Drug-Induced Hypersensitivity Syndrome Due to Long-Term Usage of Methotrexate: A Case Report.

Methotrexate (MTX), a cornerstone treatment for rheumatoid arthritis (RA), is associated with drug-induced hypersensitivity syndrome (DIHS), including rare instances of methotrexate-induced pneumonitis. We report a significant case of a 65-year-old woman with RA, treated with MTX for over two decades, who presented with fever, headache, nausea, and malaise and was later diagnosed with DIHS, manifesting as pneumonitis and hepatosplenomegaly. Despite initial suspicion of bacterial pneumonia, her condition deteriorated, leading to the consideration of DIHS.

The Balance Between Intensive and Palliative Care in an Anti-melanoma Differentiation-Associated Gene 5 (MDA5) Antibody-Positive Acute Interstitial Pneumonia in a Nonagenarian: A Case Report.

This case report details the management of anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive acute interstitial pneumonia in a 93-year-old man, a condition characterized by rapid progression and high mortality. Despite the grim prognosis typically associated with this disease, especially in elderly patients, the subject of this report survived beyond the expected timeframe, illustrating the effectiveness of prompt and aggressive treatment strategies. Initially presenting with dyspnea, the patient's diagnostic process was challenging due to the absence of dermatomyositis (DM)-specific skin manifestations.

Eosinophilic Granulomatosis With Polyangiitis Gradually Worsening With Consecutive Pregnancies: A Case Report.

This case report elucidates the diagnosis and management of eosinophilic granulomatosis with polyangiitis (EGPA), a form of systemic vasculitis, in a 32-year-old female presenting with progressive dermal, respiratory, and gastrointestinal symptoms following multiple pregnancies. The patient's history of allergic reactions and pregnancies suggested a gradual progression of EGPA, a condition rarely associated with pregnancy. Initial symptoms were misinterpreted as allergic reactions and acute gastroenteritis, delaying the correct diagnosis.

Occult Bacteremia Caused by Enterococcus-Associated Pyuria in an Elderly Man.

We report a case of -associated pyelonephritis in a 74-year-old Parkinson's patient. He showed constipation, a mild fever, and altered consciousness. Blood cultures revealed Gram-positive cocci (GPC), prompting vancomycin treatment.

Diagnostic Errors in Japanese Community Hospitals and Related Factors: A Retrospective Cohort Study.

Diagnostic error has recently become a crucial clinical problem and an area of intense research. However, the reality of diagnostic errors in regional hospitals remains unknown. This study aimed to clarify the reality of diagnostic errors in regional hospitals in Japan.

Tuberculous Pleurisy Diagnosed From Massive Pleural Effusion in an Older Patient With No History of Tuberculosis.

Tuberculous pleurisy is an infectious disease with a poor prognosis needing early diagnosis. The use of appropriate antituberculosis drugs can improve prognosis. However, the diagnosis of tuberculous pleurisy is often challenging in older patients.

A Case of Acute Cerebral Infarction With Chief Complaints of Abdominal Pain and Bloody Diarrhoea: The Power of a Patient-Centered Inclusive Diagnostic Team.

We present the case of a 66-year-old man who presented with acute abdominal pain and bloody stool as his chief complaints and was finally diagnosed with ischemic colitis from colon cancer and acute cerebral infarction. Although several cognitive biases led to physicians missing the presence of acute stroke, a diagnostic team consisting of the patient, his family members, a ward nurse, and the physician worked effectively to reach the correct diagnosis soon after admission. A physician is not the only person involved in the diagnostic process.