Rejected

Tuberculosis is a public health problem in Portugal. It can have extrapulmonary manifestations, with the spine being the most frequent and significant location affected within the bone area. We present the case of a 65-year-old man with left lumbar sciatic pain, 11% body weight loss, and anorexia. Later, he developed left crural hemiparesis and hypoesthesia, failing to respond to analgesia. A computerized tomography scan of the lumbar spine showed L5-S1 spondylodiscitis. The patient was admitted for study and started empirical antibiotic therapy. Due to lack of clinical and analytical response and inconclusive bone biopsy, surgical decompression of the lumbar abscess was performed, with isolation of multi-sensitive . He took anti-tuberculostatic drugs for a year and did physiotherapy, fully recovering from neurological deficits due to his illness. On account of tuberculosis's prolonged and non-specific clinical presentation, a high index of clinical suspicion is needed for a well-timed diagnosis and treatment to prevent serious complications.

[This retracts the article DOI: 10.7759/cureus.21311.].

Sacroiliac joint (SIJ) pain is a common etiology of chronic lower back pain. Treatment of persistent sacroiliac joint pain may entail intraarticular steroid injections and lateral branch radiofrequency neurotomy.

A 41-year-old female presented with an 8-month history of right upper quadrant pain, exacerbated by ingestion of saturated fats. The patient was positive for antibodies to Coxsackievirus serotype B4, established by an investigation incited by an acute episode of pleurodynia 8 months before the current presentation. Imaging studies including a hepatobiliary iminodiacetic acid scan showed no gallbladder structural or functional abnormalities. Laboratory studies indicated pancreatic enzyme insufficiency associated with below-normal lipase and amylase levels. Patient symptomology was consistent with cholecystitis with positive Murphy's sign, so cholecystectomy was recommended. Post-surgery pathological report confirmed chronic acalculous cholecystitis. Patient demonstrated full recovery, indicated by return of normal pancreatic enzymes levels and resolution of abdominal pain.

Many studies have shown that changes in lumbar flexion angle and the pelvic inclination angle can be affected by the shortening of the lumbar muscles, which can cause low back pain. Decreased lumbar flexion angle and pelvic inclination angle can cause or exacerbate low back pain by disrupting the lumbo-pelvic rhythm.

Exposure in vivo (EXP) is an effective treatment to reduce pain-related fear and disability in chronic pain populations. Yet, it remains unclear how reductions in fear and pain relate to each other. This single-case experimental design study attempted to identify patterns in the individual responses to EXP and to unravel temporal trajectories of fear and pain. Daily diaries were completed before, during and after EXP. Multilevel modelling analyses were performed to evaluate the overall effect. Temporal effects were scrutinized by individual regression analyses and determination of the time to reach a minimal clinically important difference. Furthermore, individual graphs were visually inspected for potential patterns. Twenty patients with chronic low back pain and complex regional pain syndrome type I were included. On a group level, both fear and pain were reduced following EXP. Individually, fear was significantly reduced in 65% of the patients, while pain in only 20%. A decrease in fear was seen mostly in the first weeks, while pain levels reduced later or remained unchanged. Daily measurements provided rich data on temporal trajectories of reductions in fear and pain. Overall, reductions in fear preceded pain relief and seemed to be essential to achieve pain reductions.

Old healed spinal tuberculosis sometimes makes bony ankylosis with kyphotic deformity. This bony ankylosis with adjacent vertebra is like ankylosing spinal disorders (ASDs) such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis. There is lots of report which revealed that conservative management might be failed in thoracolumbar fracture in ASDs. However, there is no report which shows surgical treatment was finally done because conservative management was failed in fracture healing of fusion mass caused by old spinal tuberculosis.

Classical symptoms of chronic mesenteric ischemia include postprandial pain referred to as "intestinal angina", food fear and weight loss. Here we present a case of chronic mesenteric ischemia treated by endovascular stenting in a patient with chronic heart failure and left ventricular assist device.

Bullous scabies (BS) is a rare and atypical presentation of scabies, usually affecting elderly males during the seventh decade of life. BS is characterised by intense pruritic eruptions, nocturnal itch, and characteristic blisters with or without burrows in scabies-prone areas. The scabies lesions might predispose patients to bacterial super-infections, resulting in bullae formation similar to bullous impetigo. The diagnosis of BS is often puzzling and delayed. Few cases of BS have been reported among children globally. We, herein, report a case of BS in an eight-year boy from Pakistan, treated successfully with 5% topical permethrin and 2% mupirocin. Complete healing was noted within four weeks with no recurrence at two months follow-up. Key Words: Scabies, Bullous, Child, Diagnosis, Treatment.

This report aims to describe a characteristic neuroimaging of brain abscess in predisposed patients. A 56-year-old man presented with fever and headache for 3 weeks. Cerebrospinal fluid (CSF) revealed pleocytosis with lymphocytosis, high protein, and low glucose. Both hemoculture and CSF culture yielded Another case is a 23-year-old woman with systemic lupus erythematosus, who presented with fever, headache and left hemiparesis. CSF showed pleocytosis with polymorphonuclear cells predominance and low glucose. Hemoculture positive for Their MRI brain revealed conglomerate ring and tract-like enhancement lesions at the right parietotemporal lobe. The patients were diagnosed with brain abscess. They received a high dose of ceftriaxone and ampicillin for 6 weeks. The clinical and MRI at the end of treatment was a substantial improvement. Our information can help the physician concern about this pathogen in patients who presented with brain abscess and had these MRI findings.