Case Reports in Medicine最新文献

{"title":"Fever of Unknown Origin From the Primary Care Perspective: A Case Report.","authors":"Kalsang Chodon, Shakir M Saud, Angela R Rodgers","doi":"10.1155/carm/9086960","DOIUrl":"https://doi.org/10.1155/carm/9086960","url":null,"abstract":"<p><p>A 60-year-old immunocompetent man presented to his primary care physician with 3 weeks of fever without an obvious source or risk factors. After multiple encounters, he was found to have a pyogenic liver abscess on computed tomography (CT). He improved with interventional radiology (IR) drainage and antibiotics. Primary care and outpatient providers should be prepared to initiate an appropriate workup for fever of unknown origin (FUO). Family medicine providers working in acute care settings such as urgent care and the emergency department similarly need a framework for FUO. Once common causes have been excluded, pyogenic liver abscess should be considered.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"9086960"},"PeriodicalIF":0.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324712","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":"Mitral Valve Nonbacterial Thrombotic Endocarditis Associated With Antiphospholipid Syndrome in a Male Patient: A Comprehensive Case Report.","authors":"Afshin Amirpour, Niloufar Razavi, Mahmoud Saeidi, Anahita Amirpour, Reyhaneh Zavar, Mohammadsadegh Sahebzade","doi":"10.1155/carm/6425550","DOIUrl":"https://doi.org/10.1155/carm/6425550","url":null,"abstract":"<p><p>Nonbacterial thrombotic endocarditis (NBTE) is a rare cardiac disease with a nonspecific presentation associated with hypercoagulable states including malignancy and autoimmune disorders, such as antiphospholipid syndrome (APS) and systematic lupus erythematosus. A 34-year-old male with a history of pulmonary thromboembolism presented to the hospital complaining of chest pain as an initial symptom. Transthoracic echocardiography revealed the presence of a mass-like lesion adhering to the anterior leaflet of the mitral valve. Once infective endocarditis was excluded, further imaging studies suggested that the cardiac neoplasm was the primary cause of the patient's symptoms, and the patient underwent surgical excision of mass along with mitral valve replacement. Microscopic analysis of the removed mitral valve mass indicated the presence of fibrotic tissue with thick collagen bundles and no inflammatory infiltrates, supporting the diagnosis of NBTE. Investigations for underlying conditions demonstrated persistent elevated titers of anti-β2 glycoprotein I IgG, supporting a diagnosis of APS. The patient was started on warfarin therapy with a closely monitored International Normalized Ratio (INR). After 6 months of follow-up, the patient reported no complications. This case highlights the importance of considering NBTE as a potential differential diagnosis in patients with intracardiac mass and inspecting associated conditions such as APS, as well as challenges encountered in diagnosis and management.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"6425550"},"PeriodicalIF":0.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324746","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":"Fibrous Dysplasia Meets Intramuscular Myxoma: Mazabraud Syndrome-First Documented Case in Pakistan.","authors":"Alizah Faisal, Asfand Yar Ali, Hooria Waqas, Hania Masood, Muhammad Sheraz Hameed, Noor Ul Huda Al Hadi, Rahmat Gul Omarzai","doi":"10.1155/carm/3804294","DOIUrl":"https://doi.org/10.1155/carm/3804294","url":null,"abstract":"<p><strong>Background: </strong>Mazabraud syndrome (MS) is a rare benign genetic disorder characterized by the coexistence of fibrous dysplasia (FD) and intramuscular myxoma (IM), with a very limited number of cases reported worldwide, and none has been documented in Pakistan until now. It typically presents in middle-aged females and affects the lower limbs. Its pathogenesis is associated with activating mutations in the GNAS gene. This disease is often under-recognized in low-income countries. It can rapidly progress to bone deformities, fractures, and unnecessary aggressive treatments if not promptly recognized.