OpenMed/multicare-articles huggingface dataset:
Unusual site of permanent pacing: a case report
Authors: Rakesh Yadav, Sharad Chandra, Nitish Naik, Cm Nagesh, Ss Kothari
Journal: Indian Pacing Electrophysiol J (2009)
Keywords: iliofemoral, pacemaker, subclavian, transiliac

Subclavian route is a standard way of performing a permanent pacemaker. However in cases with superior vena caval or bilateral subclavian occlusion and bilateral infection of pacemaker site, alternative site is warranted. Epicardial route needs general anesthesia and has its own problems. Iliofemoral route has been used previously but has more lead related problems and patient discomfort. Here we are reporting a case in which transiliac pacing was done due to both right and left pacemaker site active infection and to avoid the chance of lead dislodgement, an alpha loop was made in the right atrium.
A Case of Pericardial Effusion and Human Immunodeficiency Virus in the Postmodern Era
Authors: Rosaida Silverio Lopez, Pankaj Agrawal
Journal: Cureus (2023)
Keywords: antiretroviral therapy, hiv, pericardial effusion, tuberculosis, viral pericarditis
MeSH terms: Case Reports

Pericardial effusion is a relatively common cardiac pathology associated with various infectious and non-infectious etiologies. In developed countries, viral pericarditis and idiopathic reasons are the two most common causes of this condition. Mycobacterium tuberculosis is prevalent in developing countries and is the most common cause of pericardial effusion in these regions. Parasitic and bacterial etiologies are encountered less frequently. In this report, we describe the case of a large pericardial effusion in a patient with HIV and latent tuberculosis (TB). Pericardiocentesis and analysis of pericardial fluid did not reveal any specific etiology, indicating viral or idiopathic pericarditis as an etiology. We also present an analysis of global data related to pericardial effusion in HIV/AIDS patients, and the impact that the increasing availability of antiretroviral therapy (ART) worldwide over the last three decades had had on it. The CD4 count has been described as an essential factor for the prognosis of this condition. Patients with lower CD4 count levels would be at higher risk of severe pericardial effusion.
A Rare Case of Primary Intrapulmonary Neurilemmoma Diagnosed in a 43-Year-Old Asymptomatic Man with a Well-defined Intrapulmonary Mass
Authors: Serafeim Chrysikos, Maria Kaponi, Christina Triantafillidou, Theodoros Karampitsakos, Argyrios Tzouvelekis, Maria Anyfanti, Konstantinos Marossis, Marios Konstantinou, Rodoula Tringidou, Demosthenes Bouros, Katerina Dimakou
Journal: Front Oncol (2018)
Keywords: intrapulmonary schwannoma, mass, neurilemmoma, positron-emission tomography, tumor
MeSH terms: Case Reports

Neurilemmoma (NL), also termed schwannoma, presents as a well-circumscribed and encapsulated mass in the human body and is almost always solitary. CT scan of a patient with NL shows a round, ovoid, or lobulated well-demarcated solid mass of soft tissue density. Primary intrathoracic neurogenic tumors location varies. However, the development of such tumors is by far more common in the costovertebral angle of the posterior mediastinum. Here, we report a rare case of a 43-year-old patient, never smoker and previously healthy, who presented with a mass adjacent to the right pulmonary hilum. This was an incidental finding on a chest X-ray after annual checkup at his workplace. The diagnosis was primary intrapulmonary NL. Primary intrapulmonary NL is an extremely rare tumor. However, based on the above, chest CT findings of a well-defined solid mass in an asymptomatic patient should raise the suspicion of NL, irrespective of the tumor localization.
Epiploic Appendagitis Mimicking Recurrent Diverticulitis
Authors: R Plummer, Y Sekigami, Lilian Chen, James Yoo
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Here, we report a case in which a patient with an extensive history of diverticulitis of the sigmoid colon presented with left lower quadrant abdominal pain similar to her previous episodes of diverticulitis. An initial diagnosis of diverticulitis was made based on her history and exam, intravenous antibiotics were given, and an elective surgical resection was considered. However, a subsequent CT scan revealed epiploic appendagitis with no evidence of diverticulitis. Though uncommon, in patients with a history of recurrent diverticulitis, alternative causes of left lower quadrant abdominal pain such as epiploic appendagitis should be considered as this may alter future treatment decisions.
Life-Threatening Hypertriglyceridemia in a Patient on Ruxolitinib and Sirolimus for Chronic Graft-versus-Host Disease
Authors: Allison P Watson, Claudio G Brunstein, Shernan G Holtan
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Ruxolitinib is an oral selective Janus-associated kinase 1 (JAK1) and JAK2 inhibitor that was initially approved by the FDA in 2014 for treatment of myelofibrosis. In preclinical and retrospective clinical studies, use of ruxolitinib was shown to reduce graft-versus-host-disease (GVHD) in allograft recipients with moderate/severe corticosteroid-dependent or refractory chronic GVHD. While the exact mechanism for action in GVHD is not yet fully understood, prospective studies are ongoing and some patients are receiving ruxolitinib in the setting of steroid refractory GVHD. Although ruxolitinib is generally well tolerated, here we describe a case involving a 50-year-old man with acute myeloid leukemia and chronic GVHD who experienced life-threatening hypertriglyceridemia associated with concomitant use of sirolimus and ruxolitinib for GVHD. This case report highlights the importance of vigilance for severe side effects in novel immunosuppressive drug combinations.
Proximal dissection and rupture of a popliteal cyst: a case report
Authors: M H Abdelrahman, S Tubeishat, M Hammoudeh
Journal: Case Rep Radiol (2012)

