OpenMed/multicare-articles huggingface dataset:
A rare clinical entity as large intrarenal abscess in a typeII diabetic patient due to Candida tropicalis: Case report
Authors: Abhilash Chandra, Namrata Rao, Anupam Das, Manodeep Sen
Journal: Curr Med Mycol (2019)
Keywords: abscess, candida tropicalis, diabetes, fungal, renal
MeSH terms: Case Reports

Background and purpose:
Fungal renal abscesses are rare entities associated with significant morbidity and mortality. Affected kidneys can have microabscess, pyelonephritis, pyonephrosis, or papillary necrosis.
Case report:
Herein, we reported an unusual case of a large renal abscess cause by Candida tropicalis in a diabetic patient. The entity presented as a lump in the abdomen and later was diagnosed to be an abscess on computed tomography scan. Candida tropicalis was confirmed on the culture of the aspirate. The abscess was successfully treated by percutaneous drainage and administration of amphotericin B deoxycholate.
Conclusion:

Candida tropicalis is now a global concern because of its rising prevalence and high virulence. The growing resistance of this Candida species to azoles, as in our case, calls for a more judicious usage of antifungal agents. Empirical therapy with either amphotericin or echinocandins is an option in case of high azole resistance. This case highlights the importance of timely diagnosis and implementation of aggressive management in cases suffering from fungal abscesses.
Treatment of unexplained facial numbness with stellate ganglion blockade: A case report
Authors: Uno Imaizumi, Satoshi Beppu, Takuro Sanuki
Journal: Clin Case Rep (2023)
Keywords: dysesthesia, hypesthesia, numbness, stellate ganglion blockade
MeSH terms: Case Reports

To date, there is no established treatment for facial numbness or dysesthesia of unspecified causes. Herein, we report a case of unexplained facial numbness and confirmed hypesthesia that achieved clinical response to stellate ganglion blockade (SGB). SGB might be an effective treatment of psychological stress-related facial numbness of unknown origin.
Pseudomonas aeruginosa Acquisition in Cystic Fibrosis Patients in Context of Otorhinolaryngological Surgery or Dentist Attendance: Case Series and Discussion of Preventive Concepts
Authors: Jochen G Mainz, Andrea Gerber, Michael Lorenz, Ruth Michl, Julia Hentschel, Anika Nader, James F Beck, Mathias W Pletz, Andreas H Mueller
Journal: Case Rep Infect Dis (2015)

Introduction. P. aeruginosa is the primary cause for pulmonary destruction and premature death in cystic fibrosis (CF). Therefore, prevention of airway colonization with the pathogen, ubiquitously present in water, is essential. Infection of CF patients with P. aeruginosa after dentist treatment was proven and dental unit waterlines were identified as source, suggesting prophylactic measures. For their almost regular sinonasal involvement, CF patients often require otorhinolaryngological (ORL) attendance. Despite some fields around ORL-procedures with comparable risk for acquisition of P. aeruginosa, such CF cases have not yet been reported. We present four CF patients, who primarily acquired P. aeruginosa around ORL surgery, and one around dentist treatment. Additionally, we discuss risks and preventive strategies for CF patients undergoing ORL-treatment. Perils include contact to pathogen-carriers in waiting rooms, instrumentation, suction, drilling, and flushing fluid, when droplets containing pathogens can be nebulized. Postsurgery mucosal damage and debridement impair sinonasal mucociliary clearance, facilitating pathogen proliferation and infestation. Therefore, sinonasal surgery and dentist treatment of CF patients without chronic P. aeruginosa colonization must be linked to repeated microbiological assessment. Further studies must elaborate whether all CF patients undergoing ORL-surgery require antipseudomonal prophylaxis, including nasal lavages containing antibiotics. Altogether, this underestimated risk requires structured prevention protocols.
Case Report: Cytoreductive Surgery and HIPEC Associated With Liver Electrochemotherapy in a Cholangiocarcinoma Patient With Peritoneal Carcinomatosis and Liver Metastasis Case Report
Authors: Mauro Stefano, Enrico Prosperi, Paola Fugazzola, Beatrice Benini, Marcello Bisulli, Federico Coccolini, Costantino Mastronardi, Alessandro Palladino, Matteo Tomasoni, Vanni Agnoletti, Emanuela Giampalma, Luca Ansaloni
Journal: Front Surg (2021)
Keywords: cholangiocarcinoma, debulking, electrochemotherapy, heated intraperitoneal chemotherapy, peritoneal metastases
MeSH terms: Case Reports