</p><p><strong>Case presentation: </strong>A 64-year-old male presented with progressive fatigue and pallor for three months, alongside a lifelong history of multiple bone deformities and painless soft tissue swellings. He had recurrent fractures since childhood, leading to severe limb deformities and dependence on crutches. Physical exam revealed bosselated swellings over the axilla, thigh, and groin, with significant limb shortening. Imaging showed widespread lytic lesions and necrotic soft tissue masses. Blood work revealed hypochromic microcytic anemia with rouleaux formation; white cell and platelet counts were normal. Bone marrow biopsy demonstrated Grade III myelofibrosis with characteristic \"Chinese letter\" trabeculae, confirming FD. Biopsy of soft tissue masses showed benign IMs. A diagnosis of MS was made based on the coexistence of polyostotic FD and multiple myxomas.</p><p><strong>Conclusion: </strong>MS is a rare and benign genetic disorder that requires a high index of suspicion for timely diagnosis. This unique case underscores the need for increased clinical awareness of MS in resource-limited settings where genetic testing is not common and the importance of multidisciplinary evaluation for accurate diagnosis and management. Timely diagnosis and treatment can prevent bone deformities, fractures, and disabilities and improve patient outcomes for this uncommon syndrome.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"3804294"},"PeriodicalIF":0.7,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324714","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":"ANCA-Negative Granulomatosis With Polyangiitis Mimicking Sinusitis and Rhinoscleroma: A Case Report.","authors":"Sergey Gorbunov, Georgiy Polev","doi":"10.1155/carm/4144957","DOIUrl":"https://doi.org/10.1155/carm/4144957","url":null,"abstract":"<p><strong>Introduction: </strong>This case details the diagnostic challenge of ANCA-negative granulomatosis with polyangiitis (GPA) initially presenting as refractory chronic rhinosinusitis, mimicking recurrent infections, and other granulomatous conditions. It highlights the potential for significant diagnostic delay when serological markers are absent.</p><p><strong>Case presentation: </strong>A 65-year-old female with recurrent sinusitis underwent multiple antibiotic regimens and endoscopic sinus surgery. Despite this, she developed progressive destructive manifestations over 10 months: nasal septal perforation, saddle nose deformity, keratouveitis with exophthalmos, macrohematuria, and a lacunar cerebellar infarct. Serial microbiology showed various pathogens; histology initially suggested rhinoscleroma. ANCA remained negative.</p><p><strong>Interventions and outcomes: </strong>Following the clinical diagnosis of ANCA-negative GPA, therapy with rituximab and corticosteroids was initiated, leading to significant improvement and sustained remission on maintenance immunosuppression.</p><p><strong>Conclusion: </strong>This case demonstrates that ANCA-negative GPA can present as refractory sinonasal disease. Negative serology does not exclude GPA; a high clinical suspicion is warranted in cases with destructive features and systemic progression. Early immunosuppressive treatment is essential to prevent severe organ damage.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"4144957"},"PeriodicalIF":0.7,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12943459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324698","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":"Disproportionate Elevated Troponin T Without Clinical Ischemia: A Diagnostic Challenge in the Emergency Department.","authors":"Bryan Nicolalde, Ashraf Elamin, Dae Yong-Park, Michael DeCarolis, Samuel Hahn","doi":"10.1155/carm/5452369","DOIUrl":"10.1155/carm/5452369","url":null,"abstract":"<p><strong>Background: </strong>Cardiac troponins (cTns) are essential for evaluating chest pain, but elevated levels can arise from noncardiac causes or laboratory artifacts. Confirmatory testing for assay interference is often unavailable for false-positive cases, complicating diagnosis and management.</p><p><strong>Case summary: </strong>A 62-year-old female presented with chest pain and disproportionally elevated high-sensitivity troponin T (hs-cTnT) levels (8396 ng/L). Clinical evaluation, including EKG, echocardiography, and nuclear myocardial perfusion images showed no evidence of acute ischemia. Noncardiac causes of elevation of troponins, as well laboratory artifacts, were considered as differential diagnostics. A clinically driven approach was adopted to resolve this case.