Exercise is an important part of a healthy lifestyle. However, there is a subset of the population who are allergic to exercise. Exercise-induced urticaria is a rare clinical condition, which, as the name suggests, manifests as flushing, pruritus, and hives following physical exercise. A minority of patients even develop more severe reactions including angioedema and anaphylaxis induced by exercise. Some patients are affected by certain cofactors that constitute food-dependent exercise-induced urticaria, which is relatively more common when compared to exercise-induced urticaria without other cofactors. This case report documents a healthy 27-year-old Asian male, with no other allergies or cofactors, who was diagnosed with exercise-induced urticaria. He was diagnosed based on history and a positive exercise challenge test. Avoidance of exercise is the mainstay of prophylactic treatment for this condition. Modification of physical activity proved to be effective for treating this patient. We intend to increase awareness about this rare condition through this case report and literature review.
Objective: Iliopsoas abscess is a rare complication of fistulizing Crohn’s disease, which is difficult to diagnose and manage. We report this case to alert clinicians to the diagnosis and management of this unusual association. Case presentation: A 31-year-old male who presented with right groin pain, and hip pain due to an iliopsoas abscess. He was found to have iliopsoas fistula and underlying Crohn’s disease. The right iliopsoas abscess was managed with CT guided percutaneous drainage and pigtail catheter placement and intravenous antibiotics. The patient was started on mesalamine and prednisone. A month later, the patient became symptomatic again and a duodenocolic fistula was found. A laparoscopic extended right hemicolectomy with both fistulas takes-down, end ileostomy and mucus fistula were performed. Pathology revealed chronic active Crohn’s ileocolitis. His ileostomy was reversed three months later. The patient recovered uneventfully and was doing well after six-month follow-up. Conclusions: Iliopsoas abscess can be a rare presentation of Crohn’s disease. Evaluation with CT imaging, and initial management with drainage and antibiotics are recommended. Surgical intervention should be considered early for impending arthritis.
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