Kluver-Bucy syndrome (KBS) is a characterized by a group of cognitive dysfunctions that include hypersexuality, placidity, hyperorality, memory deficits and hypermetamorphosis. This syndrome is often seen in pathological states that destroy the temporal lobes, normally bilaterally. Herpes simplex encephalitis (HSE) is one of the causes of KBS, as the herpes virus can cause dysfunction/destruction of the temporal lobes. KBS is a very rare syndrome, with just a few cases described in the literature. We present the case of a 21-year-old-man who was diagnosis with KBS after HSE.
Mesothelioma is a rare and insidious neoplasm and is characterized by its highly malignant and aggressive nature. The most common etiology is asbestos exposure, but there are some reports without known asbestos exposure and other factors leading to malignant pleural mesothelioma (MPM). Here, we present the case of a 58-year-old woman with pleuritic chest pain, dyspnea, and fever on presentation to the emergency department (ED), which caused several admissions to the ED in 20 days. The patient was then admitted to the internal medicine department with a diagnosis of community-acquired pneumonia with parapneumonic effusion. During hospitalization, a positron emission tomography (PET) scan, thoracic computed tomography (CT), and pleural biopsy were performed and a final diagnosis of malignant epithelioid pleural mesothelioma was made. Six weeks after the onset of symptoms, the patient presented with an exponential disease progression, dying two months after the diagnosis, despite the initiation of chemotherapy. MPM remains a diagnostic and therapeutic challenge with a very poor prognosis. However, studies show that mesothelioma patients who undergo treatment live at least twice as long as patients who do not receive treatment. This case report is particularly significant because, although it was epithelioid mesothelioma, multiple solid masses were noted on CT and the patient exhibited rapid disease progression, dying a few weeks after starting treatment.
Kaposi sarcoma (KS), first described in 1872, is an angioproliferative neoplasm that often presents with red-purple macules in the skin. This report is of a case of classic/iatrogenic form of KS in a 79-year-old male, that had a prolonged hospitalization due to surgical complications. After discharge, he presented a red-purple macule. A biopsy was made and KS was confirmed. He was HIV negative. The patient did not require any other treatment asides from the total removal of the lesion. Kaposi's sarcoma is an uncommon disease, still very associated with HIV. This case demonstrates the importance of recognition of KS in non-HIV patients. There are four types of Kaposi's sarcoma and the importance of its recognition in non-HIV patients.
Intravesical instillation of bacillus Calmette-Guérin (BCG) is the adjuvant therapy for superficial urothelial carcinoma of the bladder with the lowest recurrence rates and is well tolerated with minor and self-limiting adverse effects. Serious complications, such as systemic BCG infection, are uncommon as the diagnosis is difficult and, in the majority of cases, Mycobacterium bovis cannot be isolated.We describe a case of a man who presented with prolonged fever associated with polyuria, dysuria, anorexia, and significant weight loss, refractory to several courses of appropriate antibiotic therapy. After an exhaustive investigation, the underlying diagnosis of systemic BCG infection with renal involvement was considered. Antituberculosis treatment resulted in a marked clinical and radiological recovery, supporting this diagnosis.
The Lane-Hamilton syndrome (LHS) is an extremely rare association between celiac disease (CD) and idiopathic pulmonary hemosiderosis (IPH), with only a few cases reported in the literature.The authors report a case of a 32-year-old man with Down syndrome who presented to the emergency department with a history of hemoptysis and chronic diarrhea. The complementary investigation revealed iron deficiency anemia and features suggestive of diffuse alveolar hemorrhage on computed tomography (CT) scan of the chest. After excluding all competing diagnosis, the IPH diagnosis was made. The biopsy of the small intestine confirmed CD and the diagnosis of LHS was established. A gluten-free diet and steroids were given to the patient with a very good clinical response.Since there is an established association between IPH and CD, if the diagnosis of IPH is made, it's recommended to screen for CD even in patients without gastrointestinal symptoms.
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