From a boy with a yellow tongue to a man with cement lodged in his heart, a number of intriguing medical cases caught our eye this year. Here are 10 of the strangest case reports Live Science covered in 2021.
IUD ends up in woman's bladder
A woman's symptom of blood in her urine had an unusual cause — the intrauterine device (IUD) that she'd received a decade earlier had "eroded" through her uterus and into her bladder.
The woman received the IUD when she was 37 years old, after she'd had two children, Live Science previously reported. Doctors believe that over time, the IUD punctured through her uterus and then her bladder, leading to her bladder symptoms when she was 47 years old, according to a report of the case, published in the January issue of the journal Case Reports in Women's Health.
IUDs are considered effective forms of birth control that can last up to 12 years. But in rare cases, the devices can perforate the uterus, which happens in about 1 in 1,000 women who get an IUD. Bladder perforation is even more rare.
In the woman's case, doctors also found that a "bladder stone" measuring 0.43 inches (1.1 centimeters) had formed on part of the device. Doctors were able to pulverize the bladder stone and remove the IUD.
Woman's pet cat gave her cowpox
A woman in the U.K. developed a severe eye infection due to cowpox, a cousin of smallpox, which she contracted from her pet cat.
The 28-year-old woman had an eye infection that was so severe, doctors feared she would lose her vision, Live Science reported. Although she received a slew of antibiotics, nothing seemed to work, according to a report of the case, published June 5 in The New England Journal of Medicine.
Interestingly, two weeks earlier, the patient's pet cat had developed unusual lesions on its paws and head. Samples from the cat's lesions and the woman's eye both tested positive for cowpox, a rare viral disease that can infect multiple animal species, including cows, cats and humans. It's closely related to the vaccinia virus, which is used in the smallpox vaccine. Transmission of cowpox from cats to people is extremely rare, with only a few cases ever reported.
The woman received treatment with the antiviral drug tecovirimat, which her doctors obtained from the U.S. Strategic National Stockpile. The stockpile contains 2 million doses of tecovirimat that are kept in case of a bioterror attack with smallpox. The drug worked to clear her infection.
Man had a 4-inch piece of cement in his heart
A man developed an uncommon side effect after his spinal procedure: a 4-inch piece of cement ended up in his heart.
The 56-year-old man went to the emergency room after he experienced chest pain and difficulty breathing, according to a report of the case, published Oct. 2 in The New England Journal of Medicine.
The man had recently undergone a spinal procedure to treat a vertebral compression fracture — a very painful condition in which part of a spine bone (vertebra) collapses into itself, Live Science reported. The man had undergone a kyphoplasty, a procedure in which doctors inject a special type of cement into the vertebra to restore its proper height and keep it from collapsing.
A rare side effect of this procedure is that the cement can leak from the bone into other areas, which can cause a blockage, or embolism, of a blood vessel. This is what happened in the man's case — the cement leaked from the bone into his veins, where it hardened and embolized, traveling to his heart, the authors said. Doctors were able to remove the cement embolism and repair a tear in his heart.
Read more: How did cement end up in a man's heart?
Chopsticks in sinuses
A woman in Taiwan had chopstick fragments embedded in her sinuses for a week without knowing it, after she had a violent fight with her sister.
The 29-year-old woman went to the hospital after she was "attacked by her sister with plastic-wood chopsticks while at the dinner table," according to a report of the case, published June 24 in The Journal of Emergency Medicine. Doctors saw that she had two small cuts under her eye and on her nose, but an X-ray did not show anything unusual.
However, one week later, the woman began to suspect that her injury was more serious than it appeared, Live Science previously reported. When she looked in the mirror, she thought she could see a gray object in her nose. Indeed, a second examination revealed pieces of chopstick that were penetrating her nasal septum, or the wall dividing the two nasal passages. A CT scan showed two chopstick pieces in her sinuses, with one embedded more deeply than the other.
The woman needed surgery to remove the fragments, which were about 1.4 inches (3.5 cm) and 2 inches (5 cm) long, respectively, according to the report. She experienced no surgical complications.
A yellow tongue isn't usually cause for alarm — a number of ordinary things can turn the tongue the color of mustard, from a dry mouth to bad oral hygiene. But for a 12-year-old boy in Canada, a yellow tongue was a sign of a serious and rare disorder.
The boy went to the hospital after he experienced a sore throat, dark urine, abdominal pain and pale skin for several days, according to the report, published July 24 in The New England Journal of Medicine. He also had a bright yellow tongue. Doctors determined that the boy had jaundice, a condition that usually causes a yellowing of the skin and the whites of the eyes as well as dark urine, and in rare cases can cause a yellow tongue, Live Science previously reported.
Jaundice happens when a yellow chemical called bilirubin builds up in the body. Bilirubin is formed during the normal breakdown of red blood cells. But what was causing the boy's jaundice?
After running a number of tests, doctors determined that the boy had cold agglutinin disease, a rare autoimmune disorder in which a person's immune system attacks and destroys its own red blood cells. This autoimmune attack is triggered by exposure to cold temperatures, and so symptoms can be worse during winter months. The condition results in anemia and may also cause jaundice because the fast breakdown of red blood cells leads to a buildup of bilirubin. In some cases, cold agglutinin disease may be caused by certain infections, including infections with Epstein-Barr virus. The boy was found to have an infection with Epstein–Barr virus, and his doctors suspect the infection triggered the boy's cold agglutinin disease.
