Vascular pythiosis caused by Pythium aphanidermatum: the first case report in Asia

Abstract Background Pythium, soil-borne plant pathogens, are in the class Oomycetes. They are not true fungi, but are related to diatom and algae. There are two human pathogens including P. insidiosum and P. aphanidermatum. To date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present herein the first case of P. aphanidermatum vascular pythiosis in Asia. Case presentation A 47-year-old Thai woman, living in North Thailand, with ß thalassemia/hemoglobin E presented with acute recurrent arterial insufficiency of both legs. Emergent embolectomy with clot removal was performed. The pathology of the clot exhibited noncaseous granulomatous inflammation with many fungal hyphal elements. PCR identified P. aphanidermatum with 100% identity. Final diagnosis is vascular pythiosis. Unfortunately, the patient eventually expired after treatment with itraconazole, terbinafine, azithromycin, and doxycycline. Conclusions To date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present herein the first case of P. aphanidermatum vascular pythiosis in Asia.

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Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00134-3 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Arti Khatri ◽

Nidhi Mahajan ◽

Niyaz Ahmed Khan ◽

Natasha Gupta

Keyword(s):

Past History ◽

Case Reports ◽

Final Diagnosis ◽

Adrenal Carcinoma ◽

Case Presentation ◽

First Case ◽

Contrast Enhanced ◽

Paediatric Age ◽

History Of ◽

Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

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First case of childhood Takayasu arteritis from Syria: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-03077-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Wafa Alwattar ◽

Rawan Al khudari ◽

Judy Naameh ◽

Jia Batha ◽

Raghad Almajzoub ◽

...

Keyword(s):

Takayasu Arteritis ◽

Granulomatous Inflammation ◽

Age Group ◽

Late Adolescents ◽

Arterial Pulse ◽

Case Presentation ◽

Young Infants ◽

First Case ◽

Peripheral Arterial ◽

Symptoms And Signs

Abstract Background Takayasu arteritis is a systemic granulomatous inflammation affecting the large- and medium-sized vessels such as aorta, its main branches, and pulmonary and renal arteries. Childhood Takayasu arteritis is a subtype of Takayasu arteritis that affects the age group ranging from young infants to late adolescents. Case presentation We report the first childhood Takayasu arteritis case from Syria, a 12-year-old Syrian girl presenting with nonspecific symptoms and signs plus ischemic clinical features in her left arm. She relapsed twice with different additional symptoms each time. Conclusions There is scarcity of reviews and studies on childhood Takayasu arteritis in Arabs. We aim to share our experience to keep childhood Takayasu arteritis in mind as a differential diagnosis in any child presenting with hypertension, absent or reduced peripheral arterial pulse, or blood pressure differences between extremities.

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A Giant Coronary Sinus Aneurysm with Secondary Vena Cava Aneurysms

The Heart Surgery Forum ◽

10.1532/hsf.1354 ◽

2016 ◽

Vol 19 (1) ◽

pp. 028

Author(s):

Shengjun Wu ◽

Peng Teng ◽

Yiming Ni ◽

Renyuan Li

Keyword(s):

Computed Tomography ◽

Heart Transplantation ◽

Coronary Sinus ◽

Unusual Case ◽

Superior Vena ◽

Vena Cava ◽

Final Diagnosis ◽

Rare Entity ◽

First Case ◽

Enhanced Computed Tomography

Coronary sinus aneurysm (CSA) is an extremely rare entity. Herein, we present an unusual case of an 18-year-old symptomatic female patient with a giant CSA. Secondary vena cava aneurysms were also manifested. The final diagnosis was confirmed by enhanced computed tomography (CT) and cardiac catheterization. As far as we know, it is the first case that such a giant CSA coexists with secondary vena cava aneurysms. Considering the complexity of postoperative reconstruction, we believe that heart transplantation may be the optimal way for treatment. The patient received anticoagulant due to the superior vena cava (SVC) thrombosis while waiting for a donor.

