Annals of Medicine and Surgery最新文献

{"title":"Predictive analysis in acute ischemic stroke imaging.","authors":"Hosam Al-Jehani, Ahmed Hafez Mousa","doi":"10.1097/MS9.0000000000005277","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005277","url":null,"abstract":"<p><p>Acute ischemic stroke is a medical emergency that requires rapid diagnosis and treatment to minimize brain damage and improve patient outcomes. Various imaging modalities, such as computed tomography, magnetic resonance imaging, and angiography, play a crucial role in the diagnosis, assessment, and prediction of outcomes in acute ischemic stroke patients. This review aims to summarize the current literature on predictive analysis in acute ischemic stroke imaging, discussing the methodologies, challenges, and potential applications of these techniques in clinical practice. A comprehensive search of the literature was conducted using electronic databases, including PubMed, MEDLINE, and Google Scholar. The search terms used included \"predictive analysis,\" \"acute ischemic stroke,\" \"imaging,\" \"computed tomography,\" \"magnetic resonance imaging,\" \"angiography,\" \"machine learning,\" and \"artificial intelligence.\" The inclusion criteria were studies published in the English language between 2010 and 2023, focusing on predictive analysis techniques using imaging data in acute ischemic stroke. The review identified several studies that have investigated predictive analysis techniques using various imaging modalities in acute ischemic stroke. These studies have demonstrated the potential of machine learning and artificial intelligence (AI) algorithms in predicting clinical outcomes, such as the extent of infarct, treatment response, and long-term prognosis. Different imaging features, including lesion volume, perfusion parameters, and vessel occlusion characteristics, have been used as inputs for predictive models. The results indicate promising predictive performance, with potential implications for personalized treatment and management strategies. Predictive analysis using imaging data has the potential to improve diagnosis, prognosis, and treatment planning in acute ischemic stroke. Advances in machine learning and AI algorithms provide opportunities for developing robust and accurate models, but further research and validation are needed to translate these techniques into routine clinical practice. This integration can empower clinicians with valuable insights and support personalized care for acute ischemic stroke patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6522-6528"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178945","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":"Elevated lipoprotein(a) and adverse pregnancy outcomes.","authors":"Ugochukwu Ebubechukwu, Toluwalase Awoyemi, Onyinye Ugoala, Ike Kendra Bolakale-Rufai, Valentine C Nriagu, Chukwuemelie Okeke, Chukwuebuka Stanley Asogwa, Queen Ugochinyere Alu, Oluwaremilekun Tolu-Akinnawo, Emmanuel Daniel, Christabel Uche-Orji, Oluwaseun Adeleke, Anandita Agarwala, Lynn M Yee","doi":"10.1097/MS9.0000000000005411","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005411","url":null,"abstract":"<p><p>Lipoprotein(a) [Lp(a)] is gaining attention as a potential marker for adverse pregnancy outcomes, in addition to its well-established role in cardiovascular disease. This review explores the evolving understanding of Lp(a) in pregnancy, focusing on its links to hypertensive disorders of pregnancy, gestational diabetes mellitus, fetal growth restriction, and preterm birth, while also addressing diagnostic and management challenges. During pregnancy, Lp(a) levels rise substantially, nearly doubling between weeks 10 and 35. Although this increase is universal, its clinical implications are unclear. Lp(a) exerts pro-inflammatory, pro-thrombotic, and pro-atherogenic effects, the mechanisms of which are discussed in detail in the body of this review. However, research into Lp(a)'s specific role in increasing the risk of adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, has produced mixed results, highlighting the need for further investigation. Routine screening for Lp(a) during pregnancy is not standard practice, though some experts suggest that it could be beneficial, particularly for high-risk pregnant people. Similar to managing other cardiovascular disease risk factors, managing elevated Lp(a) during pregnancy requires a comprehensive approach, from preconception counseling to lifestyle adjustments such as improving diet, increasing physical activity, and quitting smoking. Pharmacological options like statins and proprotein convertase subtilisin/kexin type 9 inhibitors have shown promise in non-pregnant populations, but their safety during pregnancy remains a concern, limiting their use. Further research is needed to clarify Lp(a)'s role in adverse pregnancy outcomes and to identify safe, effective treatments for managing elevated Lp(a) levels before and during pregnancy.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6557-6565"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178950","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":"Targeting neuronal pentraxin 1 microRNA-492 exerts pro-tumorigenic effects in colorectal cancer through stimulation of proliferation, migration, and invasion.","authors":"Jia Yu Zhang, Qiong Zhu Yu, Wei Wei, Jia Ming Qiu, Yu Lan Gu, Chuandan Wan","doi":"10.1097/MS9.0000000000005686","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005686","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is one of the most common cancer types affecting both men and women. MicroRNA-492 (miR-492) plays an important role in the development of various malignant tumors; however, its specific role and related mechanisms in CRC remain unclear. Therefore, we aimed to explore the relationship between miR-492 and the prognosis of patients with CRC, as well as the specific mechanisms involved in CRC development.