Eosinophilic gastritis without peripheral eosinophilia and atopy: A case report.

Eosinophilic gastritis (EG) is characterized by eosinophilic infiltration of any gastric layers. We report a 65-year-female presenting with abdominal pain and vomiting for two months. Chronic gastritis not responding to empirical treatment interrogated further investigations. In the absence of atopy and peripheral eosinophilia, successful treatment of a large solitary antral ulcer with steroids upheld the diagnosis of EG.

Diagnostic Dilemma of Widespread Vesiculobullous Lesions: A Case Report.

Stevens-Johnson syndrome and toxic epidermal necrolysis represent a spectrum of severe mucocutaneous reactions, while Acute Cutaneous Lupus Erythematosus is a variant of Systemic Lupus Erythematosus. Both are rare conditions, with significant morbidity and mortality; often indistinguishable clinically and pose a diagnostic dilemma for the clinician. We hereby present a unique case of a 17 years old female who presented with widespread vesiculobullous lesions with peeling, desquamation, and crusting of the skin surface, non-scarring alopecia, oral and nasal ulcers, as well as two episodes of generalized tonic-clonic seizures. The patient had a history of intake of itraconazole tablets for a week, 25 days before the disease manifestation.

Multiple Wasp Stings Leading to Rhabdomyolysis Induced Acute Kidney Injury with Incidental Ectopic Kidney: A Case Report.

Rhabdomyolysis refers to skeletal muscle breakdown causing a release of different intracellular proteins including myoglobin and several electrolytes in the bloodstream. Elevations diagnose rhabdomyolysis in serum creatine kinase. Mass envenomation by multiple wasp stings can cause rhabdomyolysis followed by acute kidney injury, although it is scarce. A 24-year-old male presented to our tertiary centre in an anaphylaxis-like state after multiple wasps sting, rapidly developing rhabdomyolysis followed by acute kidney injury. Despite having an ectopic kidney with a pre-existing renal parenchymal disease, he recovered and was discharged, which in itself is a rare entity of low clinical incidence. Wasp stings can potentially result in serious clinical manifestations, which need to be watched over, assessed and promptly treated. Keywords: acute kidney injury; case reports; creatine kinase; hymenoptera; rhabdomyolysis.

Herlyn Werner Wunderlich Syndrome Presenting with Ischemic Stroke due to Suspected Paroxysmal Nocturnal Hemoglobinuria: A Case Report.

Paroxysmal nocturnal hemoglobinuria can rarely present as cerebral ischemia and stroke due to arterial thrombosis. However, it should be considered in a young patient with bone marrow failure features, systemic thromboses, and hemolysis. The variants of paroxysmal nocturnal hemoglobinuria pose a diagnostic challenge and hence are important to recognize. We report a case of a 28-years-old female with Herlyn Werner Wunderlich Syndrome who presented with an ischemic cerebrovascular accident, pancytopenia, hemoglobinuria, and widespread abdominal thromboses suggestive of paroxysmal nocturnal hemoglobinuria. The patient was managed symptomatically and referred to a hematologist.

Cotrimoxazole Induced Steven Johnson Syndrome: A Case Report.

Steven Johnson syndrome and toxic epidermal necrolysis are severe and rare adverse drug reactions usually caused by drugs like antiepileptics, penicillin and allopurinol and sometimes also due to infections, malignancy or idiopathic in some cases. Here we are reporting a case of a 50 years female who came with complaint of a burning sensation on the upper half of the body with atypical flat target lesion that later coalesced involving her face, chest and bilateral upper limbs. On examination, positive nikolsky sign and tenderness with <10% body surface area involvement was noticed. The diagnosis of cotrimoxazole induced Steven Johnson syndrome was made. Patient was shifted to ICU and given supportive care along with prophylactic teicoplanin, itraconazole and dexamethasone. The mechanism of eruptions in our patient was due to cotrimoxazole. Cotrimoxazole induced Steven Johnson syndrome is rare and the supportive management with broad spectrum antibiotic and the corticosteroid was enough to beat this life-threatening condition. Keywords: cotrimoxazole; pneumonia; Steven Johnson syndrome.