ABSTRACT
Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of non-Hodgkin lymphoma (NHL). We present a case of a 60-year-old female who attended the emergency department (ED) with fatigue, recurrent fever, weight loss, and adenopathy for six months. Laboratory findings showed anemia, lymphocytosis, eosinophilia, thrombocytosis, cholestasis, hypoproteinemia, and hypoalbuminemia. Abdominopelvic computed tomography (CT) revealed multiple adenopathies. A lymph node biopsy yielded inconclusive results in the outpatient clinic. Later, during admission, the patient underwent a positron emission tomography-computed tomography (PET-CT), revealing a cervical adenopathy cluster that was excised en bloc. Histology confirmed the diagnosis of AITL. The medical team initiated chemotherapy but opted for exclusive symptomatic treatment due to disease progression. The patient died six months after diagnosis. The fluctuating and nonspecific presentation of AITL can hinder and delay definitive diagnosis, therefore impacting treatment and prognosis.
ABSTRACT
Marchiafava-Bignami disease is a rare condition characterized by demyelination of the corpus callosum that can evolve into necrosis. It is associated with thiamine deficiency, chronic alcohol consumption, and less frequently, severe malnutrition. The diagnosis is based on clinical presentation - altered mental state and changes in a neurological examination - and on neuroimaging studies, especially magnetic resonance imaging. Treatment with parenteral thiamine is recommended. The authors present a case of a 50-year-old male, with chronic alcohol abuse and malnutrition, admitted to the hospital with an acute form of the Marchiafava-Bignami disease. An early diagnosis and treatment facilitated neurological and cognitive recovery.
ABSTRACT
Fournier's gangrene (FG) is an infectious disease characterized by necrotizing fasciitis of the perineal, perianal, or genital area associated with aging, male gender, diabetes mellitus (DM), alcoholism, trauma, and immunosuppression states. It can rapidly evolve into sepsis, septic shock, and multiorgan failure with a high mortality rate. We present the case of a 55-year-old man who developed a severe FG, initially assumed as an epididymo-orchitis with new-onset DM. The early identification and treatment resulted in a favorable outcome, being discharged from the hospital after 21 days. Diabetic patients are more susceptible to having severe infections such as FG, hence the importance of adequate metabolic control and increased suspicion to prevent fatal complications.