The boy needed a blood transfusion and received treatment with oral steroids to reduce immune system activity. After the boy left the hospital, he "recovered well," and his tongue color gradually returned to normal as levels of bilirubin in his body fell, the authors said.
Fish tank harbored rare tropical disease
Even pet fish can spread diseases. Case in point; a woman in Maryland contracted a rare bacterial disease from her home aquarium.
The disease, called melioidosis, is usually seen only in tropical areas outside of the U.S., Live Science previously reported. The woman's case, which occurred in 2019 and was described in a report published Sept. 27 this year in the journal Emerging Infectious Diseases, is unusual because the woman had never traveled outside the U.S. Her case is also the first in the world to be connected to a home aquarium, the authors said.
The 56-year-old Maryland woman was first hospitalized in September 2019 with fever, cough and chest pain, and tests showed she had pneumonia. Several days later, further testing revealed that she was infected with Burkholderia pseudomallei, the bacteria that causes melioidosis. She needed to take antibiotics for 12 weeks to clear the infection.
To determine where her infection came from, health officials took samples from in and around the woman's home, including samples from her two freshwater aquariums, which contained tropical fish. Samples from one fish tank were positive for B. pseudomallei, and the bacterial strain in the tank was a genetic match to the one that infected the patient. The woman may have contracted the infection when she cleaned the tank with bare hands.
Copper 'rings' inside man's eyes
A man's eyes held an important clue to diagnosing his rare disease. When the man, who lives in India, went to the doctor with abdominal swelling, an eye exam revealed golden-brown rings encircling his irises in both eyes.
Doctors determined that these markings were Kayser–Fleischer rings, which are caused by a buildup of copper in the cornea, the eye's transparent outer covering, according to a report of the case, published Sept. 25 in The New England Journal of Medicine.
Kayser–Fleischer rings are a sign of a rare condition called Wilson's disease, Live Science previously reported. People with Wilson's disease have a genetic mutation that prevents them from removing excess copper, which leads to a buildup of copper in the body — often in the liver, brain and eyes, according to the National Institutes of Health. The condition occurs in about 1 in every 30,000 people.
The accumulation of copper in the body can lead to liver, kidney and neurological problems. In the man's case, he had developed cirrhosis, or scarring of the liver. The man received a medication known as a chelating agent, which removes copper from the body. He was also placed on a list for a liver transplant due to his serious liver damage, the report said.
BB gun pellet lodged in teen's nose
A teen unknowingly had a BB pellet lodged in his nose for eight years, which caused a "foul odor" when he blew his nose.
The teen first visited doctors for his symptoms when he was 15 years old, Live Science previously reported. By that point, he had experienced nasal congestion for several years along with a reduced sense of smell, according to a report of the case, published Feb. 18 in the journal JAMA Otolaryngology–Head & Neck Surgery.
At first, he received a nasal spray and antihistamine medication for his symptoms. But when he returned to the doctor a year later, the authors noticed "a pungent, foul odor" that filled the room when he blew his nose. A CT scan showed a 0.35-inch (9 millimeters) spherical structure in his nasal cavity. The teen underwent surgery to remove the object, which turned out to be a metallic BB pellet. A talk with the teen's family revealed that he had been shot in the nose with a pellet gun when he was about 8 or 9 years old. At the time, the boy hadn't experienced symptoms, so his parents had not sought medical care.
The pellet had been hard to spot at first because new tissue had grown over it. It had blocked the drainage pathways in the boy's nose, which led to a buildup of mucus, debris and bacteria that in turn caused the foul odor, the authors said. After the boy's surgery, the unpleasant odor disappeared.
Magic mushroom fungus grows in man's blood
A man developed a life-threatening infection in his blood after he injected a tea made from "magic mushrooms" into his veins.
The 30-year-old man had bipolar disorder and opioid dependence, and he had been looking for ways to self-treat his symptoms, according to a report of the case, published Jan. 11 in the Journal of the Academy of Consultation-Liaison Psychiatry. He decided to boil down magic mushrooms, which contain the hallucinogenic compound psilocybin, into a 'shroom tea, and injected the tea into his body, Live Science previously reported.
Afterwards, the man developed nausea along with a yellowing of his skin, and he began vomiting blood. The man's family took him to the hospital, where tests showed that several of his organs, including his liver and kidneys, were starting to fail. Further testing revealed he had a blood infection with the fungus Psilocybe cubensis, the species of magic mushroom the man had injected. In other words, the 'shroom fungus was growing in his blood, the authors said.
The man was treated with antibiotics and antifungals, and he needed to be placed on a ventilator for respiratory failure. After 22 days, he was well enough to leave the hospital.
Man controls his pupils like a muscle
A young man in Germany has an unusual talent — he can enlarge and constrict his pupils on demand, an act that researchers previously thought was impossible.
The eyes' pupils dilate and contrist automatically in response to dark and bright environments, and researchers thought it was impossible for people to directly control their pupils like a muscle, Live Science previously reported. But the 23-year-old man proved researchers wrong — multiple tests showed he could voluntarily dilate and constrict his pupils on demand, without using mental tricks like thinking about a dark or bright environment, according to a report of the case, published Aug. 12 in the International Journal of Psychophysiology.
The man, who said he had honed his ability since he was a teenager, simply concentrates on his eye in order to perform the feat. "Constricting the pupil feels like gripping, tensing something; making it larger feels like fully releasing, relaxing the eye," the man told the researchers.
The authors are now studying whether more people could learn to have this type of control over their pupils.
Originally published on Live Science.