Navigating Infertility in Kartagener's Syndrome: A Clinical Case Report.

Kartagener's syndrome is a genetic condition that is caused by a triad of symptoms, which includes bronchiectasis, chronic sinusitis, and situs inversus, and is considered rare. It is caused by defective ciliary motility, leading to impaired mucociliary clearance. We report a case of a 24-year-old male who presented with primary infertility and a long-standing history of recurrent respiratory infections. Physical examination revealed dextrocardia and digital clubbing. Radiological investigations confirmed situs inversus totalis and bronchiectasis. Semen analysis revealed azoospermia. Genetic analysis was not done due to financial constraints. However, the constellation of clinical features was diagnostic of Kartagener's syndrome. The patient was managed with antibiotics and chest physiotherapy. In vitro fertilization (IVF) was advised for infertility. A successful pregnancy was achieved through IVF, indicating viable sperm despite immotility. The aforementioned case underscores the significance of maintaining a heightened sense of suspicion for Kartagener's syndrome in individuals exhibiting unexplained bronchiectasis and infertility. Early diagnosis can prevent chronic respiratory morbidity and enable parenthood through assisted reproduction.

Black Tongue: A Rare Presentation of Rhupus Syndrome.

Black tongue is a benign condition typically caused by the overgrowth of dead skin cells, resulting in elongated papillae and a hairy appearance. Other factors contributing to this condition include inadequate oral hygiene, a soft diet, and staining from bacteria, food, yeast, and other substances. It may cause symptoms such as bad breath, a metallic taste in the mouth, and an unsightly black hairy-looking tongue. Here, we present a case of a 30-year-old female who came to our hospital complaining of bad breath and a black tongue for the past month. She had previously taken antibiotics at the primary care medical center, but there was no improvement. We then prescribed her fluconazole, an antifungal medication, for the next two weeks. After two weeks, she returned with a slightly improved tongue color. Further investigation revealed a history of abortion and mild intermittent joint pains, for which she had been self-medicating with over-the-counter acetaminophen. A complete work-up led to the discovery of positive anti-cyclic citrullinated peptide (anti-CCP) antibodies, anti-double-stranded (anti-DS) DNA antibodies, and ANA, leading to the diagnosis of Rhupus Syndrome, an overlap of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

Terlipressin-Induced Skin Necrosis While Managing Hepatorenal Syndrome: A Rare Case Report From North India.

Terlipressin is an analogue of vasopressin and is often used in the treatment of bleeding esophageal varices and also in the treatment of hepatorenal syndrome associated with liver cirrhosis. Although terlipressin is a safe drug, but it has been rarely associated with potentially serious adverse effects like ischemic necrosis of skin involving the abdominal skin, extremities, and scrotal skin. We present one such rare case where terlipressin-induced skin necrosis in bilateral lower extremities in a 48-year-old male while we were managing hepatorenal syndrome in the same.