Introduction. Reactive infectious mucocutaneous eruption (RIME) is a phenomenon that occurs predominantly in children and young adults following a bacterial or viral respiratory infection. RIME is most associated with Mycoplasma pneumoniae and generally presents with extensive mucosal and limited cutaneous involvement. Less commonly, infection with Chlamydia pneumoniae can trigger cutaneous eruptions but seldom leads to isolated mucosal involvement. Here, we describe a rare case of RIME mucositis secondary to C. pneumoniae respiratory infection. Case report. An otherwise healthy 19-year-old male presented with fever, cough, conjunctivitis, dysuria and oral mucositis with ulceration preventing food intake. C. pneumoniae was detected on a nasopharyngeal swab by a commercial multiplex PCR (BioFire Respiratory 2.1 Panel), while a broad workup of alternative infectious and autoimmune causes was unremarkable. Despite supportive care, antibiotics and initial steroid treatment, his mucositis necessitated hospital admission and eventually steroid regimen intensification before fully resolving. Conclusion. While rare, C. pneumoniae should be considered as a possible trigger of RIME in adolescents and young adults. Multiplex PCR assays capable of detecting atypical pneumonia pathogens such as C. pneumoniae and M. pneumoniae can assist in diagnosing patients presenting with RIME-compatible symptoms. Treatment involves supportive care, antibiotics and steroids if mucositis is severe. Steroid escalation may be beneficial in patients with slow-resolving mucositis.

A 59-year-old female patient was admitted due to a vaginal mass detected one month ago. There is no family history of malignant tumors, nor any relevant complications. One month prior, she incidentally palpated a cystic mass on the anterior vaginal wall while bathing. She reported no dysuria, hematuria, abdominal pain, or vaginal bleeding. Over the past week, she developed dysuria with interrupted urine flow, but no frequency or urgency. Pelvic MRI revealed a cystic-solid mass in the anterior vaginal wall with indistinct borders from the urethra. Needle biopsy of the vaginal mass combined with immunohistochemistry initially suggested clear cell adenocarcinoma. Final diagnosis was confirmed as primary urethral clear cell carcinoma by pathological examination of the radical resection specimen. Cystic masses in the anterior vaginal wall should raise suspicion for urothelial origin clear cell carcinoma. Fine-needle aspiration biopsy combined with immunohistochemistry may still yield misdiagnosis; definitive diagnosis relies on pathological examination of resected specimens.

BACKGROUND Stevens-Johnson syndrome (SJS) is a rare, immune-mediated mucocutaneous disorder usually triggered by medications or infections. It typically manifests with widespread epidermal detachment and mucosal ulcerations, but atypical cases can present with isolated mucosal involvement, leading to diagnostic uncertainty and delayed treatment. Recognizing such varying presentations is crucial to precent progression to more severe disease and improve outcomes. CASE REPORT We present the case of an 18-year-old male with no significant medical history who presented with severe odynophagia, oral ulcerations, conjunctivitis, and dysuria shortly after completing a course of cefdinir for an upper respiratory infection. Notably, he lacked the characteristic diffuse rash seen in classic SJS. Laboratory evaluation revealed elevated inflammatory markers, and imaging demonstrated non-specific soft tissue edema. Initial management included cessation of cefdinir, intravenous fluids, corticosteroids, and broad supportive care. During hospitalization, he developed macular lesions on the palms and soles and progressive mucosal sloughing. Serologic testing later confirmed elevated Mycoplasma pneumoniae IgM and IgG titers, leading to reclassification of this condition to Mycoplasma pneumoniae-associated SJS (MP-SJS). He was treated with intravenous immunoglobin and azithromycin, with gradual improvement and full recovery after a 2-week hospital course. CONCLUSIONS This case highlights an atypical, mucosal-predominant presentation of Mycoplasma pneumoniae-associated SJS in an adolescent male, initially mimicking severe oropharyngeal infection. Clinicians should maintain a high index of suspicion for SJS in patients presenting with acute mucositis and odynophagia following recent medication use or respiratory illness, even when the cutaneous findings are absent. Early identification, withdrawal of the offending agent, and prompt multidisciplinary care are critical to favorable outcomes.

