OpenMed/multicare-articles huggingface dataset:
Intracranial infection caused by Mycobacterium rhodesiae with specific imaging findings and good response to medication: a case report and literature review
Authors: Siwei Chen, Wei Sun, Ran Liu, Lanqiu Yao, Qing Peng
Journal: Front Med (Lausanne) (2024)
Keywords: central nervous system infection, encephalitis, extrapulmonary manifestation, next-generation sequencing, nontuberculous mycobacteria
MeSH terms: Case Reports

Nontuberculous mycobacteria (NTM) are exceedingly rare etiological agents of intracranial infections. Among them, Mycobacterium rhodesiae stands out as an even less common pathogen. In this paper, we report the first documented case of a central nervous system (CNS) infection in humans caused by Mycobacterium rhodesiae, which has specific imaging findings and good response to the therapy by using Linezolid, Clarithromycin, and Minocycline. The diagnosis was facilitated by a comprehensive multimodal approach, incorporating multisite imaging, cerebrospinal fluid analysis via next-generation sequencing (NGS), and targeted genetic testing. Furthermore, this paper provides a derivation of the clinical characteristics observed in other documented instances of CNS infections attributable to NTM and based on a review of the current literature. Our experience contributes to the evidence that is needed to understand the full spectrum of NTM-related CNS pathologies and underscores the importance of a multidisciplinary diagnostic process in atypical presentations of intracranial infections.
Optimized complete cytoreduction in ovarian cancer through intraoperative real-time tumor visualization by 5-ALA - a case report
Authors: Laura Tascón Padrón, Eva K Egger, Damian Johannes Ralser, Lucia Otten, Özer-Altan Toksöz, Glen Kristiansen, Walter Stummer, Alexander Mustea
Journal: Front Oncol (2023)
Keywords: 5-ala, intraoperative visualization and guidance, optimazation debulking surgery, ovarian cancer, real time imaging
MeSH terms: Case Reports

Introduction:
Complete macroscopic cytoreduction represents the most important prognostic parameter for overall survival in ovarian cancer. This dogma remains tenacious despite significant improvements in adjuvant systemic treatment. Hence, optimization of surgical therapy is an overarching goal to improve patients' outcomes. In this context, intraoperative tumor-specific imaging might facilitate optimized cytoreduction. In neurosurgery, intraoperative 5-aminolevulinic acid (5-ALA) guided imaging is applied in clinical routine to assess surgical resection margins. Here, we report the case of a patient with ovarian cancer in whom intraoperative 5-ALA tumor visualization led to optimized complete cytoreduction.
Objective:
Intraoperative administration of 5-ALA led to improved complete cytoreduction by identification and resection of additional ovarian cancer tumor manifestations.
Case:
The 39-year-old patient, Jehovah`s witness, presented to our department with a left sided ovarian mass, suspicious of ovarian cancer, based on clinical examination, sonographic suspicious features and a CA12-5 elevation. The patient's medical history and family history was unremarkable. Preoperative CT imaging of the thorax and abdomen showed no pathology besides the adnexal mass. Surgery was performed by a midline laparotomy with hysterectomy, bilateral adnexectomy, pelvic peritonectomy, omentectomy, ureterolysis, diaphragm stripping, adhesiolysis and the collection of peritoneal and rectal samples. Intraoperative 5-ALA imaging using a dedicated excitation and detection loupe system (Reveal, DVI) led to tumor detection at the diaphragm, the omentum and the rectum that was not detectable by palpation and visualization using white light. The pathology results revealed that the 5-ALA positive samples (diaphragm, rectum and omentum) obtained by intraoperative 5-ALA were positive for ovarian cancer.
Conclusion:
Intraoperative administration of 5-ALA represents a promising approach to improve complete cytoreduction in ovarian cancer surgery thereby improving clinical outcomes. Hence, further research and clinical trials are required to investigate the potential of intraoperative 5-ALA imaging in ovarian cancer debulking surgery and its impact on long-term clinical outcomes.
Scurvy in a young man: a rare case report
Authors: Rui-Ling Lu, Jie-Wen Guo, Bao-Dong Sun, Yu-Lan Chen, Dong-Zhou Liu
Journal: Front Nutr (2023)
Keywords: dietary patterns change, lower extremities pain, scurvy, staying indoors, vitamin c deficiency
MeSH terms: Case Reports

