OpenMed/multicare-articles huggingface dataset:
Aspergillus Section Nigri-Associated Calcium Oxalate Crystals in an Eurasian Eagle Owl ( Bubo bubo)
Authors: Patti K Kiser, Danielle M Meritet, Robert J Bildfell
Journal: Case Rep Vet Med (2018)
MeSH terms: Case Reports

An adult male Eurasian eagle owl (Bubo bubo) housed at a wildlife rehabilitation facility in southern Oregon died after a short period of progressive ill-thrift. Radiographs taken prior to death demonstrated abnormal radiopaque material in the coelom and the owl was submitted for postmortem examination. Black pigmented fungus was noted grossly, particularly in the respiratory tissues, with abundant oxalate crystal deposition associated with and without hyphal elements subsequently observed histologically. Aspergillus section Nigri was cultured from the lesions. Although there have been a few reports of aspergillosis caused by Aspergillus niger in avian species, the severity and wide tissue distribution of oxalates in this case are highly unusual.
Ventriculocoronary Fistulas with Hypoplastic Left Heart in a Neonate: Imaging with Cardiac CT
Authors: Serap Baş, Utku Alkara
Journal: Case Rep Radiol (2021)
MeSH terms: Case Reports

Fistulous communications between the ventricular cavities and the coronary arterial tree can be found in the presence of hypoplasia of the left ventricle, especially when the ventricular septum is intact and mitral stenosis and aortic atresia subtype are present. The cardiac CT provides excellent anatomic information especially in the evaluation of extracardiac vessels and coronary arteries. In this case study, we report a newborn with ventriculocoronary fistulas (VCFs) with the hypoplastic left disease diagnosed with cardiac CT. Transthoracic echocardiography of a term baby showed hypoplastic left heart syndrome (HLHS) with mitral stenosis and aortic atresia. The patient immediately underwent a Sano variation of the Norwood procedure. On the postoperative second day, the clinical status of the patient deteriorated. A prospective electrocardiogram-gated axial technique was performed within a single heartbeat for the patient and large VCFs were detected and a second operation were performed to close the VCFs that failed. On the nineteenth day after the operation, the baby passed away. According to us, cardiac CT can also be performed free-breathing and without anesthesia in the neonatal period for the definition of complex cardiac anatomy with the lower radiation dose from the latest scanners, radiation risk of CT should be weighed against the anesthesia risk of cardiac MRI and intraoperative risk of conventional cardiac angiography. Pre-operative cardiac CT may increase surgical success.
Dynamic Magnetic Resonance Imaging Demonstrates the Integrity of Perineal Reconstruction following Cylindrical Abdominoperineal Excision with Reconstruction of the Pelvic Floor Using Porcine Collagen
Authors: D O Kavanagh, H Imran, A Almoudaris, P Ziprin, O Faiz
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

A 72-year-old female presented with a six-month history of increased frequency of defecation, rectal bleeding, and severe rectal pain. Digital rectal examination and endoscopy revealed a low rectal lesion lying anteriorly. This was confirmed histologically as adenocarcinoma. Radiological staging was consistent with a T(3)N(2) rectal tumour. Following long-course chemoradiotherapy repeat staging did not identify any metastatic disease. She underwent a laparoscopic cylindrical abdominoperineal excision with en bloc resection of the coccyx and posterior wall of the vagina with a negative circumferential resection margin. The perineal defect was reconstructed with Permacol (biological implant, Covidien) mesh. She had no clinical evidence of a perineal hernia at serial followup. Dynamic MRI images of the pelvic floor obtained during valsalva at 10 months revealed an intact pelvic floor. A control case that had undergone a conventional abdominoperineal excision with primary perineal closure without clinical evidence of herniation was also imaged. This confirmed subclinical perineal herniation with significant downward migration of the bowel and bladder below the pubococcygeal line. We eagerly await further evidence supporting a role for dynamic MR imaging in assessing the integrity of a reconstructed pelvic floor following cylindrical abdominoperineal excision.
A huge malignant solitary fibrous tumor of kidney: case report and review of the literature
Authors: Hui Wang, Qing Liao, Xin Liao, Ge Wen, Zuguo Li, Chuang Lin, Liang Zhao
Journal: Diagn Pathol (2014)
MeSH terms: Kidney Neoplasms / pathology, Solitary Fibrous Tumors / pathology, Case Reports, Review, Aged, Antigens, CD34 / analysis, Biomarkers, Tumor / analysis, Female, Humans, Immunohistochemistry, Ki-67 Antigen / analysis, Kidney Neoplasms / metabolism, Solitary Fibrous Tumors / metabolism, Antigens, CD34, Biomarkers, Tumor, Ki-67 Antigen