</p><p><strong>Methods: </strong>The Gene Expression Omnibus and The Cancer Genome Atlas datasets were downloaded to analyze the relationship between the miR-492 expression level and the overall survival of patients with CRC. Forty-four pairs of primary CRC tissues and paired normal tissues were collected. The relationship between the miR-492 expression level and clinicopathological parameters of patients with CRC was analyzed using statistical methods. MiRNA quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect miR-492 expression levels in CRC tissues and cell lines. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and colony-formation assays were performed to assess cell growth and proliferation, respectively. Transwell assays were performed to analyze the migration and invasion potential of CRC cells. The interaction between miR-492 and 3' untranslated regions (3'-UTRs) of neuronal pentraxin 1 (NPTX1) was evaluated using a luciferase reporter assay. The expression of NPTX1 in CRC tissues and cells was detected by qRT-PCR.</p><p><strong>Results: </strong>Low expression of miRNA-492 in CRC tissues is closely associated with patients' survival prognosis. miR-492 can recognize the 3'-UTR of NPTX1 mRNA and directly target and regulate NPTX1 expression, thereby promoting the growth, migration, and invasion of CRC cells.</p><p><strong>Conclusions: </strong>The ability of miR-492 to mediate the biological behavior of CRC by targeting NPTX1 is associated with poor prognosis and suggests that miR-492 is a potential therapeutic candidate for CRC.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6441-6453"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179074","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":"Digital and algorithmic strategies for guideline-directed medical therapy initiation and up-titration in adults with heart failure with reduced ejection fraction: a systematic review.","authors":"Naveen Gautam, Saroj Gc, Preeti Kharel, Raj Deep Khatiwada, Bibhusan Basnet","doi":"10.1097/MS9.0000000000005672","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005672","url":null,"abstract":"<p><strong>Background: </strong>Guideline-directed medical therapy (GDMT) reduces morbidity and mortality in heart failure with a reduced ejection fraction (HFrEF), yet underuse and suboptimal up-titration remain common. Digital and algorithmic strategies are increasingly being used to address these gaps, but their comparative effectiveness remains uncertain.</p><p><strong>Methods: </strong>This systematic review followed the PRISMA 2020 guidance and was prospectively registered with PROSPERO (CRD420251268580). PubMed, Embase, and Scopus were searched from inception through 26 December 2025. Randomized and comparative studies enrolling adults with HFrEF were eligible if they evaluated digital, algorithm-based, or telemonitoring strategies designed to facilitate GDMT initiation, titration, or optimization versus usual care.</p><p><strong>Results: </strong>Six randomized comparative trials involving 3706 participants were included. Interventions comprised provider-facing electronic health record alerts and digitally enabled remote titration or telemonitoring pathways. Five of the six trials showed improvements in medication-optimization outcomes; the single neutral trial was a provider-facing alert intervention that showed no difference in GDMT prescribing at hospital discharge. Remote pathway-based strategies demonstrated the largest effects, including higher titration completion (82.1% vs 53.8% at 6 months; an absolute difference of approximately 28 percentage points) and greater improvements in therapy scores. Alert-based interventions showed mixed findings, including no difference in overall GDMT class prescribing at discharge in one inpatient trial (34% vs 34%). Meta-analysis was not performed because of substantial heterogeneity in interventions, outcomes, and reporting formats.</p><p><strong>Conclusion: </strong>Digital strategies appear to improve GDMT optimization in HFrEF, particularly when embedded within structured care pathways that enable repeated reassessment and protocol-driven titration. Passive alerts alone appear less effective. Standardized outcome measures and trials evaluating clinical endpoints are needed.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6708-6717"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178987","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":"Non-aneurysmal perimesencephalic subarachnoid hemorrhage in a middle-aged female possibly triggered by Valsalva-like event and uncontrolled hypertension: a case report.","authors":"Abhishek Shrestha, Diksha Shrestha, Prabin Duwadee, Saroj Gc","doi":"10.1097/MS9.0000000000005690","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005690","url":null,"abstract":"<p><strong>Introduction: </strong>Non-aneurysmal perimesencephalic subarachnoid hemorrhage (NAPMSAH) is a rare subtype of subarachnoid hemorrhage with a generally benign course and accounts for a small proportion of spontaneous SAH cases. Compared with other SAH populations, patients with this condition are more commonly male and less likely to have a history of smoking or hypertension.