patient with T2DM, HTN, and dyslipidemia associated with hyperferritinemia received the conventional treatment of T2DM and HTN, with a poor control of hyperglycemia and HTN. Since the patient had elevated SF, we obtained informed written consent for epinephrine's use to lower SF. Epinephrine 0.6 mcg/kg was injected subcutaneously under hemodynamic monitoring, and the results showed normalization of SF and complete recovery of T2DM and HTN. CONCLUSIONS Epinephrine can normalize elevated SF by its iron chelating effect; therefore, it can relieve IO and alleviate IR associated with T2DM and HTN. Epinephrine has an anti-inflammatory and scavenging properties that can inhibit ferroptosis. As a new clinical indication, extensive studies are required for further assessment and possible therapeutic uses in IO disorders such as hereditary hemochromatosis (HH), Alzheimer disease (AD), Parkinsonian disease (PD), and multiple sclerosis (MS).</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947289"},"PeriodicalIF":1.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004922","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":"Circumferential Stanford Type A Acute Aortic Dissection with Proximal Intimo-Intimal Intussusception: A Case Report and Literature Review.","authors":"Masato Hayakawa, Atsushi Tashiro, Yuka Higuma, Keisei Koizumi, Ryo Ikemura, Satoshi Yamashiro, Kiyoshi Iha","doi":"10.12659/AJCR.946875","DOIUrl":"https://doi.org/10.12659/AJCR.946875","url":null,"abstract":"<p><p>BACKGROUND Circumferential acute aortic dissection is a rare and fatal condition. We present a surgical case of a 76-year-old woman presenting with Stanford type A acute aortic dissection with intimo-intimal intussusception. CASE REPORT A 76-year-old woman living on a remote island with no significant medical history visited a local general hospital because of sudden anterior thoracic strangulation. Contrast-enhanced computed tomography revealed Stanford type A acute aortic dissection, and the patient requested helicopter transport to our hospital for surgery. During preparation for transport, the patient's level of consciousness decreased, shock vitals were observed, and she was intubated at the hospital. The patient arrived at the hospital approximately 5 h after the request for transportation, and surgery was started immediately. Following anesthesia induction, transesophageal echocardiography showed that the intima was in a to and fro state. Inspection of the ascending aorta revealed that the intima was completely circumferentially dissected and that the inverted intima was entrapped in the left ventricle. The dissection extended into the sinus of Valsalva; however, because the intima of the bilateral coronary arteries was normal, Bio-Glue was applied to the false lumen of the sinus of Valsalva for adequate repair, and ascending aortic replacement was performed using a 26-mm graft. CONCLUSIONS In this case, the dissection progressed during transport, and the patient experienced intimo-intimal intussusception, leading to shock. In such cases, swift transportation should be prioritized, and immediate surgical intervention is necessary.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946875"},"PeriodicalIF":1.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062575","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":"Diagnostic and Surgical Management of Nesidioblastosis in a 42-Year-Old Man with Refractory Hypoglycemia.","authors":"Cleomar Ana de Souza Valentim, Vivien Suemi Arimura, Isabella De Melo Pompei, Denis Bonvechio, Marcio Shimabuku Silva, Fabio José Turrini, Mariana Soares Dalla Mariga Jorgino, Andre Silva Valentim","doi":"10.12659/AJCR.945453","DOIUrl":"https://doi.org/10.12659/AJCR.945453","url":null,"abstract":"<p><p>BACKGROUND Nesidioblastosis is an uncommon cause of hypoglycemia and is part of a group of diseases known as non-insulinoma pancreatogenic hypoglycemia syndrome (NIHPS). The objective of this report is to provide a comprehensive discussion on the diagnostic and therapeutic management of a case of nesidioblastosis, a rare and potentially fatal condition. CASE REPORT A 42-year-old non-diabetic man with a history of coronary artery disease and systemic arterial hypertension underwent extensive diagnostic investigation because he had been hospitalized several times over a period of approximately 2 years with a clinical history compatible with persistent refractory hypoglycemia. Despite laboratory and imaging tests, the underlying cause of the hypoglycemia remained unclear. Comprehensive investigation included computed tomography (CT), magnetic resonance imaging (MRI), upper endoscopy, PET/CT, and selective pancreatic arteriography. Persistent hypoglycemia associated with high insulin levels led to the suspicion of