Solitary fibrous tumor (SFT) is a spindle cell neoplasm that rarely occurs in the kidney. Malignant SFT of the kidney is particularly rare. Here, we report a 66-year old woman with a right flank mass that has been proved clinically and radiographically. Grossly, the largest diameter of the mass were measured up to 23 cm, was poorly circumscribed. Approximately 80% of the neoplasm consisted of hyperchromatic and pleomorphic spindled cells surrounding staghornlike blood vessels. Tumor cells frequently had mitoses and necrosis. However, the remainder of the mass was composed of haphazard, storiform or short fascicular arrangements of spindle cells in a loose myxoid to fibrous stroma. Immunohistochemically, we observed diffusely strong CD34 staining and an 85% Ki-67 proliferative index. The tumor partly showed negative CD34 and a 20% proliferative index. To our knowledge, this is the largest malignant renal SFT in the reported literatures and shows an obviously high proliferative index.
Virtual slides:
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1603694556107408.
Granulomatous Pancreas: A Case Report of Pancreatic Sarcoid
Authors: Tatiana Bihun, Yanet Diaz, Seth Wenig
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Sarcoidosis is a chronic, systemic, noncaseating granulomatous disease process of unknown etiology. Sarcoidosis most commonly manifests in the lungs; however, gastrointestinal manifestations can occur. If in the GI tract, it is almost always found in the liver. Solitary pancreatic lesions are extremely rare, with less than 50 documented cases found in the literature. We present a case of a 61-year-old female, with a past medical history of sarcoidosis, who presented to the ER with unexpected weight loss, scleral icterus, right upper quadrant pain, and epigastric and back pain. US and MRI found a dilated common bile duct and mild dilation of the pancreatic duct, as well as a focal prominence in the head of the pancreas surrounded by areas of atrophy. A pancreaticoduodenectomy procedure was performed and fresh frozen sections were taken. The pathologist made a diagnosis of nonnecrotizing granulomatous pancreatitis. Pancreatic sarcoid is often asymptomatic and a benign finding on autopsy; however, clinicians should be mindful of pancreatic involvement when working up differential diagnosis for pancreatic masses.
Simultaneous Extensive Intraductal Papillary Neoplasm of the Bile Duct and Pancreas: A Very Rare Entity
Authors: Vor Luvira, Ake Pugkhem, Theerawee Tipwaratorn, Yaovalux Chamgramol, Chawalit Pairojkul, Vajarabhongsa Bhudhisawasdi
Journal: Case Rep Surg (2016)

Intraductal papillary neoplasm of the bile duct (IPNB) is a specific type of bile duct tumor. It has been proposed that it could be the biliary counterpart of the intraductal papillary neoplasm of the pancreas (IPMN-P). This hypothesis is supported by the presence of simultaneous intraductal tumors of both the bile duct and pancreas. There have been five reports of patients with simultaneous IPNB and IPMN-P. In all of these cases, biliary involvement was limited to the intrahepatic and perihilar bile duct, which had characteristics similar to IPMN-P and usually had slow progression in nature. Herein, we present the first case of extensive intraductal neoplasm involving the extrahepatic bile duct, intrahepatic bile duct, and entire length of the pancreas with a poor outcome, even after being treated aggressively with radical surgery and adjuvant chemotherapy. Additionally, we summarize previous case reports of simultaneous intraductal lesions of the bile duct and pancreas.
Successful treatment of a patient with giant cell vasculitis (horton arteritis) with tocilizumab a humanized anti-interleukin-6 receptor antibody
Authors: Alfredomaria Lurati, Luca Bertani, Katia Angela Re, Mariagrazia Marrazza, Daniela Bompane, Magda Scarpellini
Journal: Case Rep Rheumatol (2012)
MeSH terms: Case Reports