</p><p><strong>Case presentation: </strong>We report a 58-year-old hypertensive woman who presented with sudden, severe headache and repeated vomiting without focal neurological deficits. She also had a history of intermittent vomiting associated with gastroesophageal reflux disease. Brain CT showed perimesencephalic subarachnoid hemorrhage, and CT angiography was negative for aneurysm or vascular malformation, confirming NAPMSAH. She was managed conservatively, with full clinical recovery.</p><p><strong>Discussion: </strong>NAPMSAH is believed to result from venous congestion due to impaired deep cerebral venous drainage, possibly triggered by hypertension and Valsalva-like maneuvers like vomiting. Although the prognosis is excellent, aneurysmal SAH must be excluded, and imaging remains crucial for diagnosis and risk stratification.</p><p><strong>Conclusion: </strong>NAPMSAH is a rare but important cause of acute headache, with generally good outcomes. Early recognition and imaging are essential to exclude aneurysmal hemorrhage and ensure appropriate management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6902-6906"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178988","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":"Frailty and sleep quality in elderly living in old age homes of Kathmandu Valley: a cross-sectional study.","authors":"Ronit Zoowa, Dipana Pradhan, Ravi Shah, Sabin Bahadur Zoowa, Naresh Manandhar","doi":"10.1097/MS9.0000000000005652","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005652","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a clinical syndrome characterized by age-related decline in strength, endurance, and physiological function that increases vulnerability to adverse health outcomes. Sleep disturbances are also common among older adults, particularly in long-term care settings, and may contribute to worsening frailty and reduced quality of life. However, limited evidence exists regarding the relationship between frailty and sleep quality among institutionalized elderly populations in Nepal.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted among 219 individuals aged ≥60 years residing in old-age homes in Kathmandu Valley. Participants were selected through convenience sampling. Frailty was assessed using the Groningen Frailty Indicator, and sleep quality was evaluated using the Pittsburgh Sleep Quality Index.</p><p><strong>Results: </strong>The mean age of participants was 73.81 years (range 60-99 years), and 62.6% were female. Frailty was present in 75.3% (<i>n</i> = 163) of participants, with prevalence increasing from 63.5% in the 60-69 age group to 95.2% among those aged 90-99 years. Poor sleep quality was observed in 85.8% (<i>n</i> = 188) of participants. Among frail individuals, 95.8% had poor sleep quality. A significant association was found between frailty and poor sleep quality (<i>r</i> = 0.497, <i>P</i> < 0.001) and in adjusted analysis poor sleep quality was strongly associated with frailty (AOR = 22.58, 95% CI: 8.10-62.94, <i>P</i> < 0.001) .</p><p><strong>Conclusion: </strong>These findings highlight a strong association between frailty and poor sleep quality among elderly living in old age homes in Kathmandu valley, underscoring the need for integrated screening and management of sleep disturbances within frailty care.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6425-6429"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178931","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":"Early mobilization in surgery: a narrative historical review of its evolution and contemporary implications.","authors":"Martina Kostner, Federica Canzan, Elisa Ambrosi, Anna Brugnolli","doi":"10.1097/MS9.0000000000005698","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005698","url":null,"abstract":"<p><p>Early mobilization after surgery is widely recognized as a key component of enhanced recovery after surgery (ERAS) protocols, improving patient outcomes and reducing hospital stays. However, the historical roots of this practice remain insufficiently explored. This study aimed to examine the historical evolution of early mobilization from the 19th century to the mid-20th century and to reflect on its relevance for contemporary perioperative care. This study was designed as a narrative historical review based on primary historical sources, including medical articles, editorials, and case reports. Nine historical studies focusing on abdominal and pelvic surgery were included in the thematic analysis. The review identified seminal contributions such as Emil Ries' pioneering 1899 regimen and the subsequent, though intermittent, adoption of early mobilization by surgeons including Boldt and Leithauser. Initially met with resistance rooted in traditional beliefs about prolonged bed rest, early mobilization gained wider acceptance after the Second World War, as reports described reduced complications, shorter hospital stays, and improved patient well-being. Early concepts comparable to modern prehabilitation and patient engagement were also identified. This historical reconstruction suggests that early mobilization is not solely a recent innovation but part of a longer clinical trajectory. Understanding its development may help inform current surgical practice and contribute to clearer operational definitions within contemporary perioperative pathways.