OpenMed/multicare-articles huggingface dataset:
Nonsurgical management of nifedipine induced gingival overgrowth
Authors: George Sam, Staly Chakkalakkal Sebastian
Journal: Case Rep Dent (2014)

Drug-induced gingival overgrowth is frequently associated with three particular drugs: phenytoin, cyclosporin, and nifedipine. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. The awareness in the medical community about this possible side effect of nifedipine is less when compared to the effects of phenytoin and cyclosporin. The frequency of gingival enlargement associated with chronic nifedipine therapy remains controversial. Within the group of patients that develop this unwanted effect, there appears to be variability in the extent and severity of the gingival changes. Although gingival inflammation is considered a primary requisite in their development, few cases with minimal or no plaque induced gingival inflammation have also been reported. A case report of gingival overgrowth induced by nifedipine in a patient with good oral hygiene and its nonsurgical management with drug substitution is discussed in this case report.
Drug induced Kounis syndrome: does oxidative stress play a role?
Authors: Luisa Ricciardi, Fabiana Furci, Marco Casciaro, Eleonora Di Salvo, Mariateresa Cristani, Valeria Tigano, Paola Lucia Minciullo, Sebastiano Gangemi
Journal: Clin Mol Allergy (2018)
Keywords: advanced glycation end products, advanced oxidation protein products, cardiac anaphylaxis, drug allergy, kounis syndrome, oxidative stress
MeSH terms: Case Reports

Background:
Kounis syndrome (KS) has been described as the coincidental occurrence of acute coronary syndromes during an allergic reaction with cardiac anaphylaxis. It is caused by inflammatory mediators released after exposure to drugs, food, environmental and other triggers. Oxidative stress occurring in various inflammatory disorders causes molecular damage with the production of advanced oxidation products (AOPPs) and advanced glycation end products (AGEs).
Case presentation:
Markers of oxidative stress were evaluated in a patient who had experienced KS after antibiotic administration in order to investigate the possible role of these molecules in KS. No data, up to now, are available on biomarkers of oxidative stress in patients with drug-induced KS.
Conclusions:
AOPPs, but not AGEs, were significantly increased in the KS affected patient compared to controls as already reported in mastocytosis affected patients.
Allogeneic Hematopoietic Stem Cell Transplantation After Prior Lung Transplantation for Hereditary Pulmonary Alveolar Proteinosis: A Case Report
Authors: Hanne Beeckmans, Gene P L Ambrocio, Saskia Bos, Astrid Vermaut, Vincent Geudens, Arno Vanstapel, Bart M Vanaudenaerde, Frans De Baets, Thomas L A Malfait, Marie-Paule Emonds, Dirk E Van Raemdonck, Hélène M Schoemans, Robin Vos
Journal: Front Immunol (2022)
Keywords: allogeneic hematopoietic stem cell transplantation, bone marrow transplantation, lung transplantation, pulmonary alveolar proteinosis, rejection
MeSH terms: Hematopoietic Stem Cell Transplantation, Lung Transplantation, Pulmonary Alveolar Proteinosis / drug therapy, Pulmonary Alveolar Proteinosis / therapy, Pulmonary Fibrosis, Pulmonary Surfactants / therapeutic use, Case Reports, Research Support, Non-U.S. Gov't, Humans, Quality of Life, Receptors, Granulocyte-Macrophage Colony-Stimulating Factor / genetics, Surface-Active Agents / therapeutic use, Pulmonary Surfactants, Receptors, Granulocyte-Macrophage Colony-Stimulating Factor, Surface-Active Agents

