Introduction and importance: Central nervous system (CNS) inflammatory demyelinating disease known as neuromyelitis optica spectrum disorder (NMOSD) is characterized by recurrent inflammatory events that primarily affect the optic nerves and spinal cord; it may also affect the hypothalamus, area postrema, and periaqueductal gray matter. The NMOSD-specific aquaporin-4 antibody (AQP4-IgG) is available. Myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) have recently been discovered in a group of patients who do not have AQP4-IgG. Case presentation: A 29-year-old female presented to the hospital with the complaint of blurry vision in her right eye and left eye ptosis for 2 days. Two months ago, the patient had a history of generalized fatigue with continuous documented fever with an average of 38.5°C, which was relieved by acetaminophen and ibuprofen. She also complained of continuous hiccups that increased at night and interfered with her sleep pattern and breathing; they lasted for 3 weeks and disappeared suddenly. She had also developed episodes of vomiting and could not tolerate food intake due to which she lost 6 kg within 3 weeks. She was later diagnosed with neuromyelitis optica (NMO) using radiological neuroimaging. Clinical discussion: Early and correct diagnosis, followed by urgent treatment for acute exacerbations and the prevention of further relapses, are essential for treating NMO spectrum illnesses since they entail significant morbidity and, occasionally, fatality. Conclusion: The patient mentioned here represents a typical example of NMO disease. This case emphasizes the presence of this disease in our environment and the importance of accurately diagnosing this ailment, even in a context with minimal resources, to prevent disability.
Worldwide, Cryptosporidium spp. is a common parasite that affects domestic and wild animals, including humans, and causes diarrhea in both immunocompetent and immunocompromised hosts. The fecal-oral pathway accounts for the majority of its transfer. Although C. parvum and C. hominis are the most common zoonotic species in humans, other zoonotic species can also infect immunocompetent and immunocompromised people. Patients undergoing renal transplants are more likely to contract cryptosporidiosis, which can cause severe and potentially fatal diarrhea. A 41-year-old male patient who presented to the emergency department complained of a sudden onset, severe and continuous fatigue, and a feverish sensation of two-day duration. Two days prior to the current admission, the patient started to complain of weakness affecting his whole body, as well as a fever of 39°C and continuous yellowish diarrhea occurring 4-5 times daily without blood. Stool analysis revealed a cryptosporidium infection. The patient underwent surgery for kidney transplantation. The donated kidney was the left one from his brother and was attached to the patient´s right groin. As illustrated by our example, cryptosporidiosis should be considered a significant cause of acute, persistent, watery diarrhea in immunocompromised kidney transplant recipients. Patients undergoing renal transplants should be instructed to wash their hands frequently, stay away from young animals, sick people, and swimming pools in order to lower their risk of infection.
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