Foreign objects in the lower genitourinary system are a rare urological emergency often associated with selferoticism, drug intoxication, or psychiatric illness. In addition to clinical examination, multiple imaging modalities such as X-ray, ultrasound, computed tomography, and magnetic resonance imaging have been used for the diagnosis of foreign bodies. Surgical exploration and endoscopic extraction are the main approaches to the treatment. Here, we present the case of a 37-year-old male who presented to the emergency department with penile and urethral pain caused by an electrical wire inserted into the urethra. The electrical wire was protruding 15 cm from the urethral meatus. A 50 cm long cable was extracted from the urethra and urinary bladder under regional anesthesia. This case is remarkable for the length of the foreign body and the depth to which it was inserted reaching into the urinary bladder. Emergencies related to sexuality or unconventional sexual preferences can lead to avoidance or delay of medical treatment, which, in turn, can result in a higher risk of complications. The examining doctor should be sensitive to secretive and insecure behavior and should be considerate of the patient's privacy to facilitate a thorough physical examination.

Munchausen Sendromu (MS), hastalar tarafından kasıtlı olarak üretilen zihinsel veya fiziksel hastalıklarla karakterizedir. Bu olgu sunumunda MS'i sunmayı ve güncel literatürü gözden geçirmeyi amaçladık. 36 yaşındaki kadın hasta, dikiş iğneleri yutma sonrası gelişen karın ağrısı şikâyetiyle acil servise başvurdu. Fizik muayenede palpasyonla batında minimal hassasiyet vardı. Çekilen ayakta direkt batın grafisinde ondan fazla iğne şeklinde opasite mevcuttu. Hastanın anamnezinde tutarsızlıklar ve cerrahi girişim için aşırı istekli olması MS şüphesini uyandırdı. Psikiyatri konsültasyonu istendi, MS tanısıyla yatışı planlandı. Klinik şüphe ve ayrıntılı anamnez, tanı için anahtardır. Hekimler, hastaneye sık başvuran, şikâyetleri ile öykü ve muayene bulguları arasında uyumsuzluk olan hastalarda MS tanısını akla getirmeli ve psikiyatrik destek almalıdır.

Introduction: Antithyroid drugs (ATD) are commonly used for the treatment of thyrotoxicosis, particularly for the treatment of Grave's disease. Methimazole is the first line ATD. A major fatal adverse effect of ATDs, if unrecognized and not treated on time, is agranulocytosis, which is defined as an absolute neutrophil count of <500/μL. The incidence of ATD-induced agranulocytosis is 0.1%-0.3% (1). In this study, we report on a patient who developed granulocytopenic febrile neutropenia at 3 months after treatment with methimazole (5 mg twice a day per os (BID PO)). Case report: A 51-year-old female patient presented to the emergency department with complaints of fever, fatigue, and productive cough. Her body temperature was 38.5°C; rales were heard on the mid and basal part of the left lung. Drug history revealed methimazole use (10 mg per day over the last 2 months). The WBC count was 1020/μL, and the neutrophil count was 200/μL. The patients' baseline WBC differential count and immune status were normal. Following inpatient antibiotic treatment and discontinuation of methimazole, the patient became afebrile within 2 days. After 2 weeks of discontinuation of methimazole, we performed CBC and observed the following: WBC, 5180/μL and neutrophil count, 3280/μL. Conclusion: Patients visiting the emergency department with symptoms of a systemic infection and known to use ATDs should be thoroughly evaluated, and the possibility of drug-induced agranulocytosis developing because of the use of these medications should be considered. It is very important for emergency physicians to recognize this rare patient population and act in a timely manner.