Urinary tract tuberculosis misdiagnosed and treated as renal carcinoma in the presence of diffuse interstitial nephritis: a case report.

BACKGROUND: Urinary tract tuberculosis (UTTB) is a common form of extrapulmonary tuberculosis (TB) which can infrequently present as renal carcinoma, leading to serious errors in the diagnosis and treatment of UTTB. CASE PRESENTATION: A 76-year-old Syrian man presented with gross hematuria as the main symptom. A urinary endoscopic examination and pelvic multi-slice computed tomography imaging increased the suspicion of a speared renal mass in the right urinary tract. The patient was treated for renal cancer. After nephrectomy and ureterctomy, the histopathology of the resected mass confirmed the diagnosis of UTTB and interstitial nephritis. CONCLUSION: This case should serve to increase the attention of clinicians to perform an accurate diagnosis step by step. This is especially important if they have a patient similar to the case described here who presents with a renal mass, to avoid serious results such as the loss of an essential organ system.

Delay in diagnosis of intestinal obstruction in a 17 year-old female with Familial Mediterranean fever: The first case report from Syria.

Familial Mediterranean fever (FMF) is an autosomal recessive auto-inflammatory disorder characterized mainly by brief recurrent episodes of peritonitis, pleuritis, and arthritis, usually with accompanying fever. Almost all patients with FMF experience abdominal episodes. Abdominal pain develops, and may progress to peritonitis. Intestinal obstruction secondary to adhesions may be observed in FMF patients but this is the first case from Syria. A 17-year-old Syrian female patient presented to our hospital complaining of abdominal pain, frequent vomiting, weight loss and absolute constipation in the past ten days, with a confirmation of her infecting by FMF 3 years ago. The obstruction was treated conservatively and after 6 months we had to treat the obstruction by laparoscopic releasing of abdominal bands as a result of recurrence. The patient was discharged and followed up for 6 months with excellent results. We herein report the first known case of FMF with small bowel obstruction in Syria with delayed in diagnosis. Physicians should be alert to this possible complication when FMF patients arrive at the emergency room.

An atypical presentation of a strangulated bochdalek hernia in a 60-year-old woman.

Bochdalek hernia (BH), resulting from the failure of posterolateral diaphragmatic foramina to fuse, is the most common congenital diaphragmatic hernia and usually manifests in pediatric age with life-threatening complications. Here, we report the case of a 60-year-old female with a left-sided Bochdalek diaphragmatic hernia, who presented with abdominal pain and dyspnea. The patient was successfully treated by open surgery approach but the patient died due to the lung doesnt expand after atelectasis in the third day after surgery. We know that a few cases of bochdalek hernia have been reported in the elderly by the medical literature, but what distinguishes our case is that the hernia was strangulated and the patient died as a result of non-expansion of the lung after its atelectasis following surgical repair.

Osteopoikilosis with bony deformities of the right toes in a female child: Case report.

INTRODUCTION: Osteopoikilosis (OPK) is an extremely rare benign condition with sclerosing bony dysplasia and multiple benign enostoses. OPK is usually asymptomatic and is typically an incidental finding on imaging studies for unrelated conditions. CASE PRESENTATION: We presented a case of OPK in a 7-year-old female with hallux valgus, shortening and deformity of second and third metatarsals in the right foot. These abnormalities were observed on clinical findings with X-ray imaging, and osteopoikilosjs was confirmed by histopathology. The deformities were treated with surgical intervention, and the patient's condition was followed for 3 months until the patient walked and removed the gypsum. DISCUSSION: OP is a rare, benign disease that rarely causes bony deformities. It is diagnosed clinically and radiographically, so that the deformities are treated only surgically. Follow-up is necessary to assess the movement of the limb. CONCLUSION: The distinctive thing that can be added to the medical literature is that it is possible for osteopoikilosis to cause bone deformities at an early age.