Uncommon Clinical Presentations of Sporotrichosis: A Two-Case Report

Sporotrichosis is a subcutaneous endemic mycosis caused by species of the Sporothrix schenckii complex. The most common clinical form of the disease is lymphocutaneous, while the fixed cutaneous and disseminated cutaneous forms are rare. Moreover, it is more prevalent in immunocompetent individuals. In this study, we present two cases of sporotrichosis with uncommon clinical forms: fixed cutaneous (Case 1) and disseminated cutaneous (Case 2). Both cases were diagnosed in immunocompetent males from endemic regions in Mexico, who had at least 1 year of evolution without improvement in response to prior nonspecific treatments. The diagnosis of sporotrichosis caused by S. schenckii sensu stricto was established through the isolation of the pathogen and its identification through the amplification of a 331 bp fragment of the gene encoding calmodulin. In both cases, improvement was observed after treatment with potassium iodide. Cases 1 and 2 illustrate the rarity of these clinical forms in individuals residing in endemic areas; hence, it is important to ensure a high index of clinical suspicion for the diagnosis of mycosis, as the differential diagnoses vary widely.

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Diagnostic challenges in tuberculous otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215110000265 ◽

2010 ◽

Vol 124 (8) ◽

pp. 913-915 ◽

Cited By ~ 5

Author(s):

I P Tang ◽

N Prepageran ◽

C A Ong ◽

P Puraviappan

Keyword(s):

Case Report ◽

Early Diagnosis ◽

Antibiotic Therapy ◽

Otitis Media ◽

Surgical Intervention ◽

Clinical Suspicion ◽

Middle Ear Infection ◽

Clinical Presentations ◽

Tuberculous Otitis Media ◽

Systemic Antibiotics

AbstractObjectives:To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases.Case report:We report four cases of tuberculous otitis media with different clinical presentations, encountered between 1998 and 2002. None of the cases showed improvement with local or systemic antibiotics. The diagnosis, complications and management of these cases are discussed.Conclusions:A high index of clinical suspicion of tuberculous otitis media is required in patients who do not respond to standard antibiotic therapy for (nontuberculous) chronic middle-ear infection. Early diagnosis and treatment of tuberculous otitis media is important to avoid irreversible complications, surgical intervention and propagation of the disease.

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Patients With Several Clinical Presentations By SARS-CoV2 Showed A Dramatic Decrease Of Antibodies.

10.21203/rs.3.rs-491222/v1 ◽

2021 ◽

Author(s):

Salim Mattar ◽

Héctor Serrano-Coll ◽

Mara Garcia-Posada ◽

Bertha Gastelbondo ◽

Katherine Humanez-Moreno ◽

...

Keyword(s):

Vaccination Strategy ◽

Spike Protein ◽

Caribbean Region ◽

Natural Immunity ◽

Igg Antibodies ◽

Clinical Form ◽

Dramatic Decrease ◽

Blood Samples ◽

Clinical Forms ◽

Clinical Presentations

Abstract There are many doubts about the SARS-CoV-2 immune response's length, and it is unknown whether those patients may exhibit different kinetics in the secretion of IgG anti-SARS-CoV2 according to the severity of their infection. This research aimed to evaluate IgG antibodies' kinetics and persistence against the SARS-CoV-2 Spike protein in a group of COVID-19 patients with different clinical disease presentations in the Colombian Caribbean region. Two blood samples were taken. The first one was at the first surge in August 2020; the second was six months later, February 2021. The study showed a decrease of 61.1% in their median of IgG antibodies after six months (P > 0.0001). According to the clinical form of COVD-19, the patients that required hospitalization (moderate or severe) COVD-19 showed a lower secretion of IgG against SARS-CoV2 and a higher negative seroconversion for IgG 69.2% in the second serological evaluation (P < 0.05). Thus, the drop of antibodies-SARS-CoV-2 is typical in all the clinical forms of COVID-19. It is worrisome in patients with moderate or severe clinical forms. The evaluation of natural immunity is mandatory to define the vaccination strategy mainly in patients that suffered complicated forms of COVID-19.

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Primary Hepatic Neuroendocrine Tumor and its Metastasis to Breast; Case Report of an Unusual Malignancy

American Journal of Health, Medicine and Nursing Practice ◽

10.47672/ajhmn.813 ◽

2021 ◽

Vol 6 (4) ◽

pp. 14-25

Author(s):

Amjad Zafar ◽

Rabia Iqbal ◽

Amina Jafar ◽

Taimoor Bajwa ◽

Sobia Yaqub ◽

...

Keyword(s):

Case Report ◽

Mass Effect ◽

Typical Feature ◽

Clinical Suspicion ◽

Unusual Site ◽

Rare Tumors ◽

High Clinical Suspicion ◽

Clinical Presentations ◽

Metastasis To Breast ◽

Primary Hepatic Neuroendocrine Tumor

Introduction: Neuroendocrine tumors (NETs) are rare tumors with varied clinical presentations. Entero-pancreatic and respiratory systems are usually involved but it can also affect unusual sites like the liver. Purpose: This paper presents a case of a 45 years female who developed progressive and disabling symptoms of mass effect and carcinoid but remained undiagnosed for many years due to extremely low suspicion of such a tumor in liver. Methods: Diagnosis was made after extensive radiological, histopathological, and biochemical investigations. By that time, disease had spread to her breast which is also not a typical feature of NETs. Findings: Diagnosis of rare tumors at an unusual site is challenging and requires high clinical suspicion and appropriate workup.