Popliteal cysts are swellings in the popliteal fossa due to enlargement of the gastrocnemius semimembranous bursa. These cysts might burst, and they usually rupture posteriorly and inferiorly with severe pain in the calf. We describe a patient with popliteal cyst that dissected proximally and ruptured in the soft tissue of the thigh.
Article patellar aneurysmal bone cyst in children: a case report
Authors: Mounir Arroud, Karima Atarraf, Lamiae Chater, My Abderrahmane Afifi
Journal: Pan Afr Med J (2012)
Keywords: patellar, aneurysm, bone, children, cyst
MeSH terms: Bone Cysts, Aneurysmal / pathology, Chronic Pain / etiology, Patella / pathology, Case Reports, Bone Cysts, Aneurysmal / surgery, Bone Transplantation / methods, Child, Curettage / methods, Follow-Up Studies, Humans, Ilium / transplantation, Male, Patella / surgery, Range of Motion, Articular

An aneurysmal bone cyst is rare in the patella. We report the case of a 9 year-old boy who presented with chronic pain and no previous trauma history. Treatment included curettage of the cyst and filling with a iliac bone graft. Ten months after surgery, the knee was mobile and painless and graft incorporation was good.
Progressive Multifocal Leukoencephalopathy Diagnosed by Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid in an HIV Patient
Authors: Huan Xia, Yuanlin Guan, Silvère D Zaongo, Han Xia, Ziyu Wang, Zhongfang Yan, Ping Ma
Journal: Front Neurol (2019)
Keywords: hiv, pml, cerebrospinal fluid, metagenomic next-generation sequencing, progressive multifocal leukoencephalopathy
MeSH terms: Case Reports

Metagenomic next-generation sequencing (mNGS) is a novel approach to identify pathogens undetected by conventional methods. Herein, we report a case in which mNGS was used to identify JC virus from the cerebrospinal fluid sample of an HIV positive patient with progressive multifocal leukoencephalopathy (PML).
Case report: Varicella-zoster virus infection triggering progressive encephalomyelitis with rigidity and myoclonus
Authors: Jing Yuan, Aihua Wang, Yunfeng Hou, Xuxu Xu
Journal: Front Neurol (2022)
Keywords: glycine receptor, herpes zoster, paroxysmal sympathetic hyperactivity, progressive encephalomyelitis with rigidity and myoclonus, varicella-zoster virus
MeSH terms: Case Reports

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare neurological disease of unknown etiology, and most patients with PERM are positive for anti-glycine receptor (GlyR) antibody. In this case study, we report a clinical case of a varicella-zoster virus-infected patient who developed anti-GlyR antibody-positive PERM. He initially suffered from herpes zoster and gradually developed symptoms of impaired brainstem functions including hoarse voice and dysphagia, accompanied by paroxysmal sympathetic hyperactivity. The patient also suffered from severe spasms, which were easily triggered by external stimuli. Glycine receptor antibodies were then found to be positive in serum and cerebrospinal fluid, and the diagnosis of PERM was confirmed. Methylprednisolone and gamma globulin treatments were given, and spasms were improved after treatment. Unfortunately, the patient's family insisted on automatic discharge and the patient passed away several days later.
Novel GLDC Compound Heterozygous Variant Leading to Nonketotic Hyperglycinemia: Case Report and Literature Review
Authors: Yanyan Cao, Lingzhi Meng, Yudong Zhang, Jiancheng Jiao, Weicong Pu, Li Ma
Journal: Front Pediatr (2021)
Keywords: gldc variation, compound heterozygous variant, glycine cleavage enzyme system, inherited metabolic disease, nonketotic hyperglycinemia
MeSH terms: Case Reports