nesidioblastosis. After exhausting all clinical therapeutic options and after multidisciplinary discussion considering risks and benefits, we decided to perform total pancreatectomy and splenectomy. Anatomopathological and immunohistochemical examination confirmed the diagnosis of nesidioblastosis. CONCLUSIONS The diagnosis of nesidioblastosis is complex and requires a multidisciplinary approach. The decision to perform a total pancreatectomy was essential to control severe hypoglycemia and improve the patient's quality of life. This case report describes the diagnostic and therapeutic management of persistent endogenous hyperinsulinemic hypoglycemia and highlights the importance of diagnostic accuracy and early therapeutic intervention.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945453"},"PeriodicalIF":1.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054887","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":"Efficacy of Mavacamten in Reducing Cardiac Obstruction in an Elderly Patient with Hypertrophic Cardiomyopathy: A Case Study.","authors":"Nicolas Andre, Ariel Galor, Katie Testa, Jericho Sumalbag, Shaya Manouchehri, Uri Meir Ben-Zur","doi":"10.12659/AJCR.946956","DOIUrl":"https://doi.org/10.12659/AJCR.946956","url":null,"abstract":"<p><p>BACKGROUND Mavacamten, a first-in-class cardiac myosin inhibitor, targets myosin adenosine triphosphatase to treat adults with moderate to severe symptomatic obstructive hypertrophic cardiomyopathy. Previous studies have demonstrated an approximate 50% reduction in left ventricular outflow tract pressure gradient in selected patients after 4 weeks of treatment. CASE REPORT We report the case of a 91-year-old man with hypertrophic cardiomyopathy, who presented with a longstanding history of progressive shortness of breath, unresponsive to treatment. After ruling out other potential causes such as coronary and pulmonary involvement, and performing serial ultrasound evaluations, we concluded that the worsening of his hypertrophic cardiomyopathy was the most likely underlying cause. After initiating Mavacamten therapy, the patient achieved a remarkable improvement, with over 80% reduction in left ventricular outflow tract obstruction observed within 4 weeks of treatment. He reports significant improvement in his shortness of breath both at rest and during daily activities. Dose titration and safety evaluation were performed through robust echocardiographic monitoring. CONCLUSIONS While our patient did not undergo genetic testing due to its high cost and limited clinical relevance, we believe that his remarkable response to this therapy may be linked to a genotype susceptibility enhancing the drug's pharmacodynamic effects, as suggested in the literature. This may have contributed to significant symptom relief and an improved quality of life. Further research is needed to better understand how genotype and phenotype influence treatment response, which could help refine our approach to optimizing non-invasive medical therapies.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946956"},"PeriodicalIF":1.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033318","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":"Hypothyroidism and Double Mitral Lesion in Antiphospholipid Syndrome During Pregnancy: A Case Report.","authors":"José Manuel Madrazo Cabo, Ania Villavicencio Flores, Paulina Chagollán Gudiño, Nuvia Adriana Monter Valera, Jose Antonio Velasco Bárcena, Virginia Sedeño Monge","doi":"10.12659/AJCR.945578","DOIUrl":"https://doi.org/10.12659/AJCR.945578","url":null,"abstract":"<p><p>BACKGROUND Antiphospholipid syndrome (APS) is an immune system disorder that causes an increased risk of blood clots and has been associated with the development of hypothyroidism and double mitral lesion, possibly due to immune complex deposition. This report describes a 34-year-old woman presenting with hypothyroidism and antiphospholipid syndrome with a double mitral lesion at 26 weeks of gestation. CASE REPORT We report the case of a 34-year-old woman with a history of hyperthyroidism that evolved into primary hypothyroidism, as well as APS under medical treatment, and fetal death during her first pregnancy. Subsequently, at 26 weeks of gestation in her second pregnancy, she presented a clinical picture of respiratory failure and precordial pain, which persisted with the same intensity and location despite postural changes for 2 days; after that, she had an increase in chest pain with irradiation to the front part of the chest, progressing to orthopnea. She was evaluated in the emergency room by Cardiology, where an echocardiogram was performed, which showed a double mitral lesion. The decision was made to admit her to intensive care with this diagnosis and pulmonary edema and establishing the specific treatment. She remained under obstetric surveillance and cardiovascular treatment until she was discharged. She maintained maternal-fetal stability cardiologic and endocrinological care, allowing the pregnancy to be successfully carried out to term without complications, and she and her baby showed very good perinatal results during the postpartum period. CONCLUSIONS This report highlights the importance of timely and accurate diagnosis of antiphospholipid syndrome and highlights the association with both hypothyroidism and double mitral lesion.