Introduction: Cholangiocarcinoma (CCA) is the second most common primary tumor of the liver, and the recurrence after hepatic resection (HR), the only curative therapy, is linked with a worse prognosis. Systemic chemotherapy (SC) and liver loco-regional treatments, like trans-arterial chemoembolization (TACE) or radio embolization (TARE), have been employed for the treatment of unresectable intrahepatic metastasis (IM) with benefit on overall survival (OS), but SC has a limited effect on peritoneal metastasis (PM). In the last years, novel treatments like electrochemotherapy (ECT) with bleomycine (BLM) for IM and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) for PM have been applied in small series but with encouraging results. We hereby describe the first synchronous application of ECT and CRS and HIPEC for the treatment of a patient with IM and PM from CCA. Case Description: A 47-year-old male patient with CCA underwent HR followed by adjuvant SC. After 14 months, for the occurrence of IM, the patient underwent a second HR and SC. Nonetheless, a new recurrence occurred and a third attempt of HR was proposed. Due to the intraoperative finding of unresectable IM with PM, no resective procedure was performed and the patient was referred to our center. CRS and HIPEC with cisplatin and mitomycin for PM and ECT with BLM on a bulky metastasis of the hepatic hilum were performed after 38 months from the first HR. The length of hospital stay was 19 days. At the computed tomography (CT) performed 11 days after treatment complete necrosis of the treated IM was detected. Results: CT scan after 3 and 6 months and magnetic resonance after 9 months were performed. Necrosis of the treated IM nor PM but progression of the residual liver lesions was observed. After 3 months, the patient received SC and underwent TACE after 8 months and TARE after 9 months for the residual liver metastases. At 14 months from CRS and HIPEC, the patient is alive, in good condition, and with stability of the disease. Conclusions: The association of ECT and CRS and HIPEC could be safe and effective for the treatment of unresectable recurrent intrahepatic CCA with PM.
An Obsessive-Compulsive Symptom-Related Headache in a Patient with Schizophrenia
Authors: Hsinsung Yuan, Junjun Liu
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Obsessive-compulsive symptoms are prevalent, manifold, and sometimes insidious in patients with schizophrenia. In this case study, we reported an intractable headache that bears a close relationship with obsessive-compulsive symptoms in a schizophrenia patient. In a series of treatments, the headache was miraculously susceptible to haloperidol treatment.
Bilateral femoral neck fractures in an adult male following minimal trauma after a simple mechanical fall: a case report
Authors: Asheesh Sood, Christopher Rao, Ian Holloway
Journal: Cases J (2009)

Background:
Despite being rare there are several reports in the medical literature of bilateral femoral neck fractures in adult patients. They have been reported to have occurred following major trauma, or as a result of primary or secondary bone disease. In this case report we describe for the first time in the literature bilateral femoral neck fractures in a patient following minimal trauma after a simple mechanical fall.
Case presentation:
We describe the case of an 84-year-old gentleman who sustained bilateral intracapsular fractures following a simple mechanical fall. Prompt diagnosis and early surgical intervention resulted in a satisfactory outcome.
Conclusion:
This case highlights that in the elderly, even in the absence of primary and secondary bone disease, bilateral neck of femur fractures can occur following relatively minor trauma. Consequently, the orthopaedic surgeon, emergency physician and general practitioner should be aware of this injury, particularly when managing traumatic injuries in confused patients.
Meniscal Regeneration: A Cause of Persisting Pain following Total Knee Arthroplasty
Authors: Hosam E Matar, Benan Dala-Ali, Henry D Atkinson
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Many patients have persisting knee pain following total knee arthroplasty. We report the unusual case of a patient whose chronic lateral and medial knee pain were caused by entrapped regenerated meniscal tissue. This was diagnosed and successfully treated by arthroscopic debridement.
Progressive Tumefactive Demyelination as the Only Result of Extensive Diagnostic Work-Up: A Case Report
Authors: Pavel Štourač, Jan Kolčava, Miloš Keřkovský, Tereza Kopřivová, Leoš Křen, Josef Bednařík
Journal: Front Neurol (2021)
Keywords: case report, demyelinating diseases, multiple sclerosis, neuropathology, neuroradiology
MeSH terms: Case Reports