Pulmonary alveolar proteinosis (PAP) is a rare, diffuse lung disorder characterized by surfactant accumulation in the small airways due to defective clearance by alveolar macrophages, resulting in impaired gas exchange. Whole lung lavage is the current standard of care treatment for PAP. Lung transplantation is an accepted treatment option when whole lung lavage or other experimental treatment options are ineffective, or in case of extensive pulmonary fibrosis secondary to PAP. A disadvantage of lung transplantation is recurrence of PAP in the transplanted lungs, especially in hereditary PAP. The hereditary form of PAP is an ultra-rare condition caused by genetic mutations in genes encoding for the granulocyte macrophage-colony stimulating factor (GM-CSF) receptor, and intrinsically affects bone marrow derived-monocytes, which differentiate into macrophages in the lung. Consequently, these macrophages typically display disrupted GM-CSF receptor-signaling, causing defective surfactant clearance. Bone marrow/hematopoietic stem cell transplantation may potentially reverse the lung disease in hereditary PAP. In patients with hereditary PAP undergoing lung transplantation, post-lung transplant recurrence of PAP may theoretically be averted by subsequent hematopoietic stem cell transplantation, which results in a graft-versus-disease (PAP) effect, and thus could improve long-term outcome. We describe the successful long-term post-transplant outcome of a unique case of end-stage respiratory failure due to hereditary PAP-induced pulmonary fibrosis, successfully treated by bilateral lung transplantation and subsequent allogeneic hematopoietic stem cell transplantation. Our report supports treatment with serial lung and hematopoietic stem cell transplantation to improve quality of life and prolong survival, without PAP recurrence, in selected patients with end-stage hereditary PAP.
Operation makalu air crash: influence of cognitive and human factors on decision-making
Authors: Samarika Dahal, Gopal Kumar Chaudhary, Nitin Kumar Agrawal
Journal: Forensic Sci Res (2023)
Keywords: forensic sciences, nepal, cognitive bias, dental identification, disaster, mortuary
MeSH terms: Case Reports

Two onboard crew members lost their lives in the fatal Makalu Air Cessna Grand Caravan 208B domestic cargo flight crash on May 16, 2018. The Disaster Victim Identification (DVI) procedure comprises external examination, photography, DNA collection, fingerprint collection, postmortem examination, antemortem information collection from the family members, and reconciliation. The major challenge of this operation was dealing with cognitive bias. The antemortem dental information of one of the deceased was revealed to the forensic experts just before the postmortem examination. This influenced the testing strategies. There was a tendency to neglect the complete dental examination presuming the identification was established. Later, during a thorough examination, the forensic odontologist realised that the initial decision was erroneous. Furthermore, there are few experience-based resources available to resolve cognitive bias issues. The authors begin by summarising complicated operations in which they have been involved, followed by a discussion of the key sources of cognitive bias along with the solution to resolve these issues in DVI preparedness planning.
Mandibular nerve schwannoma: a case report
Authors: Jinane Kharbouch, Zakaria Aziz, Mohamed Lahrach, Yassine Bennaoui, Salma Aboulouidad, Mohamed El Bouihi, Nadia Mansouri Hattab
Journal: Pan Afr Med J (2022)
Keywords: schwannoma, case report, inferior alveolar nerve, intraosseous, mandible
MeSH terms: Neurilemmoma / diagnosis, Neurilemmoma / pathology, Neurilemmoma / surgery, Case Reports, Humans, Mandibular Nerve / pathology, Mandibular Nerve / surgery, Middle Aged, Paresthesia / etiology, Tongue / pathology

Benign schwannomas are uncommon and their intraosseous location is even rarer counting for less than 1% of all benign primary bone tumors. They exceptionally occur in the oral cavity with the tongue being the most common site of involvement. We report here a case of intramandibular schwannoma derived from the inferior alveolar nerve, in a 57-year-old patient with a 3 months history of inferior left lip paresthesia. The oral examination showed a firm, painless and non-pulsatile swelling located in the inferior vestibule. The panoramic X-ray revealed a circumscribed and homogeneous radiolucent image. Treatment consisted of total excision of the tumor with preservation of the nerve bundles. The histological examination confirmed the diagnosis of schwannoma. The patient recovered a normal sensory function 6 months post-operatively without any recurrence up to 2 years after surgery. The treatment of intramandibular schwannoma is basically surgical with the conservative approach being the most advocated by majority of authors.
A Rare Manifestation of a Rare Disease: Mantle Cell Lymphoma Presenting With Aseptic Meningitis
Authors: Elvira Umyarova, Sreedhar Adapa, Srikanth Naramala, Vijay Gayam, Narothama Reddy Aeddula, Venu Madhav Konala
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: mipi, aseptic meningitis, mantle cell lymphoma
MeSH terms: Bone Marrow / pathology, Lymphoma, Mantle-Cell / diagnosis, Meningitis, Aseptic / etiology, Pancytopenia / etiology, Case Reports, Adult, Antigens, CD20 / analysis, Cerebrospinal Fluid / cytology, Cyclin D1 / analysis, Humans, Immunohistochemistry, Lymphoma, Mantle-Cell / complications, Lymphoma, Mantle-Cell / pathology, Male, Meningitis, Aseptic / pathology, Rare Diseases, Antigens, CD20, Cyclin D1

Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin lymphoma characterized by clonal proliferation of follicular mantle zone B lymphocytes. It is caused by abnormal chromosomal translocation t(11;14) resulting in aberrant expression of cyclin D1. This leads to activation of anti-apoptotic pathways and abnormal proliferation of MCL cells. Patients can present with an indolent course or a fulminant disease with short overall survival. The disease frequently involves extranodal organs, but rarely manifests with neurological symptoms. We report a rare case of aberrant CD5-negative MCL presenting with aseptic meningitis.
Acute spontaneous suppurative thyroiditis caused by Eikenella corrodens presented with thyrotoxicosis
Authors: Pınar Akhanlı, Ömer Bayır, Seyit Murat Bayram, Sema Hepşen, Madamin Badirshaev, Erman Çakal, Güleser Saylam, Mehmet Hakan Korkmaz
Journal: Einstein (Sao Paulo) (2020)
MeSH terms: Eikenella corrodens / isolation & purification, Thyroiditis, Suppurative / microbiology, Thyrotoxicosis / microbiology, Case Reports, Adult, Anti-Bacterial Agents / therapeutic use, Eikenella corrodens / drug effects, Humans, Male, Microbial Sensitivity Tests, Neck / diagnostic imaging, Rare Diseases, Thyroiditis, Suppurative / diagnostic imaging, Thyroiditis, Suppurative / drug therapy, Thyrotoxicosis / diagnostic imaging, Thyrotoxicosis / drug therapy, Tomography, X-Ray Computed, Ultrasonography, Anti-Bacterial Agents

Acute suppurative thyroiditis is a very rare and life-threatening endocrine emergency. Thyrotoxicosis is a rare condition accompanying acute suppurative thyroiditis. While the majority of the cases in the literature are caused by different reasons, spontaneous development is very rare. We present a patient with acute suppurative thyroiditis who presented to our clinic with thyrotoxic findings, and we compared the case to the literature. A 31-year-old male patient was admitted to our clinic with a complaint of progressive neck pain, swelling and redness on midline neck, fever, and palpitations. On physical examination, swelling, redness and tenderness were detected on the neck region that was consistent with the thyroid location. He presented with tremor on the hands, tachycardia and agitation. Thyroid function tests were compatible with thyrotoxicosis, but there were findings supporting the presence of infection in biochemistry tests. On his radiological evaluations, a heterogeneous lesion divided with small septs was observed, with consolidation areas in the left thyroid lobe. In fine needle aspiration biopsy, 2mL of purulent fluid could be aspirated due to the presence of small, separated consolidation areas. He initiated on antibiotic therapy, propranolol, steroid and symptomatic treatment. Eikenella corrodens was detected on the culture antibiogram. Antibiotic therapy was continued for 14 days due to less symptoms and better biochemical values. After treatment, the patient had normal thyroid function, had relief of fever and redness of the neck, and was followed-up. It should be kept in mind that acute suppurative thyroiditis may develop spontaneously with the findings of thyrotoxicosis, with no risk factors.
Gastrointestinal CMV Disease and Tuberculosis in an AIDS Patient: Synergistic Interaction between Opportunistic Coinfections
Authors: Miriã Boaretto Teixeira Fernandes, Pedro Afonso Nogueira Moisés Cardoso, Luiza Bassani Altoé, Izana Junqueira de Castro, Guilherme Almeida Rosa da Silva, Walter de Araújo Eyer-Silva, Marcia Lyrio Sindorf, Rodrigo Panno Basílio de Oliveira, Marcelo Costa Velho Mendes de Azevedo, Jorge Francisco da Cunha Pinto
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