Nonketotic hyperglycinemia (NKH) is a lethal autosomal recessive disease resulting from alterations in glycine metabolism, commonly caused by mutations in glycine decarboxylase (GLDC). The symptoms of NKH usually manifest in the neonatal period, and can be categorized into severe NKH and attenuated NKH based on the clinical outcome. To date, only a few NKH cases have been reported in China. We here report a case of a neonate with severe NKH carrying a novel compound heterozygous variant in GLDC. The patient was a 68-h-old girl who had progressive lethargy, no crying, and poor sucking ability from birth, and was therefore transferred to our department. On admission, the patient was supported by intubation and ventilation and presented with profound coma. Metabolic investigation indicated a markedly increased glycine concentration both in the plasma and cerebrospinal fluid (CSF). Symptomatic treatments were administered, but the patient's condition did not improve substantially. Whole-exome sequencing identified compound heterozygous mutations (c.1261G>C, p.G421R and c.450 C>G, p.N150K) in GLDC, which were inherited from the mother and the father, respectively. The patient was hospitalized for 8 days in our department and died 2 days after discharge. We further summarize the clinical features, genetic characteristics, administered treatment, and prognosis of previously reported Chinese NKH patients for context. Our results highlight that due to the non-specific clinical phenotypes of NKH and difficulty in obtaining CSF samples, genetic testing is a crucial tool, not only for a diagnosis but also for predicting the clinical outcome and can potentially help to determine the optimal therapeutic strategy.
Ophthalmomyiasis in a preterm neonate resulting in blindness: A case report from Botswana
Authors: Britt Nakstad, Yeni Zandile, Kesiilwe Gaebolae, Francis Msume Banda, Tebo Dinotshe, Fizzah Imran, Alemayehu Mekonnen Gezmu
Journal: Front Pediatr (2022)
Keywords: blindness, eye-covering during phototherpy, jaundice, ophthalmomyiasis, preterm neonate
MeSH terms: Case Reports