Tumefactive demyelinating lesions belong to the rare variants of multiple sclerosis, posing a diagnostic challenge since it is difficult to distinguish them from a neoplasm or other brain lesions and they require a careful differential diagnosis. This contribution presents the case report of a young female with progressive tumefactive demyelinating brain and spinal cord lesions. An extensive diagnostic process including two brain biopsies and an autopsy did not reveal any explanatory diagnosis other than multiple sclerosis. The patient was treated by various disease-modifying treatments without significant effect and died from ascendent infection via ventriculoperitoneal shunt resulting in Staphylococcus aureus meningitis.
Acute hematogenous osteomyelitis of the talus: a case report
Authors: Nabil Dammak, Aymen Hannafi, Hassen Cheikhrouhou, Maher Teka, Hazem Ben Ghozlen, Faouzi Abid
Journal: Pan Afr Med J (2020)
Keywords: acute, case report, hematogenous, osteomyelitis, talus
MeSH terms: Arthritis, Infectious / diagnosis, Osteomyelitis / diagnosis, Talus / pathology, Case Reports, Acute Disease, Anti-Bacterial Agents / administration & dosage, Arthritis, Infectious / etiology, Arthritis, Infectious / therapy, Delayed Diagnosis, Humans, Infant, Male, Osteomyelitis / complications, Osteomyelitis / therapy, Treatment Outcome, Anti-Bacterial Agents

In children, osteomyelitis is common in the long bones of the femur and the tibia. However, talar osteomyelitis is extremely rare. The condition is difficult to diagnose due to the slow onset and atypical pattern of the symptom. We report the case of a 9-month-old male, coming from a rural area, with talar osteomyelitis. The patient's history of a trauma that resembled an ankle contusion had delayed the diagnosis and subsequently developed into septic arthritis. He was treated by curettage, immobilization in plaster and appropriate antibiotics with full recovery of function in his right ankle and foot three months after the first outpatient visit. The bony cavity was healed six months after the operation and there were no growth disturbances or any abnormalities of the adjacent joints. This case report aims to present the difficulties in the diagnosis and therapeutic approach of this disease.
Home birth preference, childbirth, and newborn care practices in rural Peruvian Amazon
Authors: Irene Del Mastro N, Paul J Tejada-Llacsa, Stefan Reinders, Raquel Pérez, Yliana Solís, Isaac Alva, Magaly M Blas
Journal: PLoS One (2021)
MeSH terms: Home Childbirth / statistics & numerical data, Infant Care / statistics & numerical data, Parturition, Rural Population / statistics & numerical data, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Adult, Female, Health Knowledge, Attitudes, Practice, Humans, Infant, Newborn, Peru, Pregnancy, Socioeconomic Factors, Young Adult