Scurvy, resulting from vitamin C deficiency, has nonspecific constitutional symptoms, including weakness, malaise, and fatigue. It is frequently misdiagnosed due to the lack of specific clinical manifestations. Although there are sporadic cases of scurvy currently reported in children, scurvy in young people is seldom encountered. Here, we report on a 25-year-old male patient without any underlying conditions who presented with severe pain and ecchymoses of both lower extremities. He was diagnosed with scurvy due to a long history of staying indoors and inadequate intake of fruits or vegetables.
Case report: Gait-induced palilalia in a patient with hemiplegia due to cerebral infarction
Authors: Yoshiyuki Kaneko, Takahiro Suzuki, Hideto Nakajima, Tadashi Kanamori, Masahiro Suzuki
Journal: Front Hum Neurosci (2024)
Keywords: carbamazepine, cerebral infarction, hemiplegia, network reorganization, palilalia
MeSH terms: Case Reports

Background:
Palilalia is a type of speech characterized by compulsive repetition of words, phrases, or syllables. Several reports have noted that palilalia can occur in response to external verbal stimuli. Here, we report, for the first time, a patient with palilalia induced by gait, which we call "movement-related palilalia."
Case presentation:
Eleven months after the onset of cerebral infarction sparing the right precentral gyrus and its adjacent subcortical regions, a 63-year-old, left-handed Japanese man was referred for psychiatric consultation because of a complaint of irritability caused by the stress of compulsive repetition of a single meaningless word, "wai." The repetition of a word, palilalia, in this case, was characterized by its predominant occurrence during walking and by its melodic tones. The palilalia during walking disappeared almost completely after 5 months of treatment with carbamazepine 600 mg.
Conclusion:
Palilalia induced by gait can occur in patients with a history of cerebral infarction. This palilalia during walking may be due to the reorganization of networks in areas nearby or surrounding cerebral infarcts.
Bilateral Carotid-Cavernous Fistula Following Traumatic Fall: A Case Report
Authors: Fatim Camara, Chiara Mabiglia, Thomas Bonnet
Journal: J Belg Soc Radiol (2024)
Keywords: carotid-cavernous fistulas, digital subtraction angiography, endovascular treatment, exophthalmos, magnetic resonance angiography, neuro-ophthalmologic risks, ophthalmoplegia, traumatic brain injury
MeSH terms: Case Reports

Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid arteries and the cavernous sinus, posing significant neuro-ophthalmologic risks. This report presents a rare case of bilateral post-traumatic CCFs, focusing on clinical presentation, diagnosis, and management. Symptoms mimic conjunctivitis, causing diplopia, exophthalmos, and ophthalmoplegia. Diagnosis relied on computed tomography, magnetic resonance angiography, and digital subtraction angiography. Management involved transarterial embolization with coils, achieving successful outcomes. This highlights the importance of timely intervention and comprehensive imaging to prevent complications. Teaching point: This case report details a rare instance of bilateral post-traumatic carotid-cavernous fistulas, emphasizing clinical presentation, diagnostic evaluation, and management.
Case report: Dupilumab: a promising treatment option for adult linear IgA bullous dermatosis with severe pruritus
Authors: Li Wang, Jing Peng, Jinbo Chen
Journal: Front Immunol (2024)
Keywords: hla-b*1301, dapsone, dupilumab, linear iga bullous dermatosis (labd), pruritus
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Linear IgA Bullous Dermatosis / diagnosis, Linear IgA Bullous Dermatosis / drug therapy, Pruritus / drug therapy, Pruritus / etiology, Pruritus / immunology, Case Reports, Adult, Female, Humans, Male, Middle Aged, Skin / pathology, Treatment Outcome, Antibodies, Monoclonal, Humanized, dupilumab

