OpenMed/multicare-articles huggingface dataset:
Case report: Systemic tuberculosis with prostate involvement mimicking prostate cancer with multiple metastases on 18F-FDG and 18F-PSMA PET/CT
Authors: Xinyao Sun, Yongkang Qiu, Lele Song, Lei Kang
Journal: Front Med (Lausanne) (2024)
Keywords: 18f-fdg, 18f-psma, pet/ct, prostate, tuberculosis
MeSH terms: Case Reports

Background:
Prostate tuberculosis is a common form of urogenital tuberculosis that occurs in men. Clinical and imaging manifestations of prostate tuberculosis are atypical, which often need to be differentiated from benign prostatic hyperplasia, a prostate malignant tumor, and a urinary tract infection. Although prostate-specific membrane antigen (PSMA) is considered a specific biomarker for prostate cancer, it is also found within tuberculosis tissues that may be stimulated by angiogenic factors. An abnormal PSMA uptake on positron emission tomography combined with computed tomography (PET/CT) should eliminate the possibility of tuberculosis.
Case report:
In this study, we reported a case of a 51-year-old man with an elevated erythrocyte sedimentation rate (ESR) but a normal prostate-specific antigen (PSA) value. 2-Deoxy-2-[fluorine-18]-fluoro-D-glucose (18F-FDG) and [fluorine-18]-prostate-specific membrane antigen (18F-PSMA) PET/CT scans were performed for further evaluation. The prostate showed a high fluoro-D-glucose (FDG) uptake but a slight PSMA uptake. Multiple osteolytic bone destruction and lymph nodes with an increased FDG uptake but a mild PSMA uptake were observed throughout the body. Systemic tuberculosis was diagnosed based on the prostate biopsy and the positive result of the T-cell spot test regarding tuberculosis infection. After 6 months of standard anti-tuberculosis treatment, the patient experienced symptom relief.
Conclusion:
In the case of a urinary tract infection, where the prostate shows high FDG uptake lesions with perilesional abscess, a mildly increased PSMA uptake, a low PSA value, a high ESR, and relevant clinical symptoms, tuberculosis should be considered and laboratory tests are required, especially when symptoms are relieved after successful anti-tuberculosis therapy. The final confirmation of the diagnosis still relies on pathological examination.
Osteonecrosis of the Hip Misdiagnosed as Lumbar-Disc Herniation: Тhree Case Studies
Authors: Plamen N Penchev, Petar-Preslav Petrov, Edvin Vasvi
Journal: Cureus (2024)
Keywords: disc herniation, hip avascular necrosis, hip joint, mri, relevant physical examination
MeSH terms: Case Reports

Disc herniation and hip-joint pathology may present with overlapping symptoms, complicating the diagnosis and treatment strategy in some cases. To ensure a correct diagnosis, this study emphasizes the need for imaging methods like MRI scans of the hip joints, complementary to the lumbar spine, when in doubt of coexisting hip pathology with symptomatic lumbar disc herniation. A typical complaint in clinical practice among patients with lumbar disc herniation is chronic back pain, often radiating down the legs. Although there could be considerable overlap in pain between hip joint issues and disc herniation, the etiology of these two conditions might differ. In these situations, a comprehensive diagnostic evaluation is crucial, as demonstrated by the three clinical case studies provided here. This article underscores the importance of conducting thorough imaging tests such as hip-joint and spine MRI scans to accurately differentiate among various disorders. Pathologies such as avascular necrosis can go unnoticed on X-rays of the hip joint, but an MRI scan provides a more precise diagnosis in these situations. The cases described here highlight the challenge of differentiating between hip-joint pathology and disc herniation due to their similar symptoms. For a diagnosis to be made quickly and accurately, modern imaging techniques must be used in conjunction with a comprehensive diagnostic approach and physical examination, which will improve patient outcomes and enable proper management.
Extracorporeal Membrane Oxygenation in Acute Respiratory Failure due to Hemorrhagic Alveolitis in a Patient with Acute Myeloblastic Leukemia
Authors: Martina Cuccarelli, Lorenzo Schiavoni, Felice Eugenio Agrò, Giuseppe Pascarella, Fabio Costa, Rita Cataldo, Massimiliano Carassiti, Alessia Mattei
Journal: Case Rep Crit Care (2024)
MeSH terms: Case Reports

Introduction. Extracorporeal membrane oxygenation (ECMO) support for severe acute respiratory distress syndrome (ARDS) is nowadays widely used with notable results on the overall survival as reported in the ELSO registry near to 55% at 90 days. This is the reason why ECMO teams force the use of this extreme technique to several populations, even though there is still a lack of data about its use on hematological patients. Case Report. A 39-year-old woman without a history of previous diseases, but a new diagnosis of acute myeloblastic leukemia (AML) was admitted to intensive care unit (ICU) for worsening hypoxia and respiratory acidosis, presenting an ARDS with PaO2/FiO2 < 100 in spontaneous breathing treated with noninvasive ventilation via full-face mask. Meanwhile, chemotherapy was started leading to a severe bone marrow aplasia that was managed with multiple blood and platelet transfusions. These conditions did not allow physicians to start any invasive approaches. After 14 days, ARDS worsened whereas bone marrow recovered, making possible the beginning of an invasive mechanical ventilation, with low positive end-expiratory pressure and a low tidal volume. Moreover, an immediate extracorporeal CO2 removal (ECCO2R) therapy was added. Despite these efforts, no improvement was achieved, and that is why venovenous ECMO throughout femoral-jugular cannulation was applied. A full protective lung ventilation by ultralow tidal volumes was guaranteed. After 2 weeks of ECMO, a gradual weaning from ECMO support was started and completed after two days. No ECMO-related complications were registered. In the end, the patient started her weaning from the mechanical ventilation and reached 12 hours of spontaneous ventilation in oxygen therapy. Discussion. ECMO is used as a rescue therapy in patients affected by severe respiratory failure with life-threatening hypoxia and respiratory acidosis nonresponsive to other maneuvers. However, immunosuppression and coagulopathies of hematological malignancies are considered relative contraindications for ECMO, while long-lasting respiratory failure represents another relative contraindication to extracorporeal support. ECMO could be a valid option to improve the survival of hematological patients with severe ARDS and thrombocytopenia, and management could change case by case, even if high incidence of recurrency.
Cefepime-Induced Generalized Fixed Drug Eruption With Morbilliform Rash
Authors: Grayson P Clark, Haley M Caldwell, Christopher A Coop, Brittanie I Neaves, Peter W Barnes
Journal: Cureus (2024)
Keywords: cd8+ t cell activation, cefepime, fixed drug eruptions, morbilliform rash, violaceous patches
MeSH terms: Case Reports

Fixed drug eruption (FDE) is a cutaneous reaction that characteristically recurs in the same locations upon re-exposure to the offending drug(s). The typical presentation of FDEs is single or multiple violaceous plaques with hyperpigmentation due to inflammation. The causative agents for FDEs include antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, barbiturates, and anticonvulsants. We present an interesting case of a generalized fixed drug eruption secondary to cefepime that resolved with the cessation of the offending drug and the institution of antihistamines and topical steroids.
Case report: An intriguing case of Philadelphia chromosome-positive acute lymphoblastic leukemia recurrence
Authors: Nicolò Peccatori, Elena Chiocca, Valentino Conter, Annalisa Tondo, Matilde Marzorati, Tommaso Casini, Marinella Veltroni, Andrea Biondi, Grazia Fazio
Journal: Front Oncol (2024)
Keywords: bcr
MeSH terms: Case Reports

The incorporation of tyrosine kinase inhibitors (TKIs) in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) led to significant improvement. However, in the pediatric setting, the outcomes of Ph+ ALL are still inferior compared to those of other ALL subtypes even in the TKI era due to higher relapse rate. Herein, we report a very peculiar case of late extramedullary Ph+ ALL relapse in a child, characterized by lymphomatous presentation in the tonsils and lymphoid lineage switch. The diagnostic dilemma between the occurrence of a second malignant neoplasm and the recurrence of the primary disease is further discussed, highlighting the importance of molecular backtracking analysis. This case report emphasizes the high plasticity and polyclonal nature of ALL and expands the heterogeneity of possible clinical presentation of Ph+ ALL at relapse.
Case report: Acquired resistance to crizotinib from a MET Y1230H mutation in a patient with non-small cell lung cancer and KIF5B-MET fusion
Authors: Su-Su Dong, Wen Dong, Ya-Fen Tan, Qiang Xiao, Tian-Li Wang
Journal: Front Oncol (2024)
Keywords: met fusion, acquired resistance, crizotinib, gene mutations, non-small cell lung cancer
MeSH terms: Case Reports

Background:
The c-met proto-oncogene (MET) serves as a significant primary oncogenic driver in non-small cell lung cancer (NSCLC) and has the potential to fuse with other genes, such as KIF5B, although it occurs infrequently. Only a limited number of reported cases have examined the clinical efficacy of crizotinib in patients with KIF5B-MET gene fusion, with no known data regarding acquired resistance to crizotinib and its potential mechanisms. In this report, we present the clinical progression of a female patient diagnosed with NSCLC and harboring a KIF5B-MET gene fusion.
Case description:
The patient initially exhibited partial response to first-line crizotinib treatment, albeit for a short duration and with limited efficacy. Subsequent disease progression revealed the emergence of a secondary MET mutation, specifically MET Y1230H, leading to acquired resistance to crizotinib.
Conclusion:
The reporting of this case is imperative for informing clinical practice, given the uncommon occurrence of NSCLC with MET fusion, displaying responsiveness to MET tyrosine kinase inhibitor therapy, as well as the emergence of the secondary Y1230H alteration as a potential resistance mechanism.
Acral melanoma of the heel mimicking a pressure sore
Authors: Matthias Fischer, Anita Sünkenberg, Reem Ali Deeb, Björn Dirk Krapohl
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2024)
Keywords: melanoma, nursing, pressure ulcers
MeSH terms: Case Reports

Background:
The clinical appearance of acral melanoma is diverse and can cause diagnostic difficulties in individual cases.
Case description:
We present a clinical case of an 83-year-old patient with a melanoma in the heel area that was initially interpreted as a pressure ulcer, resulting in delayed and more complicated treatment.
Conclusions:
Melanomas should be included in the differential diagnosis even in "typical" pressure ulcer areas. Against the background of increasingly poor healthcare in rural areas, an increase in such cases can be expected.
Contribution of preoperative ultrasound-guided implantation of a magnetic seed for optimal localization and resection of vulvar angiosarcoma: A case report
Authors: Pauline Chapellier, Basile Pache, Laura Haefliger, Loïc Lelièvre, Patrice Mathevet, Rami Hajri
Journal: Int J Surg Case Rep (2024)
Keywords: case report, imaged-guide surgery, localization, ultrasound, vulvar neoplasm
MeSH terms: Case Reports

Introduction:
Vulvar cancer is a rare cause of malignancy among women. It is key for surgeons to achieve negative resection margins, as it greatly impacts patient's prognosis. Unfortunately, additional surgical procedures are often performed due to the regional anatomical complexity. Based on non-palpable breast tumors, where image-guided preoperative localization tools have enhanced the complete resection rates, we aimed at evaluating the feasibility of magnetic seed technique for localizing perineal lesions.
Presentation of the case:
We present the case of a 40-year-old female patient, who underwent iterative resections for a recurrent epithelioid angiosarcoma of the left labia major. Imaging revealed a suspicious regional involvement at 3 months of follow-up, for which another surgery was planned. We decided to target this non-palpable lesion with the Magnetic Seed technique to guide the intervention. A seed was inserted into the nodule under ultrasound guidance. Resection was then performed, with negative margins and no recurrence on last follow-up.
Discussion:
Surgical procedures with minimal extension are recommended in vulvar cancer, to limit the aesthetic and functional complication. Unfortunately, recurrences and residual tumors remain frequent, even higher when surgical margin safety is not achieved. Many studies have suggested the benefit of image-guided localization tools in non-palpable breast tumors. By reducing the excising volume and focusing on the lesions, relapse and complications are rarer. We considered Magnetic Seed to be the most appropriated technique for perineal lesions.
Conclusion:
As for breast cancer, Magnetic Seed technique could be appropriate for non-palpable perineal lesions, optimizing resection margins with minimal procedures.
Immune checkpoint inhibitor-induced subacute cutaneous lupus erythematosus: a case report and review of the literature
Authors: Adam Khorasanchi, Abraham M Korman, Ashish Manne, Alexa Meara
Journal: Front Med (Lausanne) (2024)
Keywords: case report, cutaneous lupus erythematosus, esophageal cancer, immune checkpoint inhibitor, literature review
MeSH terms: Case Reports

Immune checkpoint inhibitor (ICI) use has been associated with numerous autoimmune side effects, known as immune related adverse events (irAEs). Cutaneous irAEs are common and affect up to 50% of patients treated with ICIs. There have been an increasing number of cases reported in the literature regarding ICI-induced subacute cutaneous lupus erythematosus (SCLE). ICI-induced SCLE is important to recognize as it can result in a delayed and/or prolonged skin reaction despite treatment discontinuation. We describe a patient with gastro-esophageal adenocarcinoma who developed SCLE following one cycle of nivolumab treatment. A 75-year-old man presented to our clinic with a new photo-distributed rash composed of oval scaly pink papules and plaques involving his chest and arms. Despite treatment with topical corticosteroids, he presented to the emergency department 1 week later with worsening rash. Skin biopsy showed vacuolar interface pattern, along with superficial perivascular lymphocytic infiltrate, consistent with a drug eruption. The clinicopathological presentation was consistent with ICI-induced SCLE. Nivolumab treatment was discontinued due to the severity of the rash. The rash remitted with systemic corticosteroids, high potency topical steroids, and hydroxychloroquine. Unfortunately, the patient developed intraperitoneal metastatic disease, and was enrolled in hospice care. In this paper, we highlight the importance of early identification and treatment of this irAE. A review of the literature, including a discussion on the management of ICI-induced SCLE is also provided.
Misleading subcutaneous mycosis: a case report of subsequent clinical mycetoma-like and histological chromoblastomycosis-like lesions
Authors: João Paulo Turri Brufatto, Laís Pontes, Angélica Zaninelli Schreiber, Maria Leticia Cintra, Cintia Avila Souza, Luciana Vilela Gomide, Helena Maciel Mendonça Tolentino Guerra, Rafael Fantelli Stelini, Isabela Vilela Brum, Andrea Fernandes Eloy da Costa França, Renata Ferreira Magalhães, Paulo Eduardo Neves Ferreira Velho
Journal: Rev Inst Med Trop Sao Paulo (2024)
MeSH terms: Chromoblastomycosis / diagnosis, Chromoblastomycosis / drug therapy, Chromoblastomycosis / microbiology, Chromoblastomycosis / pathology, Mycetoma / diagnosis, Mycetoma / drug therapy, Mycetoma / microbiology, Mycetoma / pathology, Case Reports, Diagnosis, Differential, Exophiala / isolation & purification, Humans, Hyalohyphomycosis / diagnosis, Hyalohyphomycosis / microbiology, Hyalohyphomycosis / pathology, Immunocompromised Host, Male, Middle Aged

Hyalohyphomycosis and phaeohyphomycosis are groups of mycoses caused by several agents and show different clinical manifestations. We report a case of an immunocompromised patient who presented rare manifestations of opportunistic mycoses: mycetoma-like hyalohyphomycosis on his right foot caused by Colletotrichum gloeosporioides, followed by cutaneous phaeohyphomycosis on his right forearm caused by Exophiala oligosperma. Further to the rarity of this case, the patient's lesion on the foot shows that the clinical aspects of mycetomas could falsely appear in other fungal infections similar to hyalohyphomycosis. We also show that the muriform cells that were seen in the direct and anatomopathological examination of the skin are not pathognomonic of chromoblastomycosis, as observed in the lesion of the patient's forearm.
Rare Spiroplasma Bloodstream Infection in Patient after Surgery, China, 2022
Authors: Ningning Xiu, Chao Yang, Xiaowei Chen, Jianping Long, Pinghua Qu
Journal: Emerg Infect Dis (2024)
Keywords: china, spiroplasma, bacteria, bloodstream, infection, surgery
MeSH terms: Sepsis / diagnosis, Sepsis / etiology, Spiroplasma / genetics, Case Reports, China / epidemiology, Humans

We report a case of Spiroplasma bloodstream infection in a patient in China who developed pulmonary infection, acute respiratory distress syndrome, sepsis, and septic shock after emergency surgery for type A aortic dissection. One organism closely related to Spiroplasma eriocheiris was isolated from blood culture and identified by whole-genome sequencing.
Isolated Ocular Relapse of Acute Myeloid Leukaemia Post Allogeneic Stem Cell Transplant
Authors: M H Tong, A Kwok, A Walsh, P Heydon, E S Koh, N McNamara, A Bryant
Journal: Case Rep Ophthalmol Med (2024)
MeSH terms: Case Reports

We present a rare case of a 39-year-old female with extramedullary relapse of acute myeloid leukaemia (AML) isolated to the left eye 2 months post allogeneic haematopoietic stem cell transplant. She initially presented with painless left eye erythema, swelling, and visual impairment. Initial ophthalmology review revealed conjunctival chemosis, raised intraocular pressure, and serous retinal detachments. She was initially treated for suspected orbital cellulitis with intravenous antibiotic and antifungal therapy but clinically progressed so was then treated with intravenous corticosteroids. One week later, she progressed to angle-closure glaucoma with development of a hypopyon and an enlarging subconjunctival mass. She proceeded to urgent subconjunctival biopsy and drainage of subretinal fluid which confirmed extramedullary relapse of AML. Notably, further investigation found no evidence of bone marrow or central nervous system relapse. She proceeded to localized radiotherapy with gradual resolution of the subconjunctival mass and serous retinal detachment and was for consideration of donor lymphocyte infusions and azacitidine therapy; unfortunately, she developed respiratory sepsis and passed away despite maximal efforts. This case represents a rare and unusual presentation of isolated ocular extramedullary relapse of AML and emphasises the importance of early ophthalmology involvement and tissue biopsy when there is high clinical suspicion of the disease.
Brown crusts on infant owing to contact dermatitis associated with ethanol disinfection
Authors: Yuki Matsuhisa, Tsuneaki Kenzaka, Hideo Hirose, Tadao Gotoh
Journal: J Gen Fam Med (2023)
Keywords: brown crusts, contact dermatitis, ethanol disinfection, infant
MeSH terms: Case Reports

A 2-year-old girl developed dermatitis with atypical brown crusts after ethanol disinfection. Since many Oriental people have genetically reduced acetaldehyde dehydrogenase type 2 (ALDH2) activity, ethanol disinfection causes acetaldehyde to accumulate in the skin, resulting in dermatitis.
Case Report: A rare homozygous patient affected by TTR systemic amyloidosis with a prominent heart involvement
Authors: Emanuele Micaglio, Gloria Santangelo, Silvia Moscardelli, Daniela Rusconi, Francesco Musca, Alessandro Verde, Laura Campiglio, Francesca Bursi, Marco Guazzi
Journal: Front Cardiovasc Med (2023)
Keywords: val142ile, atrial fibrillation, hereditary transthyretin amyloidosis cardiomyopathy, homozygous variant, stroke
MeSH terms: Case Reports

Hereditary transthyretin amyloidosis is a severe, adult-onset autosomal dominant inherited systemic disease predominantly affecting the peripheral and autonomic nervous system, heart, kidney, and the eyes. We present a case of a Caucasian 65-year-old man with cardiac amyloidosis and the homozygous mutation Val142Ile (classically, Val122Ile) in the transthyretin gene. We provide a genotype-phenotype correlation regarding the genetic status of both heterozygous and homozygous individuals and their clinical conditions at the time of genetic testing.
Case report: Treatment of cyclobenzaprine ingestion in two dogs with intravenous intralipid therapy
Authors: Kaitlyn Dreese, Adesola Odunayo, Melissa C Bucknoff
Journal: Front Vet Sci (2024)
Keywords: case report, cyclobenzaprine, intralipid emulsion, intralipid emulsion therapy, skeletal muscle relaxant
MeSH terms: Case Reports

Introduction:
The objective of this case series is to describe the clinical signs and outcome of cyclobenzaprine ingestion in two dogs treated with intralipid emulsion (ILE) and supportive care.
Case or series summary:
Two dogs presented for evaluation of cyclobenzaprine ingestion. A 4-year-old female spayed Rat Terrier (dog 1) presented within 4 h of ingestion of cyclobenzaprine (between 9.7 and 25.9 mg/kg). The dog experienced abnormal behavior, agitation, tremors, tachycardia, and hypertension. There were no significant clinicopathological abnormalities. The dog was treated with ILE, cyproheptadine, and activated charcoal. All clinical signs resolved after treatment. A 5-month-old female intact mixed-breed dog (dog 2) presented after ingestion of an unknown amount of cyclobenzaprine 2-3 h prior to presentation. The dog experienced dull mentation, tremors, loss of gag reflex, tachycardia, and hypertension. There were no significant clinicopathological abnormalities. Orogastric decontamination was performed via gastric lavage, and activated charcoal was given via orogastric tube, followed by ILE. All clinical signs resolved after therapeutic intervention.
Discussion:
This is the first report documenting clinical signs of cyclobenzaprine toxicity in two dogs followed by successful treatment with gastric emptying, ILE, and supportive care.
Left Juxtaposition of the Right Atrial Appendage: Pitfalls in Diagnosis
Authors: Kanya Singhapakdi, Wesam Sourour, Thomas R Kimball
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

Several congenital anomalies of the right atrial appendage (RAA) have been described including aneurysm, herniation (in association with a pericardial defect), and left juxtaposition. The left juxtaposition of the RAA (LJRAA), first described by Birmingham in 1893 and subsequently introduced by Dixon in 1954, is usually associated with complex cardiac malformations such as obstruction of the left ventricular outflow tract. In this case report, we will describe an unusual variant of LJRAA in the absence of any other cardiac defects, which was initially misinterpreted as an aortic dissection. The correct diagnosis was made after careful reinterpretation and the use of multiple imaging modalities as highlighted.