OpenMed/multicare-articles huggingface dataset:
Case report: Fibrotic interstitial lung disease as the initial manifestation of hereditary pulmonary alveolar proteinosis caused by CSF2RB mutation
Authors: Qiuhong Li, Huikang Xie, Manhui Li, Kebin Cheng
Journal: Front Pharmacol (2024)
Keywords: csf2rb, chest high-resolution computed tomography, fibrotic interstitial lung disease, mutation, pulmonary alveolar proteinosis
MeSH terms: Case Reports

A 50-year-old male was admitted to the hospital with a 3-year history of dyspnea and cough. Chest high-resolution computed tomography (HRCT) did not show typical features of pulmonary alveolar proteinosis (PAP), but rather atypical features of interstitial lung disease with fibrosis. The diagnosis of PAP was confirmed through transbronchial lung cryobiopsy. Whole exome sequencing identified a rare homozygous frame shift mutation (c.304_305del:p.S102Ffs*5) in exon 3 of the CSF2RB gene in our patient. This case represents a rare occurrence of fibrotic interstitial lung disease in PAP.
Oncocytic cell carcinoma of the thyroid with TERT promoter mutation presenting as asphyxia in an elderly: a case report
Authors: Xiqian Wang, Yingao Liu, Lijie Chen, Jie Zhang, Ruoyu Jiang, Lei Zhang, Han Yan
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: aged, asphyxia, carcinoma, mutation, thyroid neoplasms
MeSH terms: Asphyxia / genetics, Mutation, Promoter Regions, Genetic / genetics, Telomerase / genetics, Thyroid Neoplasms / diagnosis, Thyroid Neoplasms / genetics, Thyroid Neoplasms / pathology, Case Reports, Adenoma, Oxyphilic / diagnosis, Adenoma, Oxyphilic / genetics, Adenoma, Oxyphilic / pathology, Aged, 80 and over, Female, Humans, Male, Telomerase, TERT protein, human

Introduction:
The prevalence of thyroid nodules and malignancies in the elderly is a growing concern. Thyroid nodules in this population have unique characteristics, requiring careful treatment strategies that balance risks and benefits. Oncocytic carcinoma of the thyroid (OCA) is a rare, aggressive subtype with diagnostic challenges.
Methods:
This case features an 84-year-old patient who presented with a neck mass and symptoms of asphyxia. Clinical evaluation, imaging studies, and biopsy were conducted to assess the nature of the thyroid lesion. Molecular testing, including genetic analysis, was performed to identify specific mutations associated with OCA and guide treatment decisions.
Results:
The patient was diagnosed with oncocytic carcinoma of the thyroid. The molecular testing revealed specific genetic mutations indicative of OCA, confirming the diagnosis. The presence of these mutations guided the treatment plan, emphasizing the importance of molecular diagnostics in managing thyroid malignancies, especially in the elderly.
Discussion:
This case illustrates the complexities of diagnosing and treating thyroid malignancies in the elderly. Biopsy and molecular testing provided diagnostic accuracy and informed treatment. Individualized approaches are essential for better outcomes, especially in aggressive subtypes, balancing the risks and benefits of intervention.
Complete Heart Block and Ventricular Asystole Caused by Vagus Nerve Stimulation Therapy
Authors: Jarrod Warnock, Cody Ashcroft, Raphael J Sabado, Andrea Keithler, Serafim Perdikis
Journal: Cureus (2024)
Keywords: bradyarrhythmia, complete heart block, refractory epilepsy, transient ventricular asystole, vagus nerve stimulation
MeSH terms: Case Reports