Home birth is very common in the Peruvian Amazon. In rural areas of the Loreto region, home to indigenous populations such as the Kukama-Kukamiria, birth takes place at home constantly. This study aims to understand the preference for home births as well as childbirth and newborn care practices among Kukama-Kukamiria women in rural Loreto. Following a case study approach, sixty semi-structured, face-to-face interviews were conducted with recent mothers who experienced childbirth within one year prior to the interview, female relatives of recent mothers who had a role in childbirth, male relatives of recent mothers, community health workers, and traditional healers. We found that for women from these communities, home birth is a courageous act and an intimate (i.e. members of the community and relatives participate in it) and inexpensive practice in comparison with institutional birth. These preferences are also linked to experiences of mistreatment at health facilities, lack of cultural adaptation of birthing services, and access barriers to them. Preparations for home births included handwashing and cleaning delivery surfaces. After birth, waiting for the godparent to arrive to cut the cord can delay drying of the newborn. Discarding of colostrum, lack of skin-to-skin contact as well as a range of responses regarding immediate breastfeeding and immediate drying of the baby were also found. These findings were used to tailor the educational content of the Mamas del Rio program, where community health workers are trained to identify pregnancy early, perform home visits to pregnant women and newborns, and promote essential newborn care practices in case institutional birth is not desired or feasible. We make recommendations to improve Peru's cultural adaptation of birthing services.
Concurrent manifestation of clinical hypodontia and blindness: a case report
Authors: Jeremiah Robert Moshy, Karpal Singh Sohal, Mark Chindia
Journal: J Dent Res Dent Clin Dent Prospects (2017)
Keywords: blindness, hypodontia impacted teeth, syndrome
MeSH terms: Case Reports

A case is reported of a 26-year-old blind man with hypodontia and multiple apparently underdeveloped impacted teeth. The patient reported that he had progressively developed visual impairment at the age of 11 years whence he became totally blind when he turned 12 years. The aim of this report is to open an academic and professional debate on the challenges of its definitive diagnosis and appropriate intervention.Blindness is not reported in any of the previously described syndromes; therefore, concurrent manifestation of "hypodontia, blindness, failure of eruption and digital lesions" can be proposed as a syndrome. However, in the absence of genetic studies, it is difficult to characterize this case with any one of the specifically documented syndromes; therefore, academic and professional discourse is suggested with regard to appropriate intervention.
A modified IRS-III chemotherapy regimen leads to prolonged survival in children with embryonal tumor with multilayer rosettes
Authors: Derek Hanson, Lindsey M Hoffman, Sumanth Nagabushan, Liliana C Goumnerova, Allison Rathmann, Timothy Vogel, David S Ziegler, Susan Chi
Journal: Neurooncol Adv (2020)
Keywords: brain tumor, chemotherapy, embryonal tumor with multilayer rosettes, pediatric

Background:
Embryonal tumor with multilayer rosettes (ETMR) is a rare CNS malignancy affecting young children that carries a very poor prognosis. Treatment with intensive surgical resection, radiotherapy, and high-dose chemotherapy is insufficient treatment in the vast majority of cases. Effective, biologically based therapies for this tumor are therefore desperately needed. The Dana-Farber Cancer Institute-modified IRS-III protocol incorporates preclinically active agents, such as doxorubicin and actinomycin D, into the treatment regimen for ETMR and may improve patient outcomes.
Methods:
The authors present a case series of 5 children with ETMR treated with an IRS-III-based chemotherapy backbone.
Results:
All 5 patients received a gross-total tumor resection. Patients received between 12 and 51 weeks of IRS-III therapy at the discretion of their treating physician. Four patients received focal radiation therapy, with the fifth patient instead receiving a cycle of high-dose chemotherapy with autologous stem cell rescue. Four patients have progression-free survival of more than 18 months. Chemotherapy treatment was reasonably tolerated by all 5 patients with one case of mild sinusoidal obstructive syndrome and one case of Grade 3 peripheral neuropathy.
Conclusions:
The patient outcomes in this small cohort are far better than would be expected based on the historical survival for this tumor. Given the tremendous need for effective therapy for ETMR, further investigation of this approach is warranted. An international consensus protocol based on the IRS-III regimen has been developed and will be available through a multicenter clinical trial and a global treatment registry.
Erythema nodosum leads to the diagnosis of pulmonary tuberculosis
Authors: Theocharis Koufakis, Ioannis Gabranis
Journal: Pan Afr Med J (2014)
Keywords: erythema nodosum, hilar lymphadenopathy, tuberculosis
MeSH terms: Erythema Nodosum / etiology, Tuberculosis, Pulmonary / complications, Tuberculosis, Pulmonary / diagnosis, Case Reports, Aged, Female, Humans

