Background: Common variable immunodeficiency (CVID) is recognized as the most common form of primary immunodeficiency. Despite its prevalence, CVID often remains underdiagnosed due to its heterogenous clinical manifestations and a lack of awareness among healthcare providers. Early and accurate diagnosis is crucial, as it significantly impacts patient management and outcomes. This case report aims to highlight notable features of CVID, emphasizing the importance of enhanced detection and awareness. Case Presentation: A 39-year-old male, with no significant medical history, presented with recurrent sinopulmonary infections characterized by intermittent fevers and respiratory symptoms over several months. Initial examinations during his first hospital admission revealed patchy lung consolidations and positive tests for human rhinovirus and influenza A. Despite treatment, follow-up was missed, leading to a subsequent hospital admission. Further investigations, including CT scans and biopsies, were negative for infections and malignancies but revealed deficiencies in immunoglobulins IgA, IgM, and IgG. The patient's inadequate response... Continue Reading

Background: Episiotomy, a perineal incision during labor to facilitate vaginal delivery, is now selectively used in instrumental births like vacuum-assisted procedures to lessen severe perineal trauma, though it risks rare extensions into the rectal wall. Such full-thickness rectal tears, classified as fourth-degree injuries, occur more commonly with midline incisions and can lead to fecal incontinence, pain, or sepsis if not addressed swiftly. Case Presentation:A 32-year-old woman with an unremarkable prenatal history underwent vacuum-assisted vaginal delivery complicated by a mediolateral episiotomy extending to a full-thickness anterior rectal tear 10 cm from the anal verge. She presented hemodynamically stable with perineal pain, bleeding, and stool spillage; digital exam confirmed the injury without soiling. Under anesthesia, a triple-layer closure was used with absorbable sutures for mucosa, muscularis, and serosa, avoiding colostomy. Broad-spectrum antibiotics continued for two weeks, with nil per os for 48 hours followed by enteral feeding. Postoperative monitoring showed no infection or incontinence;... Continue Reading