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Immediate post partum macular subretinal bleeding in a highly myopic patient: a case report

BMC Ophthalmology ◽

10.1186/s12886-021-01814-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Karen Bitton ◽

J.-L. Bacquet ◽

F. Amoroso ◽

S. Mrejen ◽

M. Paques ◽

...

Keyword(s):

Valsalva Maneuver ◽

Post Partum ◽

Pathologic Myopia ◽

Pathological Myopia ◽

Case Presentation ◽

Sudden Loss ◽

Corrected Visual Acuity ◽

First Case ◽

History Of ◽

Macular Hemorrhage

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.

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Emphysematous pyelonephritis with air bubble in the inferior vena cava

African Journal of Urology ◽

10.1186/s12301-020-00081-2 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Tiffany A. Perkins ◽

Alberic Rogman ◽

Murali K. Ankem

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Case Presentation ◽

Air Bubble ◽

First Case ◽

The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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Robotic-assisted proximal gastrectomy using the double-flap technique for early gastric cancer with situs inversus totalis: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01262-z ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Atsushi Takeno ◽

Toru Masuzawa ◽

Shinsuke Katsuyama ◽

Kohei Murakami ◽

Kenji Kawai ◽

...

Keyword(s):

Gastric Cancer ◽

Situs Inversus ◽

Autosomal Recessive ◽

Intraoperative Complications ◽

Proximal Gastrectomy ◽

Situs Inversus Totalis ◽

Upper Body ◽

Robot Assisted ◽

Case Presentation ◽

First Case

Abstract Background The robotic system has been applied in the treatment of gastric cancer (GC), and the procedure has been found to be safe and feasible. Situs inversus totalis (SIT) is a relatively rare autosomal recessive congenital anomaly. We successfully performed robot-assisted proximal gastrectomy (RAPG) and handsewn double-flap esophagogastrostomy for GC in a patient with SIT. Case presentation A 71-year-old woman was referred to us with an asymptomatic ulcerative lesion in the upper body of the stomach. Computed tomography revealed that she had SIT. She was diagnosed with cT1bN0M0, cStageIA gastric cancer. RAPG with lymph node dissection and handsewn double-flap esophagogastrostomy was performed. Robotic surgery enabled the surgeon to perform the surgery without changing his position and experiencing any confusion resulting from the patient’s reversed anatomy. It took 448 min, and no intraoperative complications occurred. Her postoperative course was uneventful; she was discharged on postoperative day 10. The final pathologic report showed pT1b1N0M0, pStage IA. Conclusions This is the first case describing RAPG with handsewn double-flap esophagogastrostomy for a SIT patient with early GC.

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The impact of bZIP Atf1ortholog global regulators in fungi

Applied Microbiology and Biotechnology ◽

10.1007/s00253-021-11431-7 ◽

2021 ◽

Author(s):

Éva Leiter ◽

Tamás Emri ◽

Klaudia Pákozdi ◽

László Hornok ◽

István Pócsi

Keyword(s):

Transcription Factors ◽

Stress Response ◽

Secondary Metabolite ◽

Plant Pathogens ◽

Leucine Zipper ◽

Secondary Metabolite Production ◽

Special Focus ◽

Human Pathogens ◽

Metabolite Production ◽

The Impact

Abstract Regulation of signal transduction pathways is crucial for the maintenance of cellular homeostasis and organismal development in fungi. Transcription factors are key elements of this regulatory network. The basic-region leucine zipper (bZIP) domain of the bZIP-type transcription factors is responsible for DNA binding while their leucine zipper structural motifs are suitable for dimerization with each other facilitiating the formation of homodimeric or heterodimeric bZIP proteins. This review highlights recent knowledge on the function of fungal orthologs of the Schizosaccharomyces pombe Atf1, Aspergillus nidulans AtfA, and Fusarium verticillioides FvAtfA, bZIP-type transcription factors with a special focus on pathogenic species. We demonstrate that fungal Atf1-AtfA-FvAtfA orthologs play an important role in vegetative growth, sexual and asexual development, stress response, secondary metabolite production, and virulence both in human pathogens, including Aspergillus fumigatus, Mucor circinelloides, Penicillium marneffei, and Cryptococcus neoformans and plant pathogens, like Fusarium ssp., Magnaporthe oryzae, Claviceps purpurea, Botrytis cinerea, and Verticillium dahliae. Key points • Atf1 orthologs play crucial role in the growth and development of fungi. • Atf1 orthologs orchestrate environmental stress response of fungi. • Secondary metabolite production and virulence are coordinated by Atf1 orthologs.