Left vagus nerve stimulation (VNS) is an advanced therapeutic option for refractory, drug-resistant epilepsy. A 45-year-old woman with a history of refractory catamenial focal epilepsy since age 16, treated with a five-drug antiepileptic regimen and VNS (implanted eight and one-half years prior), presented with dyspnea, chest discomfort, and lightheadedness. During observation, symptoms recurred and were associated with bradycardia (<20 bpm) and a complete atrioventricular node (AVN) block. Following admission, she continued to experience recurrent symptomatic AVN block and transient ventricular asystole, temporally correlated with her baseline seizure activity and resultant activation of her VNS. Deactivation of VNS resolved her bradyarrhythmia, and she experienced no recurrence over 14 months of follow-up. This case highlights a therapeutic dilemma in cases of refractory epilepsy, with limited therapeutic options if seizure activity requires VNS to be controlled.
Perioperative Management Conundrum for a Case With Multiple Commonly Used Drug Hypersensitivity
Authors: Vikash Bansal, Habib Md R Karim, Abhishek K Rai, Dipak Bhuyan, Sanjay Kumar
Journal: Cureus (2024)
Keywords: anaesthesia and analgesia, diclofenac allergy, drug hypersensitivity reactions, mefenamic acid, paracetamol allergy
MeSH terms: Case Reports

Perioperative hypersensitivity reactions vary from mild to potentially fatal anaphylaxis, resulting in significant morbidity and mortality. Most of the perioperative hypersensitivity and allergic reactions are attributed to antibiotics, antiseptic solutions, latex, and opioids. In the current thrust for opioid-free anesthesia, owing to its multiple advantages, paracetamol and nonsteroidal antiinflammatory agents play a significant role in multi-modal pain and inflammatory response management. Nearly nine out of ten individuals experience postoperative pain, one-third experience postoperative nausea and vomiting, and one-fourth experience fever, irrespective of surgery and type of anesthesia, often as an inflammatory response. While perioperative hypersensitivity reactions are common, a patient allergic to multiple commonly used drugs for the treatment of pain, fever, acid-peptic disorder, and nausea and vomiting is scarce. Such cases pose a great challenge in perioperative management. A 14-year-old male child with a traumatic foot drop planned for tibialis posterior tendon transfer developed an allergic reaction with mild fever following an injection of Ranitidine and Ondansetron in the preoperative area. Surgery was deferred and was investigated for allergy profile testing for commonly used drugs, which showed high IgE levels and moderate to severe hypersensitivity for diclofenac and paracetamol. The patient was operated on after one month under spinal anesthesia, avoiding ranitidine, ondansetron, diclofenac, and paracetamol. The following morning, he developed a high-grade fever (102.3° F), which did not resolve with conservative measures. Hypersensitivity and allergic reactions to NSAIDs are reported in the literature. While there are multiple drugs available as NSAIDs, cross-sensitivity or allergy to other drugs within the same group, and even chemically related groups, is also another possibility that needs to be considered while managing such patients. Mefenamic acid controlled the fever, and the child was discharged home after 48 hours of observation. However, the case posed a great perioperative management dilemma; the present report intends to highlight and discuss it.
Complete Traumatic Rupture of the Pancreas by a Horse Saddle: A Case Report
Authors: Pablo Avila-Sanchez, Javier A Pliego-Zermeño, Natalia M Barron-Cervantes, Carlos Chan
Journal: Cureus (2024)
Keywords: distal pancreatectomy, horse-riding abdominal trauma, pancreatic trauma, pediatric emergency room, pediatric trauma
MeSH terms: Case Reports

Pancreatic trauma is one of the least observed diagnoses in the emergency room, much less in pediatric emergencies. Any cause of direct abdominal blunt trauma can cause it. With only a few cases presented in the literature, horse accidents have been associated with this complication, but it has been never seen in literature as a case where the horse-riding saddle is the one causing the pancreatic trauma, until now. Emphasizing the importance of an early diagnosis is the key point, but more importantly, to highlight that the correct diagnostic approach will grant the opportunity for a lesion in the main pancreatic duct to be identified, which will allow a timely surgical approach, increasing overall survival rates and decreasing morbidity in these patients. Here lies the importance of not only utilizing a specific study, such as a computerized tomography (CT) scan to evaluate abdominal trauma but also using other image studies that are better suited for pediatric patients, such as magnetic resonance image (MRI) with cholangiopancreatography (MRCP).
Case report and brief literature review: possible association of secukinumab with Guillain-Barré syndrome in psoriasis
Authors: Gang Liang, Yongmei Han, Haiyan He, Ci Lu, Chen Zhu
Journal: Front Immunol (2024)
Keywords: guillain–barré syndrome (gbs), il-17, adverse drug reaction (adr), case report, secukinumab
MeSH terms: Antibodies, Monoclonal, Humanized / adverse effects, Antibodies, Monoclonal, Humanized / therapeutic use, Guillain-Barre Syndrome / chemically induced, Guillain-Barre Syndrome / etiology, Psoriasis / complications, Psoriasis / drug therapy, Case Reports, Review, Aged, COVID-19 / complications, Humans, Male, SARS-CoV-2, secukinumab, Antibodies, Monoclonal, Humanized