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6741-6746"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178959","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":"Medullary thyroid carcinoma with pheochromocytoma and cystic parathyroid degeneration in a ret-negative patient: a case report.","authors":"Ahmad El Khatib, Zeina Maria Semaan, Mohamad El Haress, Elie Nehme, Nada Assaf, Monzer Saleh, Nina Shabb, Jad Chokr, Anthony Shebly, Hind Salloum, Mustapha El Lakis","doi":"10.1097/MS9.0000000000005688","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005688","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple endocrine neoplasia type 2A (MEN2A) is a rare autosomal dominant hereditary cancer syndrome, predominantly caused by mutations of the <i>RET</i> proto-oncogene on chromosome 10q11.2. It typically presents with medullary thyroid carcinoma (MTC), pheochromocytoma, and primary hyperparathyroidism. Cases with a MEN2A phenotype but negative <i>RET</i> testing are uncommon, posing challenges for diagnosis and patient management.</p><p><strong>Case presentation: </strong>We report the case of a 63-year-old female who was diagnosed with MTC and pheochromocytoma. and cystic parathyroid gland. Genetic workup was negative for <i>RET</i> proto-oncogene mutations but positive for a heterozygous variant in the <i>TMEM127</i> tumor suppressor gene.</p><p><strong>Case discussion: </strong>MEN2A is associated with pathogenic germline variants in the RET proto-oncogene in approximately 95-99% of cases. Our patient, however, exhibited a MEN2A-like clinical phenotype in the absence of an identifiable RET mutation, with a pathogenic TMEM127 variant instead. Although TMEM127 is an established susceptibility gene for pheochromocytoma and paraganglioma, its association with the broader MEN2A phenotype remains unclear. This unusual genotype-phenotype discordance raises important questions regarding the potential role of alternative genetic pathways in MEN2-like syndromes and creates uncertainty regarding postoperative surveillance and the appropriate extent of screening and genetic counseling for family members.</p><p><strong>Conclusion: </strong>Our case represents an unusual scenario where the patient presents with a clinical phenotype of MEN2A but is <i>RET</i> negative and positive heterozygous for a variant in the <i>TMEM127</i>. This atypical genetic finding introduces complexities in determining the appropriate follow-up protocol and the scope of familial screening necessary.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6890-6895"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178979","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":"Mass casualty management in resource-limited settings: a three-tiered medical student -inclusive model.","authors":"Sheeza Maryam, Eman Maryam, Sara Maryam, Aisha Karim","doi":"10.1097/MS9.0000000000005711","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005711","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6922-6923"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178828","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":"Suspected immune-mediated inflammatory myositis with rhabdomyolysis following yellow fever vaccination: a case report.","authors":"Rawan J AlGhawi, Zainab H Alkhalifa, Ghada A Aljanobi","doi":"10.1097/MS9.0000000000005668","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005668","url":null,"abstract":"<p><strong>Background: </strong>The yellow fever vaccine is a live-attenuated vaccine with an excellent safety profile; however, rare adverse events have been reported. Musculoskeletal complications, particularly inflammatory myositis with rhabdomyolysis, are exceedingly uncommon and not well characterized in the literature.</p><p><strong>Case presentation: </strong>We report a case of a 49-year-old man who developed acute febrile illness, severe myalgia, and progressive proximal muscle weakness 1 week after receiving his first yellow fever vaccination. An extensive diagnostic evaluation was performed. The patient presented with high-grade fever and lower-limb proximal muscle weakness, with creatine kinase (CK) peaking at 14 082 U/L and elevated aldolase. Magnetic resonance imaging of the pelvis and bilateral thighs demonstrated diffuse bilateral upper-thigh inflammatory myositis. Electromyography did not reveal any findings suggestive of myopathic disorders. Extensive infectious testing, including viral and travel-related pathogens, was negative. Autoimmune and myositis-specific antibody panels were also negative. Given the temporal association with vaccination, exclusion of alternative etiologies, and supportive imaging findings, a diagnosis of suspected vaccine-associated inflammatory myositis with rhabdomyolysis was made. The patient was treated with high-dose corticosteroids followed by a taper, resulting in rapid clinical and biochemical recovery, with normalization of CK levels and full functional restoration.</p><p><strong>Conclusion: </strong>This case highlights a rare but significant presentation of inflammatory myositis with rhabdomyolysis following yellow fever vaccination. Clinicians should consider this diagnosis in patients presenting with acute muscle weakness and elevated muscle enzymes after recent immunization. Early recognition and appropriate management are essential for favorable outcomes. Despite this rare complication, the overall benefit-to-risk profile of the yellow fever vaccine remains strongly favorable.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6874-6878"},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178892","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}