Appendix Playing Hide and Seek: A Variation to Amyand's Hernia.

Amyand's hernia is a rare condition where the appendix becomes trapped in the inguinal hernia sac, leading to severe complications if left untreated. Treatment typically involves surgical repair of the hernia, with the removal of the appendix if necessary. This case report presents a 65-year-old male with compromised cardiac status and a right inguinal hernia, confirmed by ultrasound. The surgery was performed under local anesthesia, and the appendix was normal and reduced back. The patient was discharged on the next day of surgery after an uneventful course in the hospital. There is a difference of opinion regarding the need for an appendectomy in an Amyand's hernia with a normal appendix, with the appendix dancing in and out of the inguinal canal while coughing on the table. The decision to remove or leave a normal appendix in this situation should be based on several factors, including the patient's age, appendix anatomy, and extent of intraoperative inflammation. In conclusion, local anesthesia can be a safe and effective option for patients who are not fit for general or spinal anesthesia. The decision to remove or leave a normal appendix in Amyand's hernia should be based on several factors.

A Rare Co-occurrence of Monkeypox Encephalitis and Neurosyphilis.

Monkeypox (MPOX according to the Centers for Disease Control and Prevention) has been a disease of interest in populations with high-risk sexual behavior. As sporadic outbreaks of MPOX have led to a worldwide spread, it has been declared a public health emergency by the World Health Organization. Here, we describe the case of a 44-year-old male with high-risk sexual behavior who presented with typical rashes of MPOX and altered mental status. MPOX polymerase chain reaction from the skin lesion and cerebrospinal fluid-Venereal Disease Research Laboratory tests were positive, raising the possibility of concomitant infection with neurosyphilis. The patient was treated with tecovirimat and aqueous penicillin G resulting in an improvement in the patient's clinical condition. Our case describes that MPOX has the potential to cause central nervous system manifestations through possibly a direct viral invasion or an immune-meditated insult.

Langerhans Cell Histiocytosis Presenting With Clinical Features of Hidradenitis Suppurativa.

Langerhans cell histiocytosis (LCH) is a rare neoplastic disease of myeloid dendritic cells with a widely variable presentation of organ system involvement and severity. In this case report, we share the details of a rare case of cutaneous LCH resembling hidradenitis suppurativa (HS).

Neuroblastoma Masquerading as a Septic Hip Infection in a Three-Year-Old.

Metastatic neuroblastoma to the bone and septic joint shares the same incidence in age and clinical symptomology. Here we discuss a three-year-old male who presented with anemia, persistent hip pain, and a refusal to bear weight. A thorough evaluation based on a broad differential diagnosis allowed for an expedient diagnosis of metastatic neuroblastoma. The timely diagnosis allowed for rapid enrolment in a children's oncology group (COG) clinical trial for advanced neuroblastoma. The patient tolerated the therapy without adverse events and remains in remission.

Atypical Nelson Syndrome Following Right Partial and Left Total Nephrectomy With Incidental Bilateral Total Adrenalectomy of Renal Cell Carcinoma: A Chat Generative Pre-Trained Transformer (ChatGPT)-Assisted Case Report and Literature Review.

Nelson syndrome (NS) is a dangerous condition that can sometimes manifest after bilateral adrenalectomy (BA), typically in treating Cushing's disease. It is defined by the collection of systemic signs and symptoms that can arise in a state where there are chronically and massively elevated levels of adrenocorticotropic hormone (ACTH). Traditionally it may manifest from six months to 24 years following the loss of both adrenal glands, with the meantime of development being 15 years following BA. The diagnostic criteria are controversial, with historically many different methods being used, ranging from visual field defects and an enlarged pituitary corticotrophinoma to elevated plasma ACTH levels and skin hyperpigmentation. What remains consistent between criteria is that it is secondary to total BA, traditionally in treating refractory Cushing's disease. We describe here a rare case of a patient diagnosed with bilateral renal cell carcinoma (RCC) treated with right partial and left total nephrectomy, and incidental BA, presenting with the symptoms and signs of NS. Although NS classically presents following total BA for the treatment of Cushing disease, further research is required to look for etiologies of Nelson's-like pathology outside the context of Cushing's disease treatment, thereby necessitating a change to the traditional diagnostic criteria for the syndrome to identify cases that would otherwise go untreated. In addition, this case report's outlining, drafting, and conclusions were written in part by or with the support of Chat Generative Pre-Trained Transformer (ChatGPT), a large language transformer open-source artificial intelligence.