Linear IgA bullous dermatosis (LABD) is an acquired autoimmune subepidermal blistering disorder. Diagnosis always relies on skin pathology and direct immunofluorescence (DIF), with typical linear deposits of IgA along the basement membrane zone (BMZ). The typical clinical manifestation is tense bullae arranged like the "string of pearls" companied with severe pruritus. Dapsone is often considered first-line therapy for LABD, and it is necessary to test the HLA-B*1301 gene to prevent the occurrence of dapsone-induced hypersensitivity syndrome (DHS). Here we report a case of LABD resistant to corticosteroid and sulfasalazine, while waiting for HLA-B*1301 gene test results, dupilumab was used to control severe pruritus.
Serous Borderline Ovarian Epithelial Type Tumors of Testis in A Young Man with Only Mass Resection: A Case Report
Authors: Mandana Rahimi, Yasaman Moradi, Farhood Khaleghimehr
Journal: Iran J Pathol (2023)
Keywords: papillary carcinoma, serous, testis
MeSH terms: Case Reports

Tumors of the ovarian epithelial type of testis are an infrequent entity. We report a case of borderline serous tumor in an 18-year-old male who presented with a right testicular mass, clinically suspicious of carcinoma. After right inguinal exploration, two pedunculated para-testicular masses were identified in the appendix of the right testis and epididymis. The histological features were as complex papillary structures lined by columnar cells with mild to moderate pleomorphism. Microscopically, features of borderline serous testicular tumors are identical to the morphology of the same tumors encountered in the ovarian counterparts. These tumors usually reveal papillae with fibrovascular cores lined by stratified cuboidal to columnar epithelium. This case highlights a need for clinicians and pathologists to be aware of this infrequent entity and improve the best patient management attitude. Serous epithelial tumors are common ovary tumors but are very rare entities in the testis. These tumors originate from the remnant of Mullerian ducts or Mullerian metaplasia of tunica vaginalis and are nonaggressive, even associated with extra ovarian spread, and have outstanding prognosis. A review of the literature has shown nearly fifty reported cases worldwide, and most of the cases occur in young to middle-aged adults.
A case report of Pallister-Killian syndrome with an unusual mosaic supernumerary marker chromosome 12 with interstitial 12p13.1-p12.1 duplication
Authors: T V Karamysheva, I N Lebedev, L I Minaycheva, L P Nazarenko, A A Kashevarova, D A Fedotov, N A Skryabin, M E Lopatkina, A D Cheremnykh, E A Fonova, T V Nikitina, E A Sazhenova, M M Skleimova, N A Kolesnikov, G V Drozdov, Y S Yakovleva, G N Seitova, K E Orishchenko, N B Rubtsov
Journal: Front Genet (2024)
Keywords: pallister-killian syndrome (pks), a supernumerary marker of chromosome 12, chromosomal abnormalities, duplication 12p1333-p111, mosaic trisomy 12p, the chromosomal region 12pter-12q11

Pallister-Killian syndrome (PKS) is a rare inherited disease with multiple congenital anomalies, profound intellectual disability, and the presence in the karyotype of sSMC - i(12)(p10). The frequency of PKS may be underestimated due to problems with cytogenetic diagnosis caused by tissue-specific mosaicism and usually a low percentage of peripheral blood cells containing sSMC. Such tissue-specific mosaicism also complicates a detailed analysis of the sSMC, which, along with the assessment of mosaicism in different tissues, is an important part of cytogenetic diagnosis in PKS. Unfortunately, a full-fledged diagnosis in PKS is either practically impossible or complicated. On the one hand, this is due to problems with the biopsy of various tissues (skin biopsy with fibroblast culture is most often used in practice); on the other - a low percentage of dividing peripheral blood cells containing sSMC, which often significantly complicates the analysis of its composition and organization. In the present study, a detailed analysis of sSMC was carried out in a patient with a characteristic clinical picture of PKS. A relatively high percentage of peripheral blood cells with sSMC (50%) made it possible to perform a detailed molecular cytogenetic analysis of de novo sSMC using chromosomal in situ suppression hybridization (CISS-hybridization), multicolor FISH (mFISH), multicolor chromosome banding (MCB), array CGH (aCGH), and quantitative real-time PCR (qPCR), and short tandem repeat (STR) - analysis. As a result, it was found that the sSMC is not a typical PKS derivative of chromosome 12. In contrast to the classical i(12)(p10) for PKS, the patient's cells contained an acrocentric chromosome consisting of 12p material. Clusters of telomeric repeats were found at the both ends of the sSMC. Furthemore, the results of aCGH and qPCR indicate the presence of interstitial 8.9 Mb duplication at 12p13.1-p12.1 within the sSMC, which leads to different representations of DNA from different segments of 12p within cells containing sSMC. The obtained data raise the question of the instability of the sSMC and, as a consequence, the possible presence of additional rearrangements, which, in traditional cytogenetic analysis of patients with PKS, are usually described as i(12)(p10).
Cost-effectiveness of active surveillance versus early surgery for thyroid micropapillary carcinoma based on diagnostic and treatment norms in China
Authors: Min Lai, Miao Miao Zhang, Qing Qing Qin, Yu An, Yan Ting Li, Wen Zhen Yuan
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: active surveillance (as), cost-effectiveness (ce), early surgery, papillary thyroid cancer (ptc), papillary thyroid microcarcinoma (ptmc)
MeSH terms: Carcinoma, Papillary / diagnosis, Carcinoma, Papillary / surgery, Thyroid Gland, Case Reports, Adult, Aged, China / epidemiology, Cost-Benefit Analysis, Female, Humans, Medicare, United States, Watchful Waiting, Papillary Thyroid Microcarcinoma

