Cutaneous leishmaniasis in Sudan is caused by Leishmania major zymodeme LON1. Self-healing usually occurs within 1 year but occasionally its duration is prolonged and treatment is required. The clinical forms are ulcers, nodules and noduloulcerative lesions. Here we describe seven patients with uncommon lesions that were difficult to recognize as Leishmania infections. These included mycetoma-like lesions, lesions that resembled L. tropica infection and others. One HIV/AIDS patient had Kaposi's sarcoma with Leishmania parasites in the Kaposi lesions. Most of these uncommon clinical forms were difficult to treat. The diagnosis depended on a high degree of suspicion and the demonstration of parasites in smears or culture. PCR was used to characterize parasites from the patients described here. Leishmania major was found by kDNA PCR in all patients, except one, who had a leishmanioma due to L. donovani. In three patients, including one with a L. tropica like-lesion, the parasites were confirmed as L. major by gp63 PCR-RFLP.
Pure acute subdural hematoma (ASDH) is an uncommon clinical presentation of ruptured intracranial aneurysms, and only rarely, the culprit is a cortical microaneurysm.Mortality can be high; thus, appropriate diagnosis and treatment are crucial. Due to its extreme rarity, there are no available guidelines.
Trifunctional protein deficiency (TFP) is a disorder of fatty acid beta-oxidation associated with metabolic, cardiac, and liver dysfunction in severe forms. We present two siblings diagnosed by newborn screening and confirmed by biochemical testing at birth. Their clinical course was complicated by recurrent rhabdomyolysis, retinopathy, and hypoparathyroidism.
The occurrence of spontaneous bladder rupture during labor or the postpartum period after an uncomplicated vaginal delivery is exceedingly uncommon. However, we encountered a case involving spontaneous bladder rupture, which resulted in the development of localized fluid collections in the abdomen after an uncomplicated vaginal delivery. In this instance, the absence of typical peritonitis symptoms, such as abdominal pain or tenderness, and the lack of typical urological symptoms, including haematuria, dysuria, and anuria, coupled with the absence of clinical manifestations of puerperal sepsis, the absence of microbial presence in the ascitic fluid, and the patient's symptomatic amelioration following antibiotic therapy, contributed to a delay in identifying the bladder rupture.
Catathrenia is an uncommon sleep disorder. Having been originally classified as a parasomnia it is now considered a sleep related breathing disorder. Polysomnography (PSG) is the gold standard for diagnosing catathrenia which demonstrates a classic pattern of a deep inhalation followed by a protracted exhalation, accompanied by groaning sounds.
Spinal cord sarcoidosis, an uncommon manifestation of neurosarcoidosis, presents diagnostic and therapeutic challenges because the condition is rare and has diverse clinical manifestations that can mimic other conditions such as multiple sclerosis and neuromyelitis optica spectrum disorder. A middle-aged African American female with a history of idiopathic intracranial hypertension and hydrocephalus with ventriculoperitoneal shunt presented with progressive, predominantly left-sided gait instability, weakness, and paresthesia. Cerebrospinal fluid showed lymphocytosis, red blood cells, elevated oligoclonal bands, and elevated kappa free light chains, concerning for multiple sclerosis.
