Hidradenitis suppurativa, holistic approach and surgical reconstruction

We present a young adult male patient with chronic Hidradenitis Suppurativa (HS) stage Ⅱ-Ⅲ, mostly involving buttocks, thighs and perineum. The patient has been followed initially by a dermatologist for 2 years with trials of Biologic treatments. The ongoing purulent discharges made him quite dysfunctional. Patient was offered a definitive and extensive surgical option. Considering this conditions’ devastating social, psychological effects, such patients should be managed with a multidisciplinary team, elaborated education and counseling. Initial line of treatment plans should be considered as preparatory to the definitive surgical excisional therapy. Patient’s acceptance to the entire package that goes with the definitive surgery is fundamental for a successful and lasting outcome. Complete surgical resection of the disease and reconstruction remains to be the only available option for cure in a fully established HS.

Acute hemodialysis catheter follows the path of least resistance

The placement of large bore double-lumen catheters for hemodialysis (HD) is one of the most frequent procedures performed in HD patients. However, these procedures are associated with complications, the most common being catheter malposition. In this context, catheter deviation to the left superior intercostal vein (LISV) is a very uncommon malposition, which must be differentiated from intrathoracic extravascular catheter lodgment. We report a case of an adult male patient on hemodialysis who presented with a thrombosed arteriovenous fistula and requiring urgent HD. His past medical history included hemophilia, allergy to contrast media, and multiple previous central vein catheterizations. A non-tunneled HD catheter was placed without any difficulty in the left internal jugular vein. However, the arterial lumen failed to pull any blood with free flow in the venous lumen. A chest X-ray revealed a surprising finding. The malpositioned catheter was removed successfully without any complications.

Type 2 bridging bronchus with left pulmonary artery sling

Bridging bronchi are the rarest of the major airway anomalies reported in the literature. In this brief report, we present a case of a symptomatic adult male patient presenting with a type 2 bridging bronchus associated with left pulmonary artery sling.

Central TSH Dysregulation in a Patient with Familial Non-Autoimmune Autosomal Dominant Hyperthyroidism Due to a Novel Thyroid-Stimulating Hormone Receptor Disease-Causing Variant

Background and Objectives. Familial non-autoimmune autosomal dominant hyperthyroidism (FNAH) is a rare cause of childhood hyperthyroidism. It is caused by the thyroid-stimulating hormone receptor (TSHR) gene variants. So far, only around 40 families with FNAH have been reported. Patients with activating TSHR variants demonstrated the same classical signs and symptoms of hyperthyroidism as seen in patients with Graves’ disease. Since 2012, ablative therapy is recommended to avoid relapses of hyperthyroidism and its consequences. Case Presentation. We presented a young adult male patient with a novel heterozygous TSHR disease-causing variant p.Arg418Lys (c.1253G>A) in the exon 10, who presented with a mild but progressive FNAH, with a follow-up since infancy. Discussion. Constantly suppressed TSH, including during the euthyreosis in childhood and hypothyreosis after iodine ablation therapy, suggested central dysregulation of the TSH secretion.

An Incomplete Form of Shone’s Complex With Double Orifice Mitral Valve

We present the case of an adult male patient with an incomplete form of Shone’s complex associated with bicuspid aortic valve and a double orifice mitral valve. Intraoperative inspection of the mitral valve showed double orifice configuration with a small, rudimentary left-sided mitral valve and a large, dominant, right-sided parachute mitral valve with Barlow-type of degeneration. The patient underwent reconstruction of both valves through a minimally invasive incision. At one year echocardiographic control both valves function normally.

When tumefactive demyelination is truly a tumor: case report of a radiographic misdiagnosis

Oligodendrogliomas are slow-growing tumors that account for 15–20% of gliomas. This case report describes the case of an adult male patient diagnosed initially with tumefactive demyelination and multiple sclerosis, which was subsequently found to be a well-differentiated low-grade oligodendroglioma. This case emphasizes the importance of timely diagnosis in oligodendrogliomas and other brain tumors for the prompt initiation of appropriate therapy, to minimize the likelihood of disease progression, ensure symptom management and escalation of unnecessary treatments for multiple sclerosis.

Draft Genome Sequence of Chromobacterium violaceum RDN09, Isolated from a Patient with a Wound Infection in Bangladesh

ABSTRACT Chromobacterium violaceum is an emerging environmental opportunistic pathogen that causes life-threatening infections in humans. Here, we describe the draft genome sequence of Chromobacterium violaceum RDN09, isolated from the infected wound of an adult male patient in Bangladesh. The genome assembly consists of 4,736,739 bp spread across 84 contigs.