Erythema nodosum is a panniculitis which may have various causes, such as drugs, infections, sarcoidosis, inflammatory bowel disease, tuberculosis or can be idiopathic. We here report a case of a woman diagnosed with pulmonary tuberculosis whose first symptom was erythema nodosum. A thorough clinical and laboratory investigation of the patient presenting with erythema nodosum is always required, in order to assess a possible systemic, underlying condition.
Therapeutic relationships and the problem of containment: Experiences of patients at a psychiatric training hospital
Authors: Manfred W Böhmer, Christa Krüger
Journal: S Afr J Psychiatr (2019)
Keywords: containment, psychiatric hospital, psychiatric inpatients, psychiatry registrar training, therapeutic relationships

Background:
The biopsychosocial model emphasises the role of human relationships in psychiatric care. Therapeutic relationships that improve treatment outcome and provide containment are desperately needed by patients in distress. Despite the importance of human relationships, they are neglected in an era dominated by biological psychiatry.
Aim:
This qualitative research project explores the experiences, perceptions and subsequent needs of patients. The role of therapeutic relationships, and the factors that patients felt influenced their relationship with their therapists, were examined.
Setting:
A psychiatric training hospital in South Africa.
Method:
Thirty in-depth semi-structured interviews were conducted with 15 inpatients. A qualitative, explorative-descriptive, collective case study design was used. Purposive sampling ensured maximum variation and richness of information. Grounded theory methods were used to analyse transcribed recordings.
Results:
Patients valued therapeutic relationships that provide containment and potentially obviate the need for 'measures of control'. A model of containment was developed to demonstrate the various factors that interact in the attempt to provide containment to patients in a psychiatric training hospital system.
Conclusion:
Training hospitals should emphasise the role of therapeutic relationships in achieving containment and positive treatment outcomes. In developing countries, severe shortcomings in mental healthcare resources hinder the building of personal therapeutic relationships.
Ocular Findings in the 16p11.2 Microdeletion Syndrome: A Case Report and Literature Review
Authors: Cybil S Stingl, Colleen Jackson-Cook, Natario L Couser
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

The recurrent 16p11.2 microdeletion is characterized by developmental delays and a wide spectrum of congenital anomalies. It has been well reported that individuals with this ∼593-kb interstitial deletion have an increased susceptibility toward the autism spectrum disorder (ASD). Abnormalities of the eye and ocular adnexa are also commonly associated findings seen in individuals with the 16p11.2 microdeletion syndrome, although these ophthalmic manifestations have not been well characterized. We conducted an extensive literature review to highlight the eye features in patients with the 16p11.2 microdeletion syndrome and describe a 5-year-old boy with the syndrome. The boy initially presented with intellectual disability, speech delay, and defiant behavior; diagnoses of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) were established. He had a Chiari malformation type 1. His ophthalmic features included strabismus, hyperopia, and ptosis, and a posterior embryotoxon was present bilaterally. From a systematic review of prior reported cases, the most common eye and ocular adnexa findings observed were downslanting palpebral fissures, deep-set eyes, ptosis, and hypertelorism.
Castleman's Disease and Posttransplant Lymphoproliferative Disorder after Liver Transplant: 3-Year Follow-Up
Authors: Lokesh K Jha, Laura L Ulmer, Marco A Olivera-Martinez, Timothy M McCashland, Kai Fu, Fedja A Rochling
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

A 59-year-old male with a history of hepatitis C cirrhosis and history of hepatitis B exposure presented 8 months after orthotopic liver transplant (LT) with fever, fatigue, myalgia, night sweats, nonproductive cough, and shortness of breath. Bone marrow biopsy for pancytopenia was positive for Epstein-Barr virus (EBV) DNA. Lymph node biopsy for lymphadenopathy on imaging showed human herpes virus 8 (HHV8) associated Castleman's disease. Treatment included valganciclovir, rituximab, and prednisone taper with eventual discontinuation. Quantitative HHV8 DNA was initially 611,000 DNA copies/mL and was later undetectable at 6 months following treatment and remained undetectable at 3-year follow-up.