</p><p><strong>Conclusion: </strong>In cases of disproportionally troponin elevation, a clinically driven approach incorporating risk stratification and alternative diagnostic tools, such as nuclear imaging, can effectively guide management and avoid unnecessary interventions.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"5452369"},"PeriodicalIF":0.7,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302714","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":"Demyelinating Neurobrucellosis Presenting With Neuropsychiatric Manifestations.","authors":"Mojtaba Varshochi, Fatemeh Ravanbakhsh Ghavghani","doi":"10.1155/carm/2210460","DOIUrl":"https://doi.org/10.1155/carm/2210460","url":null,"abstract":"<p><p>Neurobrucellosis with psychiatric manifestations is an uncommon manifestation of brucellosis. Herein, we report a 31-year-old male complaining of dizziness, nausea, malaise, imbalance, amnesia, psychosis, delusion, and impulsive and disorganized behavior. He was not responsive to antipsychotic treatment, and his brain MRI showed demyelinating hyperintensity foci in the periventricular and paraventricular areas and the subcortical areas of the right temporal and frontal lobes. His serum and cerebrospinal fluid serology were in favor of brucellosis, and he dramatically responded to anti-<i>Brucella</i> medications. Although demyelinating neurobrucellosis with psychiatric manifestations is rare, it should be suspected in unresponsive patients coming from brucellosis-endemic areas.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"2210460"},"PeriodicalIF":0.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289398","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":"Multifocal Osteonecrosis in a Patient With Systemic Lupus Erythematosus and Antiphospholipid Syndrome Associated With Pyoderma Gangrenosum and Other Complications: A Case Report.","authors":"Ehsan Adib, Shokofeh Banaei, Afsaneh Enteshari-Moghaddam","doi":"10.1155/carm/7107020","DOIUrl":"https://doi.org/10.1155/carm/7107020","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a quintessential illustration of an autoimmune disease. It results from complex interactions that include impaired apoptotic clearance, increased activity of both the innate and adaptive immune systems, complement activation, the development of immune complexes, and ensuing tissue inflammation, which collectively contribute to a sustained autoimmune response. We present a case relating to a 37-year-old female patient (from Ardabil, Iran) who received a diagnosis of SLE and antiphospholipid syndrome (APS), in accordance with established diagnostic criteria. She is currently admitted to the hospital due to a recurring pyoderma gangrenosum ulcer, accompanied by pain and swelling in her left leg. The patient tested positive for ANA, lupus anticoagulant, anti-beta2-glycoprotein I (anti-beta2GPI), and anti-Ro antibodies. These results, along with her clinical manifestations such as spontaneous abortion, stroke, malar rash, photosensitivity, and pyoderma gangrenosum ulcers, confirm a diagnosis of SLE associated with APS according to the relevant criteria. After appropriate medical treatment, she was identified as experiencing a lupus flare and multifocal osteonecrosis in the knee, hip, and shoulder.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"7107020"},"PeriodicalIF":0.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282405","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":"Chronological Changes in Urine Color and Serum Iron Levels After Deferoxamine Administration in Acute Iron Poisoning.","authors":"Hiroshi Ito, Reiichi Sugihara, Junta Imori, Shunichiro Nakao, Jotaro Tachino, Keishi Okamoto, Kazuhiro Yoneda, Hiroshi Ogura, Jun Oda","doi":"10.1155/carm/9132181","DOIUrl":"https://doi.org/10.1155/carm/9132181","url":null,"abstract":"<p><p>Acute iron poisoning is rare but potentially fatal. Deferoxamine (DFO) is the standard chelating agent and the appearance of \"vin-rose urine\" has traditionally been considered a marker of effective chelation; however, its relationship with serum iron concentration over time remains unclear. A 17-year-old female patient presented with abdominal pain and acute liver dysfunction 43 h after intentional ingestion of sodium ferrous citrate (approximately 40 mg/kg of elemental iron). Continuous intravenous DFO was administered at a dose of 100 mg/kg for approximately 6 h. The urine color changed to vin-rose within 1 h and normalized 12 h after DFO initiation. Despite the normalization of urine color, abdominal pain persisted. Serial laboratory analyses showed that serum iron levels transiently decreased, but then increased repeatedly, even after the normalization of urine color. This case provides chronological documentation of urine color changes alongside serial measurements of serum iron and ferritin, illustrating that the normalization of urine color does not necessarily indicate the normalization of serum iron levels. Urine color changes may need to be interpreted in conjunction with multiple clinical factors, clinical symptoms, and laboratory findings of acute iron poisoning.