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945578"},"PeriodicalIF":1.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052290","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 Abducens Nerve Palsy Due to Avulsion in its Cisternal Segment: Illustrative Cases.","authors":"Zhongding Zhang, Baimiao Wang, Yinda Tang, Hua Zhao, Xianda Wu, Shiting Li","doi":"10.12659/AJCR.947249","DOIUrl":"https://doi.org/10.12659/AJCR.947249","url":null,"abstract":"<p><p>BACKGROUND Traumatic abducens nerve palsy can be caused by fractures around the Dorello's canal, direct injury at the dura entry point or within the Dorello's canal, or ischemia due to posterior meningeal artery damage. Recent imaging studies have also identified avulsion of the abducens nerve at its cisternal segment as a significant cause. CASE REPORT We present 2 cases of traumatic abducens nerve palsy due to avulsion at the cisternal segment. Preoperative thin-slice T2 magnetic resonance imaging indicated unclear visualization of the nerve at the cisternal segment in both cases. Surgical exploration revealed a partially avulsed nerve at the root exit zone in Case 1. In Case 2, only the distal stump was visible, compressed by an enlarged tortuous vertebral artery. No surgical intervention was performed in Case 1, while in Case 2, a partial anastomosis was performed between motor branches of the trigeminal nerve and the abducens nerve at the cisternal segment. CONCLUSIONS Avulsion of the abducens nerve at the cisternal segment should be considered an important cause of traumatic abducens nerve palsy. Additionally, vessels located in the cistern of the brain may also contribute to nerve disruption. End-to-end anastomosis, nerve grafting, and nerve transfer are the alternative procedures to treat the avulsion.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947249"},"PeriodicalIF":1.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062592","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":"Oropharyngeal Condyloma Lata in Secondary Syphilis: Case Report and Literature Review.","authors":"Samita Srisungsuk, Nichakarn Piyawannarat, Taweegrit Siripongboonsitti","doi":"10.12659/AJCR.947118","DOIUrl":"https://doi.org/10.12659/AJCR.947118","url":null,"abstract":"<p><p>BACKGROUND Condyloma lata is a hallmark of secondary syphilis, presenting as moist, flat, or raised lesions typically located in the genital and perineal regions. However, oropharyngeal condyloma lata (OCL) is a rare and often underrecognized manifestation of secondary syphilis. Its atypical presentation can lead to diagnostic challenges, particularly in the absence of classic systemic features of syphilis. CASE REPORT We report the case of a 43-year-old man with HIV and chronic hepatitis C virus co-infection, diagnosed 2 years prior. The patient had been receiving antiretroviral therapy with tenofovir alafenamide, emtricitabine, and dolutegravir, achieving virologic suppression for 6 months. His CD4 T-cell count was 331 cells/μL. He presented with a sore throat and painful swallowing lasting 1 week. On examination, a single, non-tender, moist, broad-based whitish plaque with peripheral erythema was observed on the soft palate mucosa. There was no rash, lymphadenopathy, hepatosplenomegaly, or hair loss. Differential diagnoses included atypical oral candidiasis and viral warts. However, a positive rapid plasma reagin (RPR) test with a titer of 1: 128 and a reactive Treponema pallidum electrochemiluminescence immunoassay confirmed the diagnosis of OCL. The patient received a single dose of 2.4 million units of intramuscular benzathine penicillin G, leading to the complete resolution of symptoms within 7 days. CONCLUSIONS This case underscores the importance of considering OCL in the differential diagnosis of unexplained oropharyngeal lesions, particularly in patients with risk factors for syphilis. Early recognition, serological testing, and treatment with a prompt single dose of intramuscular benzathine penicillin G are crucial to prevent misdiagnosis, delayed care, and disease progression.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947118"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990024","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}