Brucellosis Presenting as Isolated Abdominal Lymphadenopathy Masquerading as Lymphoma: A Case Report.

Mesenteric lymphadenopathy associated with high-grade fever can be frequently associated with hematologic malignancies, especially if accompanied by joint pain, weight loss, and anorexia. However, this constellation of symptoms, also known as "B Symptoms," can be the uncommon presenting manifestation of brucellosis, still a common zoonotic disease in the Middle Eastern basin. In this article, we report the case of a Lebanese man who presented with "B symptoms" of three weeks duration, who was thought to have lymphoma but was later found to have systemic brucellosis.

Kikuchi-Fujimoto disease associated with a flare-up of a leukocytoclastic vasculitis: A rare case report and review of literature.

RATIONALE: Kikuchi-Fujimoto disease (KFD) also known as histiocytic necrotizing lymphadenopathy is an exceedingly rare cause of cervical lymphadenopathy, commonly accompanied by systemic symptoms such as fever, fatigue, night sweats, myalgia, skin rash. PATIENT CONCERNS: In this paper, we report the case of a 22-year-old female patient who experienced a flare-up of leukocytoclastic vasculitis that was complicated by the appearance of a cervical lymph node with dysphagia, fever and nausea. DIAGNOSIS: Infectious and autoimmune workup came back negative. INTERVENTIONS: Excisional lymph node biopsy was done and the pathology results were consistent with histiocytic necrotizing lymphadenitis in keeping with Kikuchi-Fujimoto disease. OUTCOMES: Patient improved on intravenous corticosteroids and was discharged on per os prednisone. Six month follow-up shows complete resolution of her symptoms. LESSONS: KFD should be ruled out in patients with autoimmune or inflammatory diseases who develop lymphadenopathies.

Chemical Meningitis and Syndrome of Inappropriate Antidiuretic Hormone Release (SIADH): A Rare Presentation of Pituitary Adenoma Apoplexy.

Pituitary apoplexy is an uncommon condition typically resulting from a sudden haemorrhage within a pituitary adenoma. This bleed can present clinically with a wide array of signs and symptoms. This report documents the case of a 62-year-old male who presented to the Lebanese Hospital Geitaoui University Medical Center with signs and symptoms of meningeal irritation. He was initially thought to have meningitis, and was started on antibiotics; he was then found to have pituitary adenoma apoplexy that was complicated by syndrome of inappropriate antidiuretic hormone release (SIADH). The patient was successfully treated with antibiotics, and fluid restriction and hypertonic saline after ruling out other more common causes for his hyponatraemia, before undergoing a transsphenoidal resection of the pituitary adenoma. A three-month follow-up evaluation of the patient demonstrated the absence of hormonal imbalances and the absence of residual tumours on imaging. LEARNING POINTS: Pituitary apoplexy has as a wide clinical presentationPituitary apoplexy should be ruled out in patients with aseptic chemical meningitis with a history of pituitary adenomasSIADH can complicate chemical meningitis due to pituitary apoplexy.