Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse myelitis, cerebellitis, Guillain-Barre syndrome, and cranial or peripheral neuritis most commonly in immunocompromised patients. These clinical manifestations may occur alone or accompanied by infectious mononucleosis. Usually, EBV encephalitis occurs infrequently and with non-specific symptoms. Herein, we report two patients: a 24-year-old female with generalized tonic-clonic fever and seizures for ten days. The other was a 28-year-old male with repeated fever, headache, 4-day amnesia, and symptoms of meningeal irritation. Since the physical examination results were not very helpful, the definite diagnosis was achieved by sampling, analysis, and polymerase chain reaction for the cerebrospinal fluid. Our patients had a direct EBV invasion of the CNS and were affected by Epstein-Barr virus encephalitis, confirmed by their clinical test results as a positive polymerase chain reaction of cerebrospinal fluid. The PCR results were negative for a panel of microorganisms that cause bacterial meningitis in the CSF, but positive for EBV. Image findings also did not show any significant results. Patients treated with acyclovir and precision control at the relative center with favorable outcomes. Acyclovir possibly will lessen viral replication. Finally, despite obtaining negative test results of EBV infection, every therapeutic effort should be undertaken and maintained continuous attention.

Coronary artery aneurysm is a relatively infrequent abnormality but its diagnosis has been increased after the advent of coronary angiography. Atherosclerosis accounts for the majority of Cases of coronary aneurysms. Other etiologies include congenital aneurysms, dissection, infection, vasculitis, and some other inflammatory conditions.We describe a 41-year-old woman who presented with typical chest pain and dyspnea and had multiple small and large coronary aneurysms associated with stenotic segments.

Background: Rice bodies can be found in rheumatic diseases, infectious diseases, and osteoarthritic joints. Rice bodies' most common locations include the subacromial bursa of the shoulder and the knee, while rice body synovitis of the wrist extensor tendons is uncommon. We have presented the Case of tuberculous tenosynovitis with rice body formation in the extensor tendon sheaths of the hand and wrist. Case Report: A 51-year-old man presented with swelling and mild pain in the dorsal side of left wrist, hand, and proximal phalanx of the second finger. He stated a history of traumatic injury to the proximal phalanx of the index finger. Radiographs showed a soft-tissue mass shadow, and magnetic resonance imaging (MRI) showed edema and soft tissue swelling around extensor tendons extending into the distal forearm and ulnar side of the second finger in favor of tenosynovitis. Laboratory test results were normal. The patient had a negative Mantoux test result and no history of mycobacterial exposure. Surgical exploration of the lesion revealed rice bodies in the synovial sheath of extensor tendons in the wrist, extending distally to the dorsal aspect of the hand, especially the radial side. Removal of the rice bodies and complete excision of the sheath and tenosynovectomy was performed. Conclusion: As in our Case, even in the absence of past tuberculosis (TB) infection or exposure, Mycobacterium TB (MTB) should be considered in the differential diagnosis of long-standing extensor tenosynovitis in the hand and wrist.

Background: Selective serotonin reuptake inhibitors (SSRIs) have proven more problematic in terms of some side effects than the original clinical trials suggested. Sertraline may displace warfarin from plasma proteins and may increase the prothrombin time. The aim of this study was to report a rare Case of the sertraline-induced severe anal pain and rectal bleeding without concurrent of taking any other drugs including non-steroidal antiinflammatory drugs (NSAIDs). Case Presentation: Here we report a Case of a 31-year old married man who referred to a psychiatrist with depressive disorder and started to take sertraline up to 400 mg daily, thereafter the patient reported severe anal pain and bleeding. Other etiologies of this side effect were evaluated with Naranjo evaluation scale and rolled out. The patient did not report any anal pain or bleeding after eight months of stopping sertraline. Conclusion: Reported from sertraline, the psychiatrists must be more cautious when prescribing sertraline and monitor the patient properly for a long time to ensure these rare adverse effects and complications do not happen.