Giant cell arteritis (GCA) is the most common form of systemic vasculitis in adults, affecting preferentially medium-large size arteries. Here we report a case of a female with a diagnosis of GCA based on temporal artery biopsy, successfully treated with tocilizumab, a humanized anti-interleukin-6 receptor antibody.
A Case Report on VT from TV: DVT and PE from Prolonged Television Watching
Authors: Alan Lucerna, James Espinosa, Lindsey Ackley, Philip Carhart, Douglas Stranges, Risha Hertz
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.
Cryptococcal infection causing longitudinal extensive transverse myelitis in an immunocompetent individual: Case report and literature review
Authors: Ashwin Kumar Panda, Sourav Hazra, Aldrin Anthony, Suman Kushwaha
Journal: Front Neurol (2023)
Keywords: letm, cryptococcal antigen, cryptococcus, immunocompetent adult, longitudinally extensive transverse myelitis
MeSH terms: Case Reports

Cryptococcal CNS infections in immunocompetent individuals are occasionally reported in literature. The spinal manifestations of cryptococcal CNS infections are epidural abscess, chronic arachnoiditis, intramedullary granuloma, myelitis and vasculitis. We report a rare case of CNS cryptococcal infection presenting as a longitudinal extensive transverse myelitis (LETM) in an immunocompetent male. This report highlights cryptococcus as an important etiology among infectious causes in acute LETM patients in-spite of the immunocompetent status of the patient and the utility of CRAG (cryptococcal antigen) for diagnosis in such patients. We also present a literature review of all reported cases of cryptococcal myelitis.
CD70 Deficiency Associated With Chronic Epstein-Barr Virus Infection, Recurrent Airway Infections and Severe Gingivitis in a 24-Year-Old Woman
Authors: Renate Krüger, Emmanuel Martin, Jasmin Dmytrus, Cornelia Feiterna-Sperling, Christian Meisel, Nadine Unterwalder, Uwe Kölsch, Volker Wahn, Jörg Hofmann, Paula Korn, Sylvain Latour, Kaan Boztug, Horst von Bernuth
Journal: Front Immunol (2020)
Keywords: cd70-deficiency, cvid, ebv, gingivitis, primary immunodeficiency
MeSH terms: CD27 Ligand / deficiency, Disease Susceptibility, Epstein-Barr Virus Infections / etiology, Gingivitis / etiology, Herpesvirus 4, Human / physiology, Reproductive Tract Infections / etiology, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Adult, Biomarkers, Child, Epstein-Barr Virus Infections / diagnosis, Female, Genetic Predisposition to Disease, Gingivitis / diagnosis, High-Throughput Nucleotide Sequencing, Humans, Pedigree, Radiography, Recurrence, Reinfection, Reproductive Tract Infections / diagnosis, Severity of Illness Index, T-Lymphocytes / immunology, T-Lymphocytes / metabolism, Young Adult, Biomarkers, CD27 Ligand, CD70 protein, human

Most of the few patients with homozygous CD70 deficiency described to date suffered from EBV-related malignancies in early childhood. We present a woman with CD70 deficiency diagnosed in adulthood. She presented in childhood with recurrent airway infections due to encapsulated bacteria, herpes zoster and a fulminant EBV infection followed by chronic EBV infection with mild lymphoproliferation and severe gingivitis/periodontal disease with high EBV viral load in saliva and gingival plaques as an adult. Up to the age of 24 years she developed no malignancy despite constant EBV viremia since primary EBV infection 15 years previously. Immunologic evaluation in childhood showed hypogammaglobulinemia with impaired polysaccharide responsiveness. She has been stable on immunoglobulin substitution with no further severe viral infections and no bacterial airway infections in adulthood. Targeted panel sequencing at the age of 20 years revealed a homozygous CD70 missense mutation (ENST00000245903.3:c.2T>C). CD70 deficiency was confirmed by absent CD70 expression of B cells and activated T cell blasts. The patient finished high school, persues an academic career and has rarely sick days at college. The clinical course of our patient may help to counsel parents of CD70-deficient patients with regard to prognosis and therapeutic options including haematopoetic stem cell transplantation.
Percutaneous vertebroplasty for Langerhans cell histiocytosis of the lumbar spine in an adult: Case report and review of the literature
Authors: Fei Feng, Hai Tang, Hao Chen, Pu Jia, Li Bao, Jin-Jun Li
Journal: Exp Ther Med (2013)

