Internal medicine
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A 34-year-old man with no medical history presented to our hospital with a sore throat and difficult oral intake for two days before admission. He had various symptoms, including red eyes, ocular discharge, a fever, and intraoral ulcers, and he was admitted immediately. ⋯ The patient's condition improved with conservative treatment. This case of severe and varied symptoms caused by co-infection with adenovirus and SARS-CoV-2 has been previously reported.
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Case Reports
Bilateral Sialadenitis as an Uncommon Initial Manifestation of Infectious Mononucleosis: A Case Report.
Sialadenitis has rarely been reported in patients with infectious mononucleosis (IM). Our patient was a 22-year-old man who presented with bilateral swelling of the parotid and submandibular glands, a fever, malaise, and splenomegaly. Laboratory tests revealed an increased percentage of atypical lymphocytes in the leukocyte fraction. ⋯ The patient was diagnosed with sialadenitis associated with IM caused by EBV infection. With symptomatic treatment, the salivary gland swelling completely resolved within a week. This case suggests that EBV-induced IM should be included in the differential diagnosis of diffuse sialadenitis with elevated atypical lymphocyte counts.
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Objective To investigate the clinical course of ulcerative colitis (UC) during pregnancy, focusing on their mutual influence. Methods We retrospectively reviewed the medical records of 58 patients with UC who had 73 pregnancies and 3 patients with newly developed UC during pregnancy. We recorded the rate of relapse of UC; the relationship between medication use and UC relapse during pregnancy; treatment for relapse; and the incidence of pregnancy, childbirth, and newborn abnormalities. ⋯ In two of the three patients with new-onset UC, UC was severe and required intensive care; however, the pregnancies continued uneventfully. Conclusion Although the progress of pregnancies complicated by UC was mostly uneventful, discontinuing medication carries the risk of UC relapse. Thus, appropriate management of medical treatments for UC during pregnancy is important.
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Hepatic undifferentiated pleomorphic sarcoma (UPS) is a rare malignant mesenchymal tumor with unclear cancer-related genetic mutations. In a 60-year-old Japanese woman with a rapidly growing, inoperable hepatic UPS, a genetic mutation analysis revealed KRAS and TP53 mutations. Despite initiating hepatic arterial infusion chemotherapy, the tumor continued to grow, and the patient's poor performance status complicated the transition to a phase I KRAS mutation drug trial, leading to death eight months after the symptom onset. A timely genetic mutation analysis may facilitate effective treatment transitions in hepatic UPS despite the lack of established treatments.
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A 74-year-old woman developed acute severe colitis after receiving her sixth mRNA vaccine against coronavirus disease-2019 (COVID-19). On the day after vaccination, she experienced bloody diarrhea, abdominal pain, and high-grade fever. Laboratory tests revealed leukocytosis and increased C-reactive protein. ⋯ Her symptoms and laboratory findings improved immediately after the initiation of prednisolone therapy. Pre-discharge total colonoscopy revealed mucosal repair in most of the colon. Clinicians should acknowledge that severe acute colitis can occur after COVID-19 vaccination.