The etiology of Guillain-Barré syndrome (GBS) may be autoimmune. About two-thirds of patients typically experience their first symptoms within 5 days to 3 weeks after common infectious diseases, surgery, or vaccination. Infection is a triggering factor for over 50% of patients. In recent years, a growing number of studies have indicated that some immune checkpoint inhibitors and COVID-19 may also contribute to the occurrence of GBS. However, drugs are considered a rare cause of GBS. The patient in our case was a 70-year-old man who developed GBS after initiating secukinumab for psoriasis. Upon diagnosis suggesting a potential association between secukinumab and the development of GBS, as per the Naranjo adverse drug reaction (ADR) probability scale, we decided to discontinue the drug. Following this intervention, along with the administration of immunoglobulin, the patient exhibited a significant improvement in extremity weakness. The association of GBS with secukinumab treatment, as observed in this case, appears to be uncommon. The underlying mechanisms that may link secukinumab to the development of GBS are not yet fully understood and warrant further scientific inquiry and rigorous investigation. However, we hope that this report can raise greater awareness and vigilance among medical professionals to enhance the safety of patients' medication.
Case report: Familial case with autism spectrum and bipolar disorder showing a 20q11.21 microduplication including TM9SF4
Authors: Marly Simoncini, Miriam Violi, Angelo Valetto, Veronica Bertini, Francy Cruz-Sanabria, Leonardo Massoni, Liliana Dell'Osso, Claudia Carmassi
Journal: Front Psychiatry (2023)
Keywords: tm9sf4, autism spectrum disorder, bipolar disorder, mental disorder, microduplication in 20q1121, neurodevelopment
MeSH terms: Case Reports

Autism spectrum disorder (ASD) is characterized by multifactorial etiology and high heritability but can be challenging to be diagnosed, especially in cases presenting subthreshold symptoms with no cognitive or language impairment, which may not be identified until adulthood but may occur in family members of subjects with ASD. This study explores the possible correlation between a genomic imbalance and clinical phenotypes in a family case of a proband with ASD, with subjects presenting full-blown or subthreshold ASD and/or mood disorders. Clinical assessments were carried out by means of the Structured Clinical Interview for DSM-5 (SCID-5) disorders, Autism Spectrum Quotient (AQ), Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule Module 2 (ADOS-2), and Adult Autism Subthreshold Spectrum (AdAS Spectrum). The genetic evaluation included array comparative genomic hybridization (array-CGH). The proband was diagnosed with ASD and bipolar disorder type I (BD-I), her twin brothers with ASD and intellectual disability (ID), and her father and sister with BD type II (BD-II) and autism traits. The proband, her father, twin brothers, and older sister showed a microduplication of 350 kb in 20q11.21. In contrast, the proband's mother did not present the microduplication or any mental disorder. This study reports a microduplication that segregates with family members affected by ASD or autistic traits comorbid in some cases with bipolar disorder, and that has never been reported in healthy subjects. Among the genes harbored in this region, the TM9SF4 gene has been recently implicated in risk for ASD.
Existing workloads among managers and healthcare workers during the COVID-19 pandemic: Meanings in the Amazon context
Authors: Wagner Ferreira Monteiro, Kássia Janara Veras Lima, Darlisom Sousa Ferreira, Lucas Lorran Costa de Andrade, Flávia Regina Souza Ramos
Journal: PLoS One (2023)
MeSH terms: COVID-19 / epidemiology, Research Support, Non-U.S. Gov't, Health Personnel / psychology, Humans, Pandemics, SARS-CoV-2, Workload

Introduction:
The global COVID-19 pandemic has increased the concern and risks of health professionals exposed by acting on the front lines in combating and controlling the spread of the virus. This study aims at analyzing the workloads and their implications for the activities carried out by managers and health workers in the face of the COVID-19 pandemic in Manaus, Amazonas, Brazil.
Method:
This is a qualitative study, of the case study type, that integrates a macro research that deals with the experiences built during the confrontation of the pandemic of COVID-19 in the capital of the state of Amazonas, Brazil, the epicenter of the pandemic in the country. Data production resorted to documentary analysis and semi-structured interviews with 56 managers or professionals from the Manaus Health Care Network. The analytical process was supported by the resources of the Atlas.ti 8.0 software and the precepts of Thematic Networks analysis.
Results:
The thematic network "workloads" brought together three topics related to the experience of psychological, physiological and biological loads. Psychological workloads were strongly present in the work routine, being referred to in a more significant way. The sources that increase them are strongly related to work stress, dealing with suffering and death and excess demand on the service. Physiological loads were related to excessive working hours, staff shortages and activity overload. "Biological burdens" include exposure to the SARS-CoV-2 virus, constant contact with infected individuals, and individual protection as key elements of this set.
Conclusion:
The study showed that both managers and workers have work processes and environments with conditions that tend to generate workloads that harm their health and safety, as well as institutions and patient care. Therefore, there is a need for more effective organizational actions in workers' health surveillance, disease prevention, adequate working conditions, reducing workloads and promoting more resolute and less stressful work environments.
Case report: Long-term follow-up of patients who received a FimCH vaccine for prevention of recurrent urinary tract infections caused by antibiotic resistant Enterobacteriaceae: a case report series
Authors: Elise Perer, Helen Stacey, Terri Eichorn, Heidi Hughey, Julie Lawrence, Eric Cunningham, Mark O'Neil Johnson, Kevin Bacon, Andrew Kau, Scott J Hultgren, Thomas M Hooton, Jennifer L Harris
Journal: Front Immunol (2024)
Keywords: fimh, carbapenem-resistant enterobacteriaceae, expanded access, urinary tract infection, vaccine
MeSH terms: Urinary Tract Infections / prevention & control, Vaccines / therapeutic use, Case Reports, Research Support, Non-U.S. Gov't, Anti-Bacterial Agents / therapeutic use, Enterobacteriaceae, Follow-Up Studies, Humans, Anti-Bacterial Agents, Vaccines

Urinary tract infections (UTI) caused by carbapenem-resistant Enterobacteriaceae (CRE) are considered one of the most urgent health threats to humans according to the Centers for Disease Control (CDC), and the World Health Organization (WHO). A FimCH Vaccine expanded access study is being conducted in patients with a history of antibiotic resistant UTIs who are considered to be at risk for development of CRE UTI. This case series describes the clinical, safety and immunogenicity findings for four participants who received a FimCH four-vaccine series. Participants were followed for 12 months after administration of the fourth vaccine for safety, general health status and UTI occurrence. The study was later amended to allow additional follow-up of up to five years post vaccine administration to assess long-term health status, UTI occurrences and to obtain blood samples for anti-FimH antibody testing. In our population of 4 study participants, the number of symptomatic UTI occurrences caused by gram-negative bacteria in the 12-month period following peak anti-FimH antibody response were approximately 75% lower than the 12-month period preceding study enrollment. These results are consistent with the 30-patient cohort of a Phase 1 study with the same FimCH Vaccine. UTI occurrences increased during the long-term follow-up period for all 4 participants but did not reach the rate observed pre-vaccination. No new safety concerns related to the FimCH Vaccine were identified during long-term follow-up. This case series has clinical importance and public health relevance since it examines and reports on UTI frequency and recurrence following vaccination with the FimCH Vaccine in a high-risk population of patients with recurrent UTI. Additionally, participants described improved well-being following vaccination which was maintained in the long-term follow-up period.
Case report: Suspected transfusion-related acute lung injury type II in a child with refractory systemic juvenile idiopathic arthritis complicated by macrophage activation syndrome
Authors: Alenka Gagro, Maja Tomičić, Ivančica Škarić, Barbara Dawidowsky
Journal: Front Pediatr (2024)
Keywords: cytopenia, macrophage activation syndrome (mas), platelets, systemic juvenile idiopathic arthritis (sjia), thrombocytopenia, transfusion-related acute lung injury (trali)
MeSH terms: Case Reports

Introduction:
Transfusion-related acute lung injury is a rare but potentially fatal complication, which may appear during or post-transfusion of blood products. Patients with macrophage activation syndrome, a serious life-threatening complication associated with systemic juvenile idiopathic arthritis, often require transfusion or administration of blood products for correction of cytopenia, coagulopathy and hypofibrinogenemia.
Case report:
A 6-year-old girl with a past medical history of systemic juvenile idiopathic arthritis had the first relapse of the disease during which she developed macrophage activation syndrome. During this life-threatening complication, she received a second dose of whole blood derived filtered and irradiated platelets from a single male donor due to profound thrombocytopenia. Approximately one hour post-infusion, the patient developed progressive dyspnea, hypoxemia and bilateral pulmonary edema. She was promptly intubated and placed on mechanical ventilation for 40 h. Clinical, laboratory and radiological findings, as well as the success of supportive ventilation therapy were highly suggestive of transfusion-related acute lung injury, a life-threatening complication that occurs within six hours of blood component transfusion. Blood immunology showed no presence of anti-human neutrophil antigen and anti-leukocyte antigen class I and class II antibodies in the donor's or patient's plasma.
Conclusion:
To the best of our knowledge, we report the first case of a child with systemic juvenile idiopathic arthritis complicated with macrophage activation syndrome who developed type II transfusion-related acute lung injury following platelet transfusion. It is important to consider transfusion-related acute lung injury in transfusion settings in these children and apply critical and restrictive approach for platelet transfusion.
Streptococcus cristatus: An uncommon cause for a common hospital admission
Authors: Usamah Al-Anbagi, Aram Salehi, Godwin Justus Wilson, Fatima Noor, Ainas Osman Mohamed, Aliyaa Haji, Abdulqadir J Nashwan, Hafsa Abdul Nasir, Bassem Al Hariri
Journal: IDCases (2024)
Keywords: bacteremia, blood culture, ceftriaxone, community acquired pneumonia, infective endocarditis, streptococcus cristatus
MeSH terms: Case Reports

Common organisms associated with community-acquired pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Pneumonia can rarely be caused by an organism such as Streptococcus cristatus, as in our case. This organism belongs to the Mitis group within the Streptococcus genus and typically coexists with humans in the oral cavity. We present a case of Streptococcus cristatus bacteremia and community acquired pneumonia in a previously healthy 40-year-old male, for whom infective endocarditis has been ruled out, and who was successfully treated with ceftriaxone. While most reported cases of Streptococcus cristatus involve infective endocarditis, our case is the first identified instance of community acquired pneumonia caused by Streptococcus cristatus. This case highlights that pneumonia with Streptococcus cristatus, typically considered a commensal in the oral mucosa microbiota of humans, is possible, as seen in our case. Unlike previous cases in the literature, our patient did not have infective endocarditis, which is the common presentation of this bacterium. Instead, he solely presented with pneumonia, marking the first reported case in the literature of Streptococcus cristatus causing pneumonia.
COVID-19 Unveiling Heart Failure in the Realm of Rheumatic Heart Disease
Authors: Monika Karki, Pramod Bhattarai, Riya Mohan, Faraaz Mushtaq
Journal: Cureus (2024)
Keywords: aortic regurgitation, aortic stenosis, atrial flutter with rapid ventricular response, covid-19, mitral regurgitation, rheumatic heart disease, rheumatic mitral stenosis, systolic heart failure, tricuspid regurgitation
MeSH terms: Case Reports

The global coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in various clinical manifestations, including cardiovascular complications. This case report focuses on a unique instance where COVID-19 infection exacerbated heart failure and induced atrial fibrillation in a previously asymptomatic young male with undiagnosed rheumatic heart disease (RHD). RHD, a prevalent cause of valvular abnormalities in developing countries, poses an additional risk for severe outcomes when coexisting with COVID-19 infection, highlighting the need for prompt and tailored interventions.