Langerhans cell histiocytosis (LCH) is extremely rare in the lumbar spine of adults. The radiological features typically manifest as vertebral tumors. The exact etiology of LCH remains unknown. Langerhans cells may cause local or systemic effects. The most frequent sites of these bony lesions are the skull, femur, mandible, pelvis and spine. To date, only 3 spinal LCH cases treated by percutaneous vertebroplasty (PVP) have been reported. The present study reports a case of LCH of the fourth lumbar vertebra (L4) in a 51-year-old male with a 10-day history of low back pain, limited waist motion and right lower limb numbness. The patient was treated using PVP. The use of PVP for treating LCH of the spine was successful. The present study provides an up-to-date literature overview of LCH.
A Case of Trichinellosis in a 14-Year-Old Male Child at Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia
Authors: Abebe Melese, Musa Mohammed, Worku Ketema, Alemayehu Toma
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Background:
Trichinellosis develops after ingestion of Trichinella cysts in pork meat. It is one of the most important parasitic human pathogens in the world. It is, however, underreported in part because none of the clinical manifestations are pathognomonic. The primary mode of transmission is ingestion of raw meat. Among the symptoms are muscle pain, swelling, and myopathy. High-grade fever and other systemic symptoms are not unusual. The hallmarks are ophthalmic and musculoskeletal manifestations, particularly conjunctival haemorrhage with periorbital edema and subungual splinter haemorrhage. Although the majority of infections are mild and asymptomatic, severe infections can result in enteritis, periorbital edema, and myositis. Presentation of the Case. A 14-year-old male patient from Oromia Region, Arsi Zone, West Arsi Zone, Bishan Guracha area, which is almost completely encircled by mountains, presented with a complaint of worsening easy fatigability and asymmetric right thigh enlargement lasting one month. The pertinent physical examinations on presentation were puffy face and eyes, and there was a 4 cm by 5 cm mass on the right lateral thigh with no overlying skin colour change, on-tender, and no discharge. Eosinophilia of 14% was noticed on the complete blood count. The definitive diagnosis of trichinellosis was made by muscle biopsy. He was then managed with albendazole and prednisolone and improved.
Conclusion:
Patients with periorbital edema, myositis, or eosinophilia should be evaluated for trichinellosis. Individuals who have these symptoms and a history of eating pork meat should be suspected of having trichinellosis. Before eating raw pork meat, it is recommended that it be cooked properly.
Intraoperative Endoscopy in Transient Adult Jejunojejunal Intussusception
Authors: Takeshi Okamoto, Hidekazu Suzuki, Katsuyuki Fukuda
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Despite improvements in imaging modalities, causative lead points in adult intussusception may be difficult to diagnose. Such lead points can be malignant, causing recurrence or metastases if left unresected. We describe a case of transient adult jejunojejunal intussusception, in which intraoperative endoscopy was used to confirm the absence of a lead point. A 39-year-old woman with a history of laparoscopic oophorectomy presented with epigastric pain, nausea, and vomiting. Contrast computed tomography revealed jejunojejunal intussusception, with no visible lead point. Spontaneous reduction was confirmed during exploratory laparoscopy. After lysis of adhesions, intraoperative peroral jejunoscopy was performed with the surgeons' assistance. Endoscopy confirmed the absence of tumor, and bowel resection was avoided. No recurrence has been observed during 24 months of follow-up. Intraoperative endoscopy may provide additional reassurance for the absence of a lead point in cases where preoperative enteroscopy cannot be performed and no lead points can be identified on imaging.
Profound Trunnion Wear Resulting in Femoral Head-Neck Dissociation in Total Hip Arthroplasty
Authors: Saif Shamshoon, Patrick Thornley, Justin de Beer
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We describe a case of aseptic failure with profound femoral stem trunnion wear and femoral head dissociation nine years after initial primary total hip arthroplasty (THA) with the Stryker Accolade total hip arthroplasty system. Current guidelines for postoperative care and follow-up after THAs as potential intervention points for early detection of prosthetic joint failure are also reviewed.
Natural history of type 1 diabetes on an immunodysregulatory background with genetic alteration in B-cell activating factor receptor: A case report
Authors: Biagio Di Lorenzo, Lucia Pacillo, Giulia Milardi, Tatiana Jofra, Silvia Di Cesare, Jolanda Gerosa, Ilaria Marzinotto, Ettore Zapparoli, Beatrice Rivalta, Cristina Cifaldi, Federica Barzaghi, Carmela Giancotta, Paola Zangari, Novella Rapini, Annalisa Deodati, Giada Amodio, Laura Passerini, Paola Carrera, Silvia Gregori, Paolo Palma, Andrea Finocchi, Vito Lampasona, Maria Pia Cicalese, Riccardo Schiaffini, Gigliola Di Matteo, Ivan Merelli, Matteo Barcella, Alessandro Aiuti, Lorenzo Piemonti, Caterina Cancrini, Georgia Fousteri
Journal: Front Immunol (2022)
Keywords: baffr mutation, circulating t follicular helper cells (ctfh), common variable immunodeficiency (cvid), islet autoimmunity, type 1 diabetes (t1d)
MeSH terms: Diabetes Mellitus, Type 1, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Autoantibodies, B-Cell Activating Factor / genetics, Humans, Insulin / genetics, Mutation, Autoantibodies, B-Cell Activating Factor, Insulin

