Search

Soft tissue eosinophilic granulomatosis (Kimura's disease) is an eosinophilic granuloma with a proliferation of lymphoid follicles in the subcutaneous soft tissue. Although no established treatment exists, it is considered a disease with a good prognosis. On the other hand, bacteremia caused by group G hemolytic streptococcus (GGS) is said to be caused by chronic local lymph abnormalities and is likely to recur. We present the case of a 41-year-old Japanese man. He had a history of treatment for Kimura's disease and sepsis due to hemolytic streptococcus and came to our hospital with a chief complaint of fever. His blood culture revealed hemolytic streptococcus, and he was admitted to the hospital. Kimura's disease involves the proliferation of lymphoid follicles, so when blood cultures repeatedly turn positive, it is important to treat the patient with a GGS infection in mind., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Togawa et al.)

High-pressure injection injuries, caused by forcefully injecting liquids or gases into the body, present significant challenges in diagnosis and treatment. Complications such as infection and compartment syndrome can occur, leading to various outcomes, including the possibility of amputation. Treatment approaches vary, with some cases undergoing surgery and others opting for conservative methods. However, due to the rarity of this injury, clear treatment guidelines are lacking. Consequently, there is insufficient data to establish specific guidelines, such as the duration of antibiotic treatment, necessity of surgery, and timing of rehabilitation intervention. While emergency surgery may be required, limited reports of detailed CT or MRI examinations being conducted before the surgical procedure are available. This case report involves an initial assessment, including physical examination, X-rays, CT scans, and MRI, to determine whether surgical or conservative treatment is appropriate. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score assists in evaluating the risk of infection, and MRI plays a crucial role in predicting complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Funato et al.)

Toluene poisoning is diagnosed based on toluene exposure history and the level of hippuric acid in the urine. Regular blood and urine tests are performed for follow-up. A 54-year-old man collided with a utility pole while driving a car and was rushed to our hospital with a complaint of loss of consciousness. Although the trauma was minor, toluene poisoning was suspected based on the presence of impaired consciousness, occupation is a painting job that involves toluene, and the presence of metabolic acidosis of the normal anion gap. Urinary hippuric acid and urinary liver-type fatty acid-binding protein (L-FABP) were measured, and a diagnosis of renal tubular acidosis (RTA) due to toluene toxicity was made. Urinary L-FABP levels decreased as the condition improved. Urinary L-FABP is a practical and rapid diagnostic and follow-up tool for toluene-induced RTA, and it is helpful to measure it in addition to conventional methods., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Fujikawa et al.)

Primary hyperparathyroidism (PHPT) is characterized by various symptoms, including malaise, psychiatric symptoms, and hypertension. When hypercalcemia is accompanied by PHPT, it may cause pathologic fractures or lethargy. Additionally, PHPT can be complicated by crowned dens syndrome (CDS). We present a case of a 72-year-old female. She had begun experiencing low back pain during movement five days before. The symptoms progressed and the patient was unable to move. Based on the imaging, blood tests, and clinical findings, the patient was diagnosed with PHPT complicated with CDS. Therefore, it is important to perform a careful physical examination of the neck and cervical spine computed tomography in patients with PHPT. Moreover, measuring calcium levels in patients with CDS may lead to early detection of PHPT., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Tamiya et al.)