H Syndrome is a rare genodermatosis. It may include facial involvement such as : facial telangiectasia, both hypo- and hyperpigmented lesions, hirsutism, swollen cheeks due to subcutaneous infiltration and eczematous lesions. We describe a new facial phenotype with dermoscopic and histological features in the spectrum of non-Langerhans cell histiocytosis.
A young man, a recent coronavirus patient, was readmitted with hypoesthesia and dysarthria following a rapid deterioration of respiratory symptoms. The brain and lung CT scans revealed ischemia and cavitary lung lesions. Clinical suspicion for aspergillus leads to prompt treatment, confirmed by biopsy. Neurologic and pulmonary symptoms resolved ultimately.
Inguinal hernia may contain the bladder as one of its contents, while bilateral inguinal bladder herniation is rare. Urinary obstruction and obesity are associated with increased abdominal pressure and are risk factors of bladder herniation. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity.
Our patient is a 39-year-old male with normal baseline blood parameters who presented with COVID-19 infection, associated with neutropenia and then progressed to critical disease culminating into CSS. Based on risks and benefits evaluation, he was treated with Tocilizumab reinforced with G-CSF leading to full recovery including reversal of neutropenia.
Desmoplastic fibroblastoma is a benign soft tissue tumor of fibroblastic and myofibroblastic origin. The present case report depicts an unusually large desmoplastic fibroblastoma, in a 50-year-old female. The lesion presented on the left side of the face, mimicking a soft tissue malignancy. Keywords: benign, desmoplastic, fibroblastoma, female.
A 44-year-Old Male with Esophageal UlcerQuestion: A 44-year-old male was admitted for acute gastrointestinal bleed, intermittent esophageal dysphagia, and odynophagia. His past medical history was significant for dermatomyositis, for which he was on mycophenolate but had previously received prednisone and methotrexate. The treatment for his dermatomyositis had been complicated by pancytopenia with Hemoglobin 6.8 (13.2 - 16.6 g/dL), platelet 73 (135 - 317 x10(9)/L), and white blood cells 1.9(3.4 - 9.6 x10(9)/L). He underwent esophagogastroduodenoscopy (EGD), which showed a deep esophageal ulcer on the background of diffuse white plaques in the middle third of the esophagus and a non-bleeding large cratered clean-based gastric antral ulcer (Figure 1, A&B). Barium swallow showed a sac-like structure consistent with the ulcer without contrast leakage to suggest a fistula (Figure 1, C). What is the most likely diagnosis?Answer: This is a classic presentation of Cytomegalovirus (CMV) esophageal ulcer. The biopsy of the ulcer revealed positive CMV immunostaining, with negative immunostaining for Herpes simplex virus and fungus. His quantitative CMV DNA was 20400 IU/mL (Reference range Undetected), and his HIV test was negative. CMV predominantly causes opportunistic infection in immunosuppressed patients. It mainly causes gastrointestinal symptoms, with about 12.9% of patients presenting with esophageal disease. Unlike other infectious esophageal ulcers, CMV tends to cause one or more giant (>1cm) ulcers that may be flat, ovoid, or diamond-shaped.
Pulmonary inflammatory myo-fibroblastic tumor (IMT) is a rare condition in normal population and specifically in pediatric population. We reported a 9-year-old male child presented by cough and intermittent fever and weight-loss that was mostly suggestive for infectious process. We reviewed the consideration of diagnosis and treatment and other previous cases.
We report an atypical presentation of a current disease to highlight the importance of making a correct diagnosis of scabies surrepticius in front of any itchy dermatosis especially in elderly patients. The misdiagnosis of this disease results in extensive infestation, especially with the use of corticosteroids.
Being rare, rhinosporidiosis is a chronic granulomatous disease that is characterized by polypoidal lesions of the mucous membrane and is caused by Rhinosporidium seeberi. The disease commonly affects the mucous membrane of the nasopharynx, conjunctiva and palate and its very rare in our geographical location.
Febrile infection-related epilepsy syndrome (FIRES) is a disease of unknown etiology, characterized by refractory frequent focal seizures, which require prolonged intensive care. We successfully treated a boy with FIRES with anti-inflammatory and immunosuppressive therapy. This case suggests that an autoimmune mechanism may play a role in the development of FIRES
Myositis ossificans circumscripta (MOC) is a benign, self-limiting heterotopic ossification in the subcutaneous fat, tendons, muscles, and nerves. It is commonly due to trauma and is frequently encountered in the arm, shoulder, thigh, and hand which are prone to trauma. Non-traumatic MOC arising from the abdominal muscles is extremely rare
Recently, in Pakistan, several cases of mysterious dengue-like illness are being reported. We present a case of a 52-year-old female presenting with a history of continuous fever, documented up to 104 F, for five days. The symptoms were associated with headache, nausea, retro-orbital headache, arthralgia, and myalgia.