Ureteral stents, introduced in 1960s, are essential for managing upper urinary tract pathologies, maintaining ureteral patency in conditions like obstruction, trauma and post-surgery. However, stent-related symptoms (SRS) including pain, dysuria, and urinary frequency, remain a significant clinical challenge. Advances in stent design, biomaterials, drug-eluting catheters and biodegradable options aim to reduce SRS and complications like encrustation and infections. Despite this improvements, the ideal stent has yet to be achieved. The future of stent therapy lies in personalized approaches, aided by artificial intelligence and machine learning, and will focus on reducing morbidity while enhancing patient outcomes and quality of life.

Urine analysis remains a fundamental tool for diagnosing renal and urothelial diseases. Although urinary sediment microscopy is primarily used to detect haematuria, leukocyturia, and other formed elements, it may occasionally reveal exfoliated malignant cells that prompt further diagnostic investigation. The detection of Upper Tract Urothelial Carcinoma (UTUC) through routine urinary sediment examination is uncommon, as voided urine samples typically show limited sensitivity for tumours arising in the upper urinary tract. We report the case of a 42-year-old woman who initially presented with persistent dysuria and abdominal discomfort and was treated empirically for a suspected urinary tract infection. Despite antibiotic therapy, symptoms persisted and urine culture remained negative. Subsequent urinalysis revealed proteinuria, haematuria, and leukocyturia. Microscopic examination of the urinary sediment demonstrated atypical cells characterized by nuclear membrane irregularity, coarse chromatin, prominent nucleolus, and an unusual cytoplasmic protrusion. These cytomorphological findings prompted further investigation with urine cytology, which was positive for malignant cells. Cystoscopy showed no abnormalities, leading to additional evaluation with computed tomography urography. Imaging revealed a large intraluminal mass occupying the left renal pelvis with associated hydronephrosis and para-aortic lymphadenopathy. Ureteroscopy with selective cytology and subsequent multidisciplinary assessment confirmed the diagnosis of high-grade UTUC. This case highlights the diagnostic value of meticulous urinary sediment examination. Although routine sediment analysis is not a substitute for cytology or imaging, careful morphological assessment may provide an early clue to underlying malignancy and trigger appropriate diagnostic pathways, particularly in patients with persistent urinary symptoms and negative urine cultures.

Background/Objectives: Obesity has been associated with the development and severity of benign prostatic hyperplasia (BPH), yet its influence on outcomes following definitive surgical management, like holmium laser enucleation of the prostate (HoLEP), remains unclear. Furthermore, gradation of body mass index (BMI) severity has yet to discern personalized outcome stratification. We evaluated BMI's influence on perioperative, immediate, short-term follow-up, and patient-reported outcomes for HoLEP patients. Methods: We performed a retrospective review of a prospectively maintained database of patients undergoing HoLEP for BPH at a single institution between January 2021 and August 2025. Outcomes included operative characteristics, post-operative complications, and validated symptom score changes. Analyses treated BMI as both a continuous and categorical variable. Multivariable linear and logistic regression models adjusted for common colinear confounders. Results: Among 1445 patients, BMI was not associated with most immediate, three-month, or patient-reported outcomes. Surgical complications were low across all BMI categories, and post-operative reported outcomes indicating high success rate for HoLEP. Higher BMI correlated with a modest increase in enucleation time (β = 0.197; p = 0.0132), increased odds of dysuria (OR = 1.084; p < 0.001), and change in American Urological Association Symptom Score (β = 0.211; p = 0.0334). All other operative metrics, complication rates, continence outcomes, and symptom scores (17 other total) were independent of BMI. Conclusions: After adjustment for relevant confounders, BMI does not meaningfully predict surgical safety, functional recovery, or patient-reported benefit following HoLEP. BMI alone should not influence candidacy or risk stratification for HoLEP in patients with BPH, instead favoring personalized, risk-stratified approaches.