Objectives:
In this study, we compared the cost-effectiveness comparison of the active surveillance (AS) and early surgery (ES) approaches for papillary thyroid microcarcinoma (PTMC) from the perspective of the Chinese healthcare system.
Methods:
We performed a cost-effectiveness analysis using a Markov model of PTMC we developed to evaluate the incremental cost-effectiveness ratio of AS and ES. Our reference case was of a 40-year-old woman diagnosed with unifocal (<10 mm) PTMC. Relevant data were extracted after an extensive literature review, and the cost incurred in each state was determined using China Medicare data on payments for ES and AS. The willingness-to-pay threshold was set at ¥242,928/quality-adjusted life-year (QALY) gained. Sensitivity analyses were performed to account for any uncertainty in the model's variables. Additional subgroup analyses were performed to determine whether AS was cost-effective when different initial monitoring ages were used.
Results:
ES exhibited an effectiveness of 5.2 QALYs, whereas AS showed an effectiveness of 25.8 QALYs. Furthermore, the incremental cost-effectiveness ratio for ES versus AS was ¥1,009/QALY. The findings of all sensitivity analyses were robust. Compared with ES, AS was found to be the cost-effective strategy at initial monitoring ages of 20 and 60 years, with an incremental cost-effectiveness ratio of ¥3,431/QALY and -¥1,316/QALY at 20 and 60 years, respectively. AS was a more cost-effective strategy in patients with PTMC aged more than 60.
Conclusions:
With respect to the norms of the Chinese healthcare system, AS was more cost-effective for PTMC over lifetime surveillance than ES. Furthermore, it was cost-effective even when the initial monitoring ages were different. In addition, if AS is incorporated into the management plan for PTMC in China at the earliest possible stage, a predicted savings of ¥10 × 108/year could be enabled for every 50,000 cases of PTMC, which indicates a good economic return for future management programs. The identification of such nuances can help physicians and patients determine the best and most individualized long-term management strategy for low-risk PTMC.
Acantholytic oral squamous cell carcinoma with clear cell change - a rare amalgamated variant
Authors: Gitika Sharma, Anju Devi, Mala Kamboj, Anjali Narwal
Journal: Autops Case Rep (2023)
Keywords: acantholytic squamous cell carcinoma, clear cells, oral squamous cell carcinoma, immunohistochemistry
MeSH terms: Case Reports

