OpenMed/multicare-articles huggingface dataset:
A Rare Case of Spontaneous Bilateral Subcapsular Renal Hematoma
Authors: Tushar Bajaj, Ngon Trang, Faisal Nasrawi, Sabitha Eppanapally
Journal: J Investig Med High Impact Case Rep (2020)
Keywords: critical care, education, hematoma, kidney, renal, subcapsular
MeSH terms: Hematoma / complications, Hemorrhage / diagnosis, Hemorrhage / etiology, Kidney Diseases / complications, Case Reports, Female, Hematoma / pathology, Hemorrhage / pathology, Humans, Kidney Diseases / pathology, Middle Aged, Retroperitoneal Space, Tomography, X-Ray Computed

Spontaneous bilateral renal subcapsular hematoma is a rare condition. On literature review, only 2 case reports have elucidated possible etiologies for such a presentation; however, no definite conclusions have been made. We present a rare case of a 52-year-old female with diabetes mellitus type 2, chronic kidney disease stage 4, hypertension, hyperlipidemia, prior traumatic brain injury via motor vehicle accident, who presented to our hospital with diabetic ketoacidosis and clinical signs of pyelonephritis; subsequently, imaging demonstrated spontaneous bilateral renal subcapsular hematoma. Risk factors for the rare presentation in this patient included pyelonephritis, history of bilateral ureteral stent placement, and a remote history of a mild unilateral renal laceration secondary to a motor vehicle accident. Typically, patients with this condition achieve spontaneous resolution with conservative management. Our patient initially presented with diabetic ketoacidosis and pyelonephritis but gradually developed retroperitoneal bleeding and hemorrhagic shock. Our patient's critical condition required close monitoring in an intensive care unit and a more invasive approach including unilateral left renal artery embolization followed by a unilateral left nephrectomy. The patient ultimately recovered and continued to be followed outpatient without any serious long-term complications.
Endourologic Intervention for Management of Infertility in a Man with Zinner Syndrome Resulting in a Natural Pregnancy
Authors: Ismaeel Aghaways, Shyaw M Ahmed
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Background:
Ipsilateral renal agenesis associated with seminal vesicular cysts is an uncommon finding. Zinner syndrome is a rare variant of wolffian duct anomalies with a triad of seminal vesicle cyst, ipsilateral renal agenesis, and male fertility problems due to ejaculatory duct obstruction (EDO).
Case presentation:
A 28-year-old man with 6 years history of primary infertility presented with left-side lower abdominal pain. A palpable cystic mass was found on digital rectal examination. Semen analysis revealed low volume ejaculate azoospermia. Abdominal ultrasonography revealed a single right kidney and transrectal ultrasonography showed an evidence of left EDO. Transurethral resection of the ejaculatory duct was performed. Semen analysis after 2 weeks showed normal sperm count (23M) and acceptable progressive motility (24%). Eight weeks later, his wife was pregnant with a 7-week viable fetus.
Conclusion:
Although not a common disease, a careful physical examination and thorough semen analysis interpretation should guide clinicians to diagnose a surgically treatable syndromic cause of male infertility.
Bullous Dermatosis in an End-Stage Renal Disease Patient: A Case Report and Literature Review
Authors: Zeenat Yousuf Bhat, Marwan Abu Minshar, Nashat Imran, Andrew Thompson, Yahya Osman Malik
Journal: Case Rep Nephrol (2016)

Patients with advanced chronic kidney disease including ESRD patients may present with a wide spectrum of cutaneous abnormalities, ranging from xerosis to hyperpigmentation to severe deforming necrotizing lesions. Skin problems are not uncommon in this population of patients, with a clinical presentation that can be quite bizarre, mandating a long list of differential diagnostic possibilities, and subsequent rise of a puzzling diagnostic challenge. We describe an ESRD patient who presented with blistering, nonhealing ulcerative lesions with a diagnostic skin biopsy revealing a mixed pattern of linear IgA bullous dermatosis and dermatitis herpetiformis. A clinical remission could be achieved with pulse intravenous steroids followed by oral maintenance in combination with dapsone, with no evidence of recurrence.
Tetralogy of Fallot associated with macrocephaly-capillary malformation syndrome: a case report and review of the literature
Authors: Jesus E Dueñas-Arias, Eliakym Arámbula-Meraz, Luis O Frías-Castro, Rosalio Ramos-Payán, Jose A Quibrera-Matienzo, Fred Luque-Ortega, E Maribel Aguilar-Medina
Journal: J Med Case Rep (2009)

Introduction:
Macrocephaly-capillary malformation syndrome is characterized by cutaneous vascular lesions, including cutis marmorata telangiectatica and hemangiomas, associated with congenital anomalies, including macrocephaly, macrosomia, asymmetry and mental retardation. In addition to these cardinal signs, several other clinical conditions have been reported in people with this condition. However, to the best of our knowledge, the presence of tetralogy of Fallot has not previously been reported in association with this syndrome.
Case presentation:
We present a case of a Mexican newborn girl with tetralogy of Fallot associated with macrocephaly-capillary malformation. We discuss the clinical treatment of the patient and its consequences.
Conclusion:
Since physiologic cutis marmorata is a common condition in newborns, the information provided in this report could be helpful in future cases in preventing severe clinical consequences or sudden death in patients with similar symptoms.
Mogamulizumab for post-transplant relapse of adult T-cell leukemia/lymphoma: a case study
Authors: Makoto Hirosawa, Midori Goto, Masahiko Oku, Kenichi Akao, Noriaki Kitamura, Tsukasa Nakanishi, Aya Tanaka, Daisuke Niino, Takehiro Higashi, Hiroaki Morimoto, Junichi Tsukada
Journal: Int J Hematol (2023)
Keywords: atll, gvatll, gvhd