Eritema nodoso: gatta ci cova

Erythema nodosum is a panniculitis that can be triggered by many different stimuli. The paper describes the case of a child who presented with erythema nodosum as the unique clinical manifestation of cat scratch disease. Bartonella henselae infection usually presents with non-tender papule in the scratch line followed by subsequent onset of regional lymphadenopathy eventually associated with systemic symptoms. It can also present with atypical manifestation, such as erythema nodosum. The heterogeneity of the clinical presentations makes the disease to be underdiagnosed, whereby it is important to recognize atypical manifestations. Therefore, it is recommended to include Bartonella henselae serology in the diagnostic evaluation of erythema nodosum.

SARS-CoV-2 infection presenting as rhabdomyolysis: case report and review

Coronavirus disease 2019 (COVID-19) is the health crisis of our time and a great challenge we face, requiring the implementation of worldwide general containment. The symptoms and complications of COVID-19 are diverse, and rhabdomyolysis is an atypical manifestation. We report a case of a 63-year-old patient, admitted to the emergency room for myalgia and fever evolving over 5 days, in whom laboratory and other examinations indicated rhabdomyolysis complicated by renal insufficiency. During the diagnostic workup, the real-time polymerase chain reaction (RT-PCR) test result for COVID-19 was positive, revealing infection with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the severity of COVID-19 infection relates mainly to acute respiratory syndrome, other complications can be prognostic, and these complications make the management of this disease difficult. Rhabdomyolysis is one of the fatal complications; first, because the pathophysiological mechanism is not yet understood, and second, because rhabdomyolysis, itself, is usually complicated by acute renal failure. This complication makes the disease management difficult, especially in patients with SARS. Rhabdomyolysis during COVID-19 infection represents a significant challenge, given the few reported cases, and further research is required to develop a therapeutic consensus.

Cutaneous Plasmacytosis: Diagnostic and Therapeutic Challenge in a Patient with an Atypical Presentation

Cutaneous plasmacytosis is a rare dermatosis that is classically characterized by the presence of multiple papules and reddish- -brown nodules mainly in the trunk. It most commonly affects elderly Asians, with few reports in Caucasians and young patients. On histopathology there is a polyclonal proliferation of mature plasm cells. The objective of this report is to present a case of atypical manifestation of this rare disease, both due to clinical and epidemiological aspects.

Unilateral vocal cord adductor weakness: an atypical manifestation of motor neurone disease

BackgroundBulbar involvement is a recognised feature of motor neuron disease/amyotrophic lateral sclerosis (MND/ALS), both as a presenting complaint and as a consequence of advancing disease. Hoarseness and dysphonia have been associated with vocal cord abductor weakness. This is usually bilateral and has also been reported as the presenting clinical feature in a handful of patients with superoxide dismutase 1 (SOD1) gene mutations. Presentation with an isolated, unilateral vocal cord adductor weakness, however, is atypical and rare.CaseIn this report, we detail the case of a 38-year-old woman with dysphonia and a family history of an SOD1 mutation. Neurological features remained confined to the territory of the left vagus nerve for the next 12 months, before a more rapid rate of disease dissemination and progression.ConclusionsThis case highlights the importance of recognition of vocal cord palsy as an early manifestation of MND/ALS and the critical need for monitoring to recognise potential disease progression.

Pulmonary metastasis of transmissible venereal tumour in a dog: a case report

The transmissible venereal tumour (TVT) is one of the most frequent neoplasias in dogs. This tumour has specific characteristics, and it is exclusively of canines. Its transmission occurs through viable neoplastic cell transplantation when in contact with mucosa or unhealthy skin and rarely metastasise. This paper aims to report a rare presentation of pulmonary metastasis of widespread transmissible venereal tumours in a Blue Heeler dog. The patient was cachectic, dyspnoeic, and dehydrated and had multiple skin and pharynx nodulations. The cytology of all cutaneous nodulations showed round vacuolated cells with large eccentric nuclei and loose chromatin, which is compatible with TVT’s microscopic characteristics. Owing to the clinical evolution and reserved prognosis, the patient was euthanized. Necroscopy revealed a mass in the right pulmonary caudal lobe. The mass showed the same histopathologic characteristic of the others: not encapsulated infiltrative neoplastic proliferation of round vacuolated cells. The atypical manifestation of cutaneous metastasis and mainly pulmonary metastasis, in this case, denote the importance of TVT inclusion as a differential in cutaneous neoplasia, even if they show distant organ metastasis. Therefore, it emphasised the importance of cytology and histology in the diagnosis of nodular affections.