The AIDS pandemic has made diseases such as tuberculosis, CMV disease, and other opportunistic infections more prevalent; these diseases may even be found to be associated among themselves, and the natural history of each disease may present in an unusual manner. We report the case of a 41-year-old man with HIV (CD4 of 144 cells/dL) and HCV with hematochezia due to tuberculosis in the ileocecal valve and descending colon and CMV tissue invasive disease in the esophagus and descending colon. Coinfection among tuberculosis and cytomegalovirus in the gastrointestinal tract was described only once in a patient with a recent diagnosis of HIV that affected the distal ileum and ascending colon. We will discuss the peculiarities of the case and the behavior of the immune system in the face of simultaneous opportunistic infections. This is a challenging scenario that has scarce publications and is of great clinical importance.
Infraglenoid Muscle as an Anatomic Variation of the Anterior Rotator Cuff
Authors: Gwan Bum Lee, Erica Kholinne, Jae-Man Kwak, Yucheng Sun, Adel Mohammaed Alhazmi, In-Ho Jeon
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Case:
We report a patient with osteoarthritis of the shoulder joint who underwent reverse shoulder arthroplasty and showed anatomical variation in the subscapularis muscle (SM). A variation of the rotator cuff originating from the anteroinferior aspect of the glenoid was separated from the SM by a septum and was named infraglenoid muscle (IGM).
Conclusion:
We suggest that the IGM may serve as an additional dynamic stabilizer for external rotation. Studying this particular muscular variation would lead to better understanding of the anatomical structures around the glenoid cavity.
Small Bowel Intussusception Due to Rare Cardiac Intimal Sarcoma Metastasis: A Case Report
Authors: Marco Chiarelli, Mauro Zago, Fulvio Tagliabue, Morena Burati, Cristina Riva, Alice Vanzati, Emanuele Dainese, Francesco Gabrielli, Angelo Guttadauro, Matilde De Simone, Ugo Cioffi
Journal: Front Surg (2021)
Keywords: bowel obstruction, cardiac tumor, intimal sarcoma, intussusception, metastasis
MeSH terms: Case Reports

Background: Intimal sarcomas are rare malignant mesenchymal tumors arising from the heart and large blood vessels. Their intraluminal growth leads to vascular obstructive symptoms and peripheral neoplastic embolization. Direct infiltration of the lungs or metastases to the pulmonary system, occur in 40% of cases and extrathoracic spread is frequent, also in presentation. Intussusception is an unusual event in adults, accounting for <5% of bowel obstructions. In most cases it is caused by a malignancy and requires surgical resection. Case Presentation: We describe a rare case of a 50-year-old man suffering of bowel obstruction due to intussusception sustained by a small bowel metastasis of a primary cardiac intimal sarcoma. One year and a half before the onset of abdominal symptoms, a grade II intimal sarcoma was removed from his left atrium and consequently he followed a chemotherapy protocol. Four months later a CT scan revealed local recurrence. Eighteen months after heart surgery he referred to the ER with abdominal pain. CT scan showed an ileal intussusception and the patient was scheduled for surgery. A tract of 10 cm ileus was removed containing an intramural polypoid solid mass. Histological analyses revealed a grade II intimal sarcoma consistent with his first diagnosis. Conclusion: Primary heart tumors are late found and often partially resected, therefore metastatic pathways are to be expected. Adult small bowel intussusception is a rare event and caused by a malignancy in one third of cases. Therefore, our recommendation is to always resect the tract involved in order to perform a proper diagnosis.
Case Report: Off-label treatment of idiopathic hypereosinophilic syndrome with Omalizumab
Authors: Zhiyu Zhang, Yingxin Sun, Su-Ning Chen
Journal: Front Pharmacol (2023)
Keywords: case report, eosinophilia, idiopathic hypereosinophilic syndrome, omalizumab, steroid resistance
MeSH terms: Case Reports

