Pleural-subarachnoid fistula is a rare type of Cerebrospinal fluid fistula with less than 60 cases reported in the literature. Here we present a case of 55-year-old female patient, known case of acute myeloid leukemia on chemotherapy, who developed pleural-subarachnoid fistula due to invasive atypical apical lung fungal infection. All of the reported cases in the literature were secondary to trauma or post-surgery. To our knowledge, this is the first reported case of pleural-subarachnoid fistula developed as sequela of fungal infection.
Digital fibromyxoma is a rare soft tissue tumor with a propensity to grow in the digits of the hands and feet. While mostly asymptomatic, the tumors can grow and cause discomfort and eventually pain. It is a benign tumor, with treatment revolving around complete excision to prevent recurrence. In this case report, we discuss the case of a 11-year old boy presented with a swelling in the right ring finger that had been increasing in size for over a year. Despite the lack of pain or limitation of movement in the finger, the swelling caused concern to the patient and family due to cosmetic appearance. An excision biopsy with histopathological analysis of the tissue sample suggested the diagnosis of digital fibromyxoma. The high rate of recurrence is due to incomplete excision, and therefore regular follow up is recommended to monitor for recurrence.
Hailey-Hailey disease (HHD), or familial benign chronic pemphigus, is a rare inherited acantholytic dermatosis. It is an autosomal dominant disease affecting the intertriginous areas. HHD has been characterized by flaccid blisters, erosions, and macerations that are limited to flexural (friction-prone) areas. The painful blisters and erosions significantly decrease patients’ quality of life. There are multiple types of therapy related to this disorder. Many of the studies have suggested benefits from steroid therapy in addition to oral antibiotics.
Posterior reversible encephalopathy syndrome (PRES) in cases of intracranial hypotension is a lifethreatening condition. Early suspicion, appropriate treatment, and tight control of possible contributing factors that may facilitate PRES in cerebrospinal fluid (CSF) leak patients may bring a more favorable outcome, lowering the morbidity and mortality rate.Two cases of PRES with features of intracranial hypotension are presented.We also discussed the possible pathogenesis of PRES in patients with intracranial hypotension. We emphasize the importance of the early diagnosis and treatment of ICH by repairing the leakage and further prompt attention to tight blood pressure control in those patients to avoid PRES development.
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