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Case Report: A Novel TNFAIP3 Mutation Causing Haploinsufficiency of A20 With a Lupus-Like Phenotype

Frontiers in Immunology ◽

10.3389/fimmu.2021.629457 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zachary R. Shaheen ◽

Sarah J. A. Williams ◽

Bryce A. Binstadt

Keyword(s):

Case Report ◽

Early Onset ◽

Autoinflammatory Disease ◽

Clinical Symptoms ◽

Novel Mutation ◽

Genetic Mutations ◽

Loss Of Function ◽

Gene Encoding ◽

Clinical Presentations ◽

Wide Range

Genetic mutations that result in loss-of-function of the protein A20 result in an early-onset autoinflammatory disease—haploinsufficiency of A20 (HA20). The reported clinical presentations of HA20 include a Behcet’s disease-like phenotype and a more lupus-like phenotype. We have identified a novel mutation in the gene encoding A20 in a pediatric patient with chronic lymphadenopathy, lupus-like symptoms, and progressive hypogammaglobulinemia. This case illustrates the wide range of clinical symptoms, including immunodeficiency, that can occur in patients with HA20.

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Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

BMJ Case Reports ◽

10.1136/bcr-2019-233179 ◽

2020 ◽

Vol 13 (12) ◽

pp. e233179

Author(s):

Eric Garrels ◽

Fawziya Huq ◽

Gavin McKay

Keyword(s):

Cognitive Impairment ◽

Case Report ◽

Potassium Channel ◽

Limbic Encephalitis ◽

Psychiatric Symptoms ◽

Differential Diagnoses ◽

Visual Hallucinations ◽

Voltage Gated ◽

History Of ◽

Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

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Cholesterol Granuloma of the Maxillary Sinus—A Case Report and Literature Review

Allergy & Rhinology ◽

10.1177/2152656720984785 ◽

2021 ◽

Vol 12 ◽

pp. 215265672098478

Author(s):

Abdulrahman Alghulikah ◽

Norah Musallam ◽

Ibrahim Sumaily ◽

Amany Fathaddin ◽

Surayie Aldossary

Keyword(s):

Case Report ◽

Literature Review ◽

Maxillary Sinus ◽

Review Article ◽

Unusual Presentation ◽

Differential Diagnoses ◽

Anatomical Site ◽

Cholesterol Granuloma ◽

Comprehensive Literature Review

Cholesterol Granulomas of the Maxillary Sinus, considered an unusual presentation at this anatomical site. Over last 2 decades, only few cases are reported in the literature (English) and no available comprehensive reviews or studies on this entity. Herein in this article we present a comprehensive literature review of the available reports of 16 cases along with reporting a new case which we managed, aided with its histopathological pictures. This review article can be a reference for practitioners in the field of otorhinolaryngology who may encounter these cases. Also, it attracts the attention to consider this pathology among the differential diagnoses of nasal masses. Moreover, including a described pathological imaging may help young pathologist to identify this pathology.

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Gorham Stout disease: a case report from Syria

Oxford Medical Case Reports ◽

10.1093/omcr/omaa121 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Asil Esper ◽

Sami Alhoulaiby ◽

Areege Emran ◽

Safwan Youssef ◽

Zuheir Alshehabi

Keyword(s):

Case Report ◽

Femoral Head ◽

Bone Formation ◽

Clinical Picture ◽

Bone Matrix ◽

Differential Diagnoses ◽

Rare Entity ◽

Relative Improvement ◽

Cellular Atypia ◽

Pathologic Fractures

Abstract Gorham-Stout disease (GSD) is a rare entity that destroys the bone matrix resulting mainly in osteolysis, pain and pathologic fractures among a broader clinical picture. We report a case of a 60-year-old female with a sudden discovery of pathologic fractures in the pelvis and the absence of the left femoral head. On biopsy, no cellular atypia was found, instead disturbed bone formation with prominent vascularity with scattered foci of necrosis & osteolysis, which lead to the diagnosis of GSD. Possible differential diagnoses were discussed and excluded. The patient was put on Bisphosphonate that led to a relative improvement in the symptoms. This disease needs a more thorough investigation to identify the key cause, what is beyond the scope of this report.

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Proteus syndrome in pregnancy: A case report

Obstetric Medicine ◽

10.1177/1753495x20970791 ◽

2020 ◽

pp. 1753495X2097079

Author(s):

Niccole Ranaei-Zamani ◽

Mandeep K Kaler ◽

Rehan Khan

Keyword(s):

Case Report ◽

Case Reports ◽

Proteus Syndrome ◽

Cutaneous Lesions ◽

Genetic Syndrome ◽

Skeletal Tissue ◽

First Case ◽

Large Teaching Hospital ◽

Clinical Presentations ◽

In Pregnancy

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.

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Ovarian Torsion in a 5-Year Old: A Case Report and Review

Case Reports in Emergency Medicine ◽

10.1155/2012/679121 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Matthew F. Ryan ◽

Bobby K. Desai

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Case Report ◽

Urinary Tract ◽

Clinical Suspicion ◽

Ovarian Torsion ◽

Surgical Emergencies ◽

High Clinical Suspicion ◽

Tract Infections ◽

Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

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Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1063 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S311-S311

Author(s):

F. Pavez Reyes ◽

M. Sánchez ◽

E. Moral ◽

M. Terradillos ◽

N. López ◽

...

Keyword(s):

Case Report ◽

Alcohol Dependence ◽

Cerebellar Atrophy ◽

Clinical Suspicion ◽

Gamma Glutamyl Transferase ◽

The Family ◽

Other Information ◽

Diagnostic Hypothesis ◽

Competing Interest ◽

Glutamyl Transferase

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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