Myiasis is an infestation of human tissue by insect larvae. While rare, healthcare-associated myiasis has been reported from immobilized patients in resource-limited healthcare facilities in warm climates without adequate vector control measures. We describe a case of Ophthalmomyiasis in a hospitalized neonate in Botswana that resulted in vision loss. The neonate, who was initially hospitalized due to the complications of prematurity, received phototherapy for jaundice, and to avoid phototherapy-related retinopathy, the neonate's eyes were covered using cotton gauze and adhesive tapes that potentially damaged the skin as commercially available eye covering was not in stock. Therefore, eye covering was not changed and when the eye covering was removed almost 3 days after placement, insect larvae were noted in the patient's eyes and nose. Ophthalmologic evaluation revealed perforated corneal ulcer and uveal prolapse in the right eye resulting in complete blindness and corneal scarring of the left eye. The patient's clinical course was further complicated by an Enterobacter species bloodstream infection. This case highlights the importance of vector control as a major patient safety measure for neonatal units in warm climates. Flies had been observed in the room and mitigation measures included reducing fly populations through traps, screens, and removal of standing water and leftover food. Every mother and staff were sanitizing hands when entering the room and gowns were used. This case also reinforces the importance to conduct vigilant monitoring of patients, especially neonates with eyes covered during phototherapy.
Psychogenic nonepileptic seizures after head injury: a case report
Authors: Laura Scévola, Luciana D'Alessio, Dario Saferstein, Estela Centurión, Damián Consalvo, Silvia Kochen
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Psychogenic nonepileptic seizures (PNESs) are diagnosed when disruptive changes in behaviour, thinking, or emotion resemble epileptic seizures (ESs), but no paroxysmal discharges are seen on electroencephalogram (EEG) and do not originate from another medical illness. The gold standard for PNES diagnosis is video electroencephalogram (Video-EEG). PNESs are defined by modern psychiatry as conversion and dissociative disorders but these disorders may coexist with many others psychiatric disorders, including depression, posttraumatic stress disorder, and personality disorders. It is well known that epileptic seizures are a frequent and well-studied complication of traumatic head injury (THI). However, THI may also generate psychic symptoms including PNES. In this paper we describe a patient who developed PNES after THI in a bus accident and received a diagnosis of refractory epilepsy for 24 years until she underwent Video-EEG.
Bartter Syndrome Type 1 Presenting as Nephrogenic Diabetes Insipidus
Authors: Gianluca Vergine, Elena Fabbri, Annalisa Pedini, Silvana Tedeschi, Niccolò Borsa
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Bartter syndrome (BS) type 1 (OMIM #601678) is a hereditary salt-losing renal tubular disorder characterized by hypokalemic metabolic alkalosis, hypercalciuria, nephrocalcinosis, polyuria, recurrent vomiting, and growth retardation. It is caused by loss-of-function mutations of the SLC12A1 gene, encoding the furosemide-sensitive Na-K-Cl cotransporter. Recently, a phenotypic variability has been observed in patients with genetically determined BS, including absence of nephrocalcinosis, hypokalemia, and/or metabolic alkalosis in the first year of life as well as persistent metabolic acidosis mimicking distal renal tubular acidosis. We report the case of a child with a genetically determined diagnosis of Bartter syndrome type 1 who presented with a phenotype of nephrogenic diabetes insipidus, with severe hypernatremia and urinary concentrating defect. In these atypical cases, molecular analysis is mandatory to define the diagnosis, in order to establish the correct clinical and therapeutic management.
Aging, Fitness, and Marathon Times in a 91 Year-old Man Who Competed in 627 Marathons
Authors: Odessa Addison, Gregory Steinbrenner, Andrew P Goldberg, Leslie I Katzel
Journal: Br J Med Med Res (2015)
Keywords: maximal aerobic capacity, athlete, exercise, longitudinal

Aging is associated with a decline in maximal aerobic capacity (VO2max) that may be attenuated by chronic endurance exercise. This case study chronicles the changes in marathon times in a 91 year old man who completed 627 marathons and 117 ultramarathons over 42 years. He began running marathons at age 48. His yearly best times remained fairly constant at ~240 minutes from age 50 - 64 years and then gradually rose to about 260 minutes in his early seventies followed by a curvilinear deterioration as he approached his ninth decade. His times plateaued at ~ 600 minutes in his late eighties. Between ages 68 and 89 his VO2max declined from 43 to 20 ml/kg/min. His marathon times were highly correlated with his VO2max (r2=0.87). The decline in marathons times and VO2max may reflect the contributions of biological aging, changes in exercise training volume and intensity, injuries, and comorbid disease.
Annotate-it: a Swiss-knife approach to annotation, analysis and interpretation of single nucleotide variation in human disease
Authors: Alejandro Sifrim, Jeroen Kj Van Houdt, Leon-Charles Tranchevent, Beata Nowakowska, Ryo Sakai, Georgios A Pavlopoulos, Koen Devriendt, Joris R Vermeesch, Yves Moreau, Jan Aerts
Journal: Genome Med (2012)

The increasing size and complexity of exome/genome sequencing data requires new tools for clinical geneticists to discover disease-causing variants. Bottlenecks in identifying the causative variation include poor cross-sample querying, constantly changing functional annotation and not considering existing knowledge concerning the phenotype. We describe a methodology that facilitates exploration of patient sequencing data towards identification of causal variants under different genetic hypotheses. Annotate-it facilitates handling, analysis and interpretation of high-throughput single nucleotide variant data. We demonstrate our strategy using three case studies. Annotate-it is freely available and test data are accessible to all users at http://www.annotate-it.org.
Tubercular endometritis detected through Pap smear campaign in Enugu, Nigeria
Authors: Wilson Onuigbo, Bessie Esimai, Chinenye Nwaekpe, Grace Chijioke
Journal: Pan Afr Med J (2012)
Keywords: nigeria, pap smear, tuberculosis, endometrium, health education
MeSH terms: Endometritis / diagnosis, Papanicolaou Test, Tuberculosis / diagnosis, Vaginal Smears / methods, Case Reports, Letter, Antitubercular Agents / therapeutic use, Endometritis / drug therapy, Endometritis / pathology, Female, Humans, Middle Aged, Nigeria, Tuberculosis / drug therapy, Tuberculosis / pathology, Antitubercular Agents

