Adult Still’s disease is a rare auto inflammatory condition characterised by fever, arthralgias and skin rash. A wide spectrum of complications have been described, such as cardiac tamponade, pulmonary hypertension, macrophage activation syndrome, thrombotic microangiopathy, diffuse alveolar haemorrhage and even acute respiratory distress syndrome. We report an 18-year old female who met enough criteria for diagnosis of Adult Still’s disease, but also presented with signs and symptoms of idiopathic intracranial hypertension.

Objectives: Hypothenar hammer syndrome is a rare clinical entity, typically presenting unilaterally, in middle-aged men, with a history of persistent trauma to their hypothenar eminence. We report a case of bilateral hypothenar hammer syndrome in a 77-year-old man with no recent occupational exposure.

Methods: We performed an extensive literature search using the Pubmed database and identified less than 175 results on hypothenar hammer syndrome. Only 12 articles referenced bilateral hypothenar hammer syndrome. Additionally, only 16 articles included patients 65 and older. The following search terms were used: hypothenar hammer syndrome, bilateral, “two aneurysms,” “multiple aneurysms,” and symptoms.

Results: A 77-year-old man who presented with pulsatile hypothenar masses bilaterally and was diagnosed with hypothenar hammer syndrome. He worked as a carpenter 15 years before presentation. He currently uses a rolling walker. CT angiography confirmed the presence of two aneurysms in his dominant right hand, the largest measuring 1.8 cm in diameter. The patient had a motor function deficit along the distribution of the ulnar nerve on the right hand. He underwent resection of the aneurysms in the right hand and reconstruction of the ulnar artery.

Conclusion: Unusual aspects of this case include age of presentation, bilateral aneurysms, and lack of recent occupational exposure. We assert that the use of a rolling walker may have contributed to the progressive aneurysmal degeneration of his ulnar artery.

Primary cardiac tumors are rare, less than 0.2% of all childhood tumors. They can be diagnosed prenatally. Although they are usually benign, they can be fatal because of the mass effects. We present a case of a prenatally diagnosed cardiac teratoma in a female fetus at 29 weeks gestation. The mass was large and the fetus showed hydrops. She was delivered at 32 weeks and underwent emergency surgery. Histologically, the tumor showed malignant yolk sac elements. One year follow up showed no recurrence. This case represents the importance of prenatal diagnosis and a multi-disciplinary approach to ensure favorable outcome.

Stiff Person Syndrome is a rare neurologic disorder characterized by progressive rigidity and stiffness and linked with features of an autoimmune disease. Stiffness, which primarily influences the truncal muscles, eventually leads to postural deformities. Here, I report a case of Stiff Person Syndrome in association with thyroiditis, epilepsy and vitiligo.

Background: Cytomegalovirus (CMV) is a common cause of viral infection. In immunocompetent patients, CMV infection is usually mild or asymptomatic and does not require any treatment. However, in some patients systemic manifestations can occur.

Case presentation: We report the case of a 40-year-old woman with a medical history of Graves’ disease and papilloma virus infection presenting with swollen ankles associated with fever and pain in the lower limbs for several weeks. Clinical examination revealed bilateral in duration of the calf. Laboratory tests showed elevated liver enzymes and systemic inflammation. Exploration by ultrasound of lower limbs and CT scan of the abdomen demonstrated superficial venous thrombosis of the lower limbs and thrombosis of the left hepatic vein. A thorough evaluation for hypercoagulability and septic states were negative. Finally, serological conversion for CMV was demonstrated with positive IgM and IgG with negative prior testing done seven years earlier. The patient was given an anticoagulation treatment and oral contraception was discontinued. The patient improved clinically and biologically after few weeks.

Conclusion: We describe a rare case of sub-acute CMV primary infection in an immunocompetent patient complicated with multiple thromboses. This case illustrates a rare complication of a common infection in order to raise awareness of this entity.