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Fetal pulmonary choristoma: report of first case and literature review

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2020-0072 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Anupam Nanda ◽

Rajinder Nanda ◽

Seema Thakur ◽

Tej Prakash Gupta ◽

Sudhir Jain ◽

...

Keyword(s):

Literature Review ◽

Exome Sequencing ◽

Posterior Fossa ◽

Spinal Column ◽

Fetal Autopsy ◽

Case Presentation ◽

Antenatal Ultrasound ◽

Clinical Exome Sequencing ◽

First Case ◽

Pathologic Findings

AbstractObjectivesLung tissue choristoma is a very rare disorder where mature lung tissues develop in the site not normal to the lung.Case presentationWe hereby report a first case of fetal pulmonary choristoma in a 23–24 weeks fetus where antenatal ultrasound showed a mass in posterior fossa with severe ventriculomegaly. The mass extended inferiorly in cervical spinal column and thereafter extended in the skin over the back of fetus. Fetal autopsy confirmed these findings. Pathologic findings showed mature lung tissues with bronchi, bronchioles, and alveoli. Clinical exome sequencing showed normal results.ConclusionsWe describe the antenatal ultrasound, fetal autopsy and pathologic findings of an intracranial and cutaneous pulmonary choristoma.

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First reported case of penile prosthesis infection from brucellosis: case report

African Journal of Urology ◽

10.1186/s12301-020-00090-1 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Nabil Nabil Moohialdin ◽

Ahmad Shamsodini ◽

Steven K. Wilson ◽

Osama Abdeljaleel ◽

Ibrahim Alnadhari ◽

...

Keyword(s):

Case Report ◽

Broad Spectrum ◽

Surgical Intervention ◽

Penile Prosthesis ◽

Raw Milk ◽

Prosthesis Infection ◽

Case Presentation ◽

First Case ◽

Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

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A First Case Report of Orbital Extra-Adrenal Paraganglioma in Cat

Veterinary Sciences ◽

10.3390/vetsci8050086 ◽

2021 ◽

Vol 8 (5) ◽

pp. 86

Author(s):

Leonardo Leonardi ◽

Raluca Ioana Rizac ◽

Ilaria Pettinari ◽

Luca Mechelli ◽

Carlo De Feo

Keyword(s):

Parasympathetic Nervous System ◽

Neuron Specific Enolase ◽

Final Diagnosis ◽

Neuroendocrine Cells ◽

Neuroendocrine Neoplasm ◽

Glial Fibrillary Acid Protein ◽

Veterinary Clinic ◽

First Case ◽

The Right ◽

Extra Adrenal Paraganglioma

Paraganglioma is a rare neuroendocrine neoplasm originating from paraganglia and consisting of neuroendocrine cells of the sympathetic and parasympathetic nervous system. Extra-adrenal paraganglioma occurs with a low incidence in both humans and animals. This report presents the first case of paraganglioma in a cat with orbital primary location. An 18-year-old spayed female European domestic shorthair cat of 3.60 kg body weight was evaluated in a private veterinary clinic in Perugia, Italy, for a pronounced exophthalmos of the right eye. The cat underwent surgery for the enucleation of the right eye and of the mass. The biopsy samples of the removed tissue were fixed in 10% buffered neutral formalin for histological and immunohistochemical evaluations. Therefore, specific markers were used for immunohistochemical investigations, such as anti-neuron specific enolase (NSE), anti-synaptophysin, anti-glial fibrillary acid protein, anti-cytokeratin and anti-chromogranin. The results of these investigations allowed establishing the final diagnosis of ocular extra-adrenal paraganglioma of the cat.

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