Background:
Acantholytic squamous cell carcinoma (ASCC) is an uncommon histological variation of oral squamous cell carcinoma (OSCC), accounting for fewer than 4% of all occurrences. The tumor shows a slight masculine predisposition, with the lower lip being the most commonly affected location. ASCC is reported to have a diverse biologic behavior, which explains its ability to metastasize to distant places and, thus, its poor prognosis. Similarly, clear cell change in OSCC is a rare occurrence with an unknown etiology that suggests its aggressive nature.
Method and results:
Histopathology reveals central acantholytic cells with numerous duct-like features. The presence of distinct cytological atypia contributes to the diagnosis of SCC. Special stains and IHC aid in distinguishing tumor from other histopathologically similar entities.
Conclusion:
The case of a 29-year-old male presented here with an updated literature review highlights the need for histological study of the unique and seldom seen oral ASCC with clear cell change, which can be ignored because of similarities with other entities. Because recurrence rates are so high for ASCC, amalgamated clear cell change makes it critical for proper treatment initiation with a definite diagnosis. To the best of our knowledge, this is the first documented occurrence. Our experience with the present case suspected a more aggressive behavior due to a high Ki-67 index, anticipating a poorer prognosis in the oral cavity considering the patient's young age.
Case Report: Minimally invasive repair of a traumatic abdominal wall hernia in a child with a fascial closure device
Authors: Huiyu Lu, Zemin Zhang, Jun Chao, Chuanguang Zhang, Guoqing Zhang, Shujie Tao, Qingtao Yan
Journal: Front Surg (2024)
Keywords: abdominal wall hernia suture repair, fascial closure device, laparoscope, pediatric trauma, traumatic abdominal wall hernia (tawh)
MeSH terms: Case Reports

Abdominal trauma is common in daily life, but a traumatic abdominal wall hernia (TAWH) in children is rare. A TAWH is caused by a huge external force that leads to subcutaneous muscle and fascia rupture, while the skin remains intact. As abdominal pressure increases, the abdominal contents protrude, forming a lump. A TAWH is highly susceptible to missed diagnosis because of other severe injuries. We report a case of a 2-year-old boy with a TAWH who developed a prominent subcutaneous mass on the right side of his abdomen after abdominal trauma; the size of the mass changed significantly with abdominal pressure and crying. In this case, we used a new approach of laparoscopic suture repair technique with the assistance of a fascial closure device and achieved good results. We found that this method offers the advantages of minimally invasive surgery, fast recovery, and no visible surgical incisions. There was no recurrence after 8 months of follow-up.
Methaemoglobinaemia Associated With Mixed Cocaine and Amphetamine Overdose: A Case Report
Authors: Mohamed Eshmandi, Ahmed Mohamed, Belal Khalil, Alla Belhaj
Journal: Cureus (2024)
Keywords: amphetamine, cocaine, critical care, methemoglobinemia, methylene blue
MeSH terms: Case Reports

Methaemoglobinaemia is a rare disorder characterized by increased levels of methaemoglobin, a form of haemoglobin with oxidized iron that cannot efficiently bind oxygen. This leads to inadequate oxygen delivery to tissues with various clinical manifestations from asymptomatic to severe persistent hypoxia, CNS symptoms, and cardiovascular collapse. Acquired methaemoglobinaemia is typically a sudden condition, often resulting from poisoning by specific drugs and compounds, which can potentially have fatal consequences. We present a case of a patient who came with severe methaemoglobinaemia due to intoxication with cocaine and amphetamine.
Acquired Bronchobiliary Fistula in a Young Adult Patient With Sepsis: A Case Report
Authors: Pallavi Pokharel, Sahar Panah, Robert J Dabek, Klara Schwarzova, Fawaz Araim, Alok Gupta
Journal: Cureus (2024)
Keywords: bbf, bronchobiliary fistula, endoscopic retrograde cholangiopancreatography (ercp), laporoscopic cholecystectomy, percutaneous cholecystostomy tube
MeSH terms: Case Reports

Bronchobiliary fistula (BBF) is a rare, highly morbid condition that results from an abnormal connection between biliary channels and the bronchial tree. In the past, this condition has been known to be caused by untreated hydatid cysts or hepatic abscesses that can erode through the diaphragm into the pleural cavity and bronchial tree, creating fistulation. However, the condition's spectrum has changed in recent years, and BBFs have also become associated with neoplasm, iatrogenic causes, and trauma. Cases of BBF are treated differently, either with simple conservative management or invasive surgery. We present a case of a 46-year-old male initially presenting with sepsis, who was found to have a BBF. The diagnosis was made after a hepatobiliary iminodiacetic acid scan showed the flow of a tracer in the lung fields. The condition was likely due to acute cholecystitis and prior biliary instrumentation. The patient was treated successfully with percutaneous cholecystostomy tube insertion followed by elective laparoscopic cholecystectomy several weeks after hospital discharge.