Idiopathic hypereosinophilic syndrome (IHES) is a rare disease characterized by causeless persistent hypereosinophilia and eosinophilia-associated end-organ damage. Current treatment modalities don't meet the needs due to adverse events of steroids as first-line therapy and the limited efficacy of second-line treatments, underscoring the need for new therapeutic strategies. Here we presented two cases of IHES with different clinical manifestations that were both refractory to corticosteroids. Patient #1 experienced rashes, cough, pneumonia, and steroid-induced side effects. Patient #2 had severe gastrointestinal symptoms attributed to hypereosinophilia. They both had high levels of serum IgE, didn't respond well to second-line treatments of interferon-α (IFN-α) and imatinib, and Mepolizumab was not accessible. We then innovatively switched to Omalizumab, an anti-IgE monoclonal antibody approved for allergic asthma and chronic idiopathic urticaria. Patient #1 was treated with Omalizumab 600 mg per month for 20 months; his absolute eosinophil count (AEC) decreased significantly and has stabilized at around 1.0×109/L for 17 months, with complete relief from erythra and cough. Patient #2 recovered promptly from severe diarrhea with a sharp drop in AEC after 3 months of treatment with omalizumab at 600 mg per month. Therefore, we concluded that Omalizumab may be a seminal therapeutic strategy for IHES patients who are refractory to corticosteroids, whether as long-term management of AEC or as an urgent intervention to address severe symptoms caused by eosinophilia.
An unusual clinical presentation of merkel cell carcinoma: a case report
Authors: Deba P Sarma, Dawn E Heagley, Julianne Chalupa, Meredith Cox, James M Shehan
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Introduction. Merkel cell carcinoma is a rare, aggressive neuroendocrine cell carcinoma arising in the sun-exposed skin of elderly patients. Most of these tumors are located in the dermis. An unusual clinical presentation of such a tumor in the subcutis, if not biopsied, may be easily mistaken as a benign lesion. Case Presentation. An 83-year-old white woman presented with a several-month history of a painless 7 mm subcutaneous mass that was initially thought to be a lipoma. A conservative follow-up was planned. At the insistence of the patient, an excisional biopsy of the mass was performed revealing a subcutaneous Merkel cell carcinoma. The tumor cells stained positively for CK 20, chromogranin, and synaptophysin. No other primary or metastatic tumors found after a thorough work-up. The patient was treated with local irradiation. She remains disease free at her six-month follow-up visit. Conclusion. When a new growth is encountered in the sun-exposed skin of elderly patients, a biopsy is warranted even if the lesion clinically appears benign.
Lactobacillus paragasseri as a novel causative pathogen of cavernosal abscess
Authors: Hirokazu Toyoshima, Takuji Shibahara, Motoaki Tanigawa, Naoto Masuda, Chiaki Ishiguro, Hiroyuki Tanaka, Yuki Nakanishi, Shigetoshi Sakabe
Journal: IDCases (2021)
Keywords: 16s rrna sequencing, cavernosal abscess, foreign body, lactobacillus paragasseri, matrix-assisted laser desorption ionization, microbial biochemical examination
MeSH terms: Case Reports

Most cases of cavernosal abscesses result from the progression of sexually transmitted diseases (STDs) commonly caused by Neisseria gonorrhoeae; however, cavernosal abscesses without STDs are rare events. Herein, we describe the first case report of a Lactobacillus paragasseri cavernosal abscess. A 63-year-old man with diabetes and a history of foreign object insertion into the urethra one year prior presented with high-grade fever and slight local pain. The patient was diagnosed with L. paragasseri cavernosal abscess based on computed tomography and microbial biochemical examinations in addition to matrix-assisted laser desorption ionization (MALDI) and 16S rRNA sequencing from blood and pus cultures. The patient was successfully treated with a surgical procedure and appropriate antimicrobials. Hence, L. paragasseri, a commensal bacterium of the gastrointestinal or genitourinary tract, can cause cavernosal abscesses. Notably, L. paragasseri is difficult to distinguish from L. gasseri using MALDI or 16S rRNA sequencing without microbial biochemical examinations owing to morphological similarities. Therefore, special attention should be paid, clinically and microbiologically, to the potential of L. paragasseri cavernosal abscess in clinical settings.
POCUS Confirmation of Intraosseous Line Placement: Visualization of Agitated Saline within the Right Heart in a Critically Ill Infant
Authors: Inbar S Y Plaut, Zachary W Binder
Journal: POCUS J (2023)
Keywords: cardiac pocus, io line, pediatrics, resuscitation
MeSH terms: Case Reports

Intraosseous (IO) line placement can be a life-saving procedure in the management of critically ill patients. Confirmation of correct IO line placement can be difficult. Prior studies have examined the use of point of care ultrasound (POCUS) to confirm IO line placement by using power Doppler over bone to detect flow within the intraosseous space. This case illustrates a novel use of POCUS in which agitated saline is visualized within the right heart as a means of confirming correct IO placement.
Sporadic Medullary Thyroid Carcinoma with Paraneoplastic Cushing Syndrome
Authors: Aleksandra I Pivovarova, Stephanie Patrick, Punuru J Reddy
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Medullary thyroid cancer (MTC) is a rare form of neoplasm affecting the thyroid gland. This neuroendocrine tumor is capable of releasing active substances causing systemic manifestation in the form of flushing, diarrhea, and uncommonly, Ectopic Cushing's syndrome (ECS). MTC can be hereditary as a part of multiple endocrine neoplasm type 2 syndrome (MEN2) or arise sporadically. We report a case of a 74-year-old female presenting with chronic diarrhea, in whom diagnosis of sporadic MTC was delayed due to previous history of gastrointestinal (GI) disturbances. The patient developed liver metastases yielding ACTH dependent Cushing's Syndrome leading to abnormal clinical presentation and laboratory values driven by elevated cortisol level. Metastatic MTC should be considered in patients presenting with chronic diarrhea and weakness unexplained by other GI related causes.