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"9132181"},"PeriodicalIF":0.7,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269621","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":"Successful Treatment of Multiple Myeloma Complicated With SARS-CoV-2 Infection: A Case Report.","authors":"Yuna Meng, Baoying Duan, Lixian Gao, Wenjiao Huang, Fang Wan","doi":"10.1155/carm/7967791","DOIUrl":"https://doi.org/10.1155/carm/7967791","url":null,"abstract":"<p><strong>Background: </strong>Since the declaration of the coronavirus disease 2019 (COVID-19) pandemic in late 2019, COVID-19 has remained a global concern. Elderly patients with hematological malignancies are immunocompromised and thus highly susceptible to COVID-19 infection and severe acute respiratory syndrome (SARS), posing significant clinical challenges. This report describes the diagnosis and treatment of a patient with multiple myeloma (MM) who developed SARS-CoV-2 infection.</p><p><strong>Methods: </strong>We collected general patient information, clinical features, laboratory results, chest CT imaging, electronic bronchoscopy results, and clinical results for analysis. This case report was approved by the Institutional Review Committee of Baiyin First People's Hospital, and informed consent was obtained from the patient.</p><p><strong>Outcomes: </strong>We report a case of a 66-year-old male newly diagnosed with multiple myeloma who developed a SARS-CoV-2 infection following chemotherapy. His clinical condition showed marked improvement after the initiation of nirmatrelvir/ritonavir therapy. This case underscores the heightened susceptibility of immunocompromised patients to SARS-CoV-2 and highlights the therapeutic importance of early administration of antiviral agents. A comprehensive understanding of the increased risk of opportunistic infections in patients with multiple myeloma postchemotherapy is essential for optimizing disease management and improving clinical outcomes.</p><p><strong>Conclusion: </strong>Patients with MM have impaired immune function and are at high risk for severe infections during treatment. Proactive infection prevention and early intervention are essential to improving outcomes during treatment.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"7967791"},"PeriodicalIF":0.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269583","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":"Localized ST Elevations and PR Depressions in Systemic Lupus Erythematosus Pericarditis: An Unusual Case Presentation.","authors":"Evan Derector, Madhurima S Gundlapally, Nicholas R Young","doi":"10.1155/carm/6633318","DOIUrl":"https://doi.org/10.1155/carm/6633318","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with frequent cardiac involvement. A 49-year-old male with a 20-year history of SLE presented with a rash and lip swelling concerning for angioedema versus anaphylaxis. During bedside rounds, point-of-care-ultrasound (POCUS) revealed a small posterior pericardial effusion, prompting a formal transthoracic echocardiogram (TTE). He subsequently developed acute substernal chest pain with ECG findings of isolated ST elevations and PR depressions, in the inferior leads (II, III, and aVF). Despite concerns for acute coronary syndrome (ACS), the team was reassured by POCUS, TTE, and negative troponins. He was diagnosed with SLE-associated pericarditis and treated with NSAIDs, steroids, hydroxychloroquine, and methotrexate. This case highlights the importance of utilizing POCUS and physical examination skills to differentiate SLE-associated pericarditis from ACS, particularly when ECG findings present in a localized, non-diffuse pattern.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2026 ","pages":"6633318"},"PeriodicalIF":0.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218589","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}