The immunological events leading to type 1 diabetes (T1D) are complex and heterogeneous, underscoring the necessity to study rare cases to improve our understanding. Here, we report the case of a 16-year-old patient who showed glycosuria during a regular checkup. Upon further evaluation, stage 2 T1D, autoimmune thrombocytopenic purpura (AITP), and common variable immunodeficiency (CVID) were diagnosed. The patient underwent low carb diet, losing > 8 kg, and was placed on Ig replacement therapy. Anti-CD20 monoclonal antibody (Rituximab, RTX) was administered 2 years after diagnosis to treat peripheral polyneuropathy, whereas an atypical mycobacteriosis manifested 4 years after diagnosis and was managed with prolonged antibiotic treatment. In the fifth year of monitoring, the patient progressed to insulin dependency despite ZnT8A autoantibody resolution and IA-2A and GADA autoantibody decline. The patient had low T1D genetic risk score (GRS = 0.22817) and absence of human leukocyte antigen (HLA) DR3/DR4-DQ8. Genetic analysis identified the monoallelic mutation H159Y in TNFRSF13C, a gene encoding B-cell activating factor receptor (BAFFR). Significant reduced blood B-cell numbers and BAFFR levels were observed in line with a dysregulation in BAFF-BAFFR signaling. The elevated frequency of PD-1+ dysfunctional Tfh cells composed predominantly by Th1 phenotype was observed at disease onset and during follow-up. This case report describes a patient progressing to T1D on a BAFFR-mediated immunodysregulatory background, suggesting a role of BAFF-BAFFR signaling in islet-specific tolerance and T1D progression.
Unruptured ovarian pregnancy following in-vitro fertilization: Missed diagnosis followed by successful laparoscopic management
Authors: Narvekar Sa, Vijaykumar Pk, Shetty N, Gupta N, Ashwini Gb, Rao Ka
Journal: J Hum Reprod Sci (2008)
Keywords: in-vitro fertilization, laparoscopy, ovarian pregnancy
MeSH terms: Case Reports

Ovarian pregnancy after in-vitro fertilization is rare and can be easily missed unless there is a high index of suspicion. Here we present such a case which was missed initially but was later successfully managed laparoscopically.
Hereditary Hyperferritinemia-Cataract Syndrome in 3 Generations of a Family in East Tennessee
Authors: Heidi A Worth, Zachary Marlette, David Aljadir, Ronald Lands
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Hereditary hyperferritinemia and cataracts syndrome (HHCS) without iron overload is a syndrome first identified less than 3 decades ago. While investigators have dissected the gene where several responsible mutations reside, it remains a relatively unknown genetic disorder to clinicians. The result is often an expensive, invasive evaluation for iron overload, followed by a well-intended prescription for a series of phlebotomies that delivers morbidity instead of benefit. We present a father with an elevated ferritin and heterozygosity for H63D HFE mutation whose clinical course followed this path. His treatment rendered him symptomatic from iron deficiency with no reduction in his ferritin. On re-evaluation, a review of his past medical history clarified the cataract surgery noted in his record had occurred at a young age. Furthermore, one of his daughters required cataract surgery as a teenager. With this information, we strongly suspected HHCS. His phlebotomies were discontinued, and within weeks, his iatrogenic iron deficiency resolved and his health returned to normal.