In a series of 3,267 cervical smears examined in Enugu, Nigeria, from 1993 through 2010, there was a single positive case of tuberculosis (TB). It was found in a 55-year-old, Para 7, postmenopausal woman. Treatment for tuberculosis was instituted successfully.
Extensive Delayed Brain Atrophy after Resuscitation in a Patient with Multiple System Atrophy
Authors: Sazuku Nisitani, Hirofumi Miyoshi, Yoji Katsuoka
Journal: Front Neurol (2018)
Keywords: alpha-synuclein, brain atrophy, hypoxic encephalopathy, magnetic resonance imaging, multiple system atrophy, resuscitation
MeSH terms: Case Reports

Brain magnetic resonance imaging (MRI) of multiple system atrophy (MSA) shows atrophy in the cerebrum, cerebellum, and brainstem. It is also characterized by specific patterns such as hyperintense lateral putaminal rim. MRI of hypoxic encephalopathy shows atrophy mainly in the gray matter, and laminar necrosis in the cerebral cortex is often observed. Here, we report an MSA patient damaged by hypoxic insult and resuscitated after 18-min cardiac arrest. The brain of the patient developed severe atrophy within a period of 10 months. Furthermore, brain atrophy was observed in the white and gray matter, which preserved the brain atrophy pattern in MSA. We assume that alpha-synuclein oligomerization is involved in the neural cell death and brain atrophy. It might have caused further neural cell death in the brain damaged by hypoxia. Alpha-synuclein, which is involved in the pathogenesis of MSA, is suggested to be a prion. Misfolded alpha-synuclein may propagate through cell-to-cell transmission and cause wide pathological change, visible as atrophied MR imaging.
Arthroscopic Treatment of 2 Consecutive Cases of Dysplasia Epiphysealis Hemimelica of the Ankle: A 5-Year Follow-Up Report
Authors: Cosma Calderaro, Carlo Iorio, Francesco Turturro, Federico Morelli, Luca Labianca, Antonello Montanaro, Andrea Ferretti
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

The dysplasia epiphysealis hemimelica (DEH) is a rare disease of unknown etiology consisting in an abnormal osteocartilaginous growth at the epiphysis, usually hemimelic with histological findings similar to benign osteochondroma. In this case series, we described the results of the arthroscopic treatment of 2 consecutive cases of intra-articular ankle localization of DEH in 2 patients aged 9 and 10 years. The good result obtained, persistent at the 5-year follow-up, leads us to consider the arthroscopic approach as a reliable treatment in patient affected by intra-articular ankle DEH.
A Unique Method for Total Nasal Defect Reconstruction - Prefabricated Innervated Osteocutaneous Radial Forearm Free Flap
Authors: Uros Ahcan, Vojko Didanovic, Ales Porcnik
Journal: Case Reports Plast Surg Hand Surg (2019)
MeSH terms: Case Reports

A 52-Year-old woman underwent a two-stage total nose reconstruction for complete nasal defect due to skin cancer. In the 1st stage, innervated osteocutaneous radial forearm flap ("Neo nose") was raised with the help of a 3D template. In the 2nd stage, well vascularised "Neo-nose" was transferred to the face and covered with pre-expanded forehead flap.
Displacement of the Spleen Mimicking Renal Cell Cancer Recurrence Post-Nephrectomy: A Case Report
Authors: Carolina S Emanuels, Krista D Timmerman, Tabish Aijaz, Thu-Cuc Nguyen, Nathaniel Jest, Walter E Drane, Scott M Gilbert, Paul L Crispen, Li-Ming Su, Lori A Deitte, Long H Dang
Journal: J Kidney Cancer VHL (2015)

Local regional recurrence of renal cell cancer post-nephrectomy most often occurs within three years after surgery. Post-nephrectomy, many processes may mimic RCC recurrence. We present the case of a 75 year-old Caucasian male patient with a mass in his renal fossa post-nephrectomy for renal cell cancer, suggesting local recurrence. Use of the technetium-99m sulfur colloid scan showed that the mass was his spleen which had been displaced into the renal fossa. With high index of suspicion, characterization of these processes as splenic in origin would prevent subjecting patients to risks of biopsy or even surgery.