This year brought about a number of public discussions surrounding not only less mainstream medical conditions, but also physically and emotionally challenging and ethically complex ones. Disorders and illnesses that routinely get minimal light shed upon them made it into the news cycle. It is only via this attention that awareness for prevention opportunities, seeking early care or research discoveries and treatment advancement get pursued, even funded.
Here are ten of this year’s more intriguing medical cases that made the spotlight:
Things aren’t always what they seem. This is exactly what was reported by the Japanese Society of Neuropathology. In the published case, the authors describe an adolescent female who—while undergoing an emergency surgery for appendicitis— was discovered to have large, bilateral, mostly cystic ovarian masses (aka tumors). Upon removal later, the mature cystic teratoma of her ovary was found to contain very highly organized and well-differentiated brain and brainstem tissue along with greasy material and hair. Portions included structures that mimicked cerebellar features and brain stem segments. A thin bone encasing it resembled elements of a skull. To learn more about teratomas with central nervous system components, read here.
A number of headlines referenced the “Tree Man” from Bangladesh with claims he was “cured” after 16 operations for his rare genetic disorder that transformed his hands and feet into bark-like warts and cutaneous horns.
Also called Epidermodysplasia Verruciformis (EV), this debilitating, heritable condition is often referred to as “Tree Man Illness” or “Tree Man Syndrome.” Though it manifests throughout the body via innumerable abnormal growths on the skin, it is considered to be caused by a genetic impairment that triggers a defect in a person’s cell-mediated immunity. To further understand this complicated condition and the harm it inflicts on those suffering from it, review here.
With the current wave of states legalizing marijuana, advocates championing the cause and the presence of greater societal acceptance, there is a growing perception that dispensary-supplied “medical marijuana”—not distinct from “recreational marijuana”— is as safe as any medical product obtained at a pharmacy. This is not so as there are no quality control measures or thorough federally-regulated vetting procedures in place to ensure safety. The reality is much is not known about the science—good, bad or indifferent.
The notion of possible hazards was sparked by a lead author of a publication in Clinical Microbiology and Infection entitled “A microbiome assessment of medical marijuana. Joseph Tuscano, MD— a cancer specialist and professor in the Division of Hematology and Oncology at UC Davis— had a patient who acquired a rare, incurable fungal infection from aerosolized marijuana.
Concerned over the possible lethal risks infectious agents could cause when directly inhaled into the lungs of patients—in particular the most vulnerable (e.g. those with cancer, AIDS, organ transplant recipients, uncontrolled diabetes or any condition involving a suppressed or weakened immunity), this research team from UC Davis decided to study it. Their testing yielded a wealth of diverse bacteria and fungi known to cause serious infections (especially in the immunocompromised patient), many of the lungs—among them Aspergillus, Cryptococcus, Mucor, Klebsiella pneumoniae, E. Coli, and Acinetobacter baumannii. (See here for my more detailed article).
4. Impossible Choices for Parents
A case report of 22-month-old conjoined twins evaluated and operated on at Massachusetts General Hospital was published in New England Journal of Medicine (NEJM). Due to the complexity of the twins abdominal and pelvic connections, doing nothing would have inevitably resulted in their demise. While intervening would facilitate the process for the more challenged one already at imminent risk of dying, it posed the best hope for the stronger, more independent twin. But, held no guarantees. For the parents and caregiving team, the undertaking was substantial physically, emotionally, spiritually and ethically (see here).
To understand the Science Behind When Two Fetuses Become One along with the different types, click here. This article also discusses a case of a baby boy born in India with two penises and four legs. In this instance, Bangalore’s Narayana Health City attributes the malformation to a “parasitic twin” condition.
To appreciate how HUD Secretary and pediatric neurosurgeon Dr. Ben Carson was a pioneer in the realm of conjoined twins, see here. Also detailed in this piece is the tale of a ten month-old baby girl – called Dominique – born with two spines and four legs who traveled from the Ivory Coast to Chicago to endure a, thankfully, successful six-hour surgery.
Sadly, a woman’s tragic story-- recently all over the news-- plays out in the real world more often than people may realize. The devastating tale of Carrie DeKlyen who died after succumbing to brain cancer, which was discovered after becoming pregnant and declining certain treatments to protect her unborn baby, ended with more misfortune. The baby she continued to carry beyond her own lost consciousness, who was born prematurely as a result, also died. (See here).
A Colorado toddler required emergency medical intervention after ingesting 28 high-powered buckyball magnets. Learn why this particular foreign body is so dangerous, see here. For further understanding of the healthcare demands when it comes to foreign bodies in general, review the Inanimate Objects In Orifices series (ear/nose/throat, the eye, vagina, penis & urethra).
6. Infant Traumas From Water Birth This Year
Though pneumonia and infection are among the litany of known complications following a water birth, the Centers for Disease Control and Prevention (CDC) reported two cases of Legionnaires’ Disease in newborns in Arizona born this way at home (see here). Upon this discovery, further investigation identified a Legionellosis death of an infant after a water birth in 2014 in Texas.
Another underwater birth resulted in another near-fatal consequence. This time the imperiled, septic newborn endured unnecessary multi-organ failure that necessitated a two-month hospitalization in the intensive care unit (ICU). The case of this infant was published in the Canadian Medical Association Journal (CMAJ).
Having published a case of a near drowning of an infant via water birth in Neoreviews and written repeatedly on the topic, I suggest you review Just Say No to Water Birth for clarification as well as Water Birth: To Breathe or Not To Breathe? where the focus is on the science behind water birth, reported cases of adverse events and detailing the recommendations of the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.
The story of Easton Elrod, a 4-year old boy “born broken, everywhere” having sustained over 100 bone breaks in his lifetime was trending in the news. Birth, alone, broke “both legs, one arm, the back of his head, all of his ribs,” according to his mother Brianna Elrod.
For the average baby not ultimately diagnosed with a moderate to severe form of Osteogenesis Imperfecta (OI)— a genetic disorder causing defects in quantity or quality of collagen— like Easton Elrod, fracturing a clavicle is not uncommon in a challenging vaginal birth. Due to the wide spectrum of OI from mild to severe forms, in extreme cases the act of being born can be life-threatening. This brittle bone disease literally makes a newborn very fragile. (See here).
This article covers a number of unfortunate consequences of penis don’ts including the untimely death of a patient published in the Journal of Forensic Sciences to avoidable, self-injurious behaviors. (See the piece in its entirety here).
Such was the situation for a One Direction concert-goer whose difficulty breathing after “intense screaming” yielded a published case report in the Journal of Emergency Medicine. To learn more about the many ways one can collapse a lung along with the limitations of the condition, read here.
A baby was born from a living-donor’s transplanted uterus for the first time in the United States. After a few false starts within Baylor University’s landmark clinical trial,having three of four uterus transplants requiring explantation, this delivery affirms the surgery can yield a truly functional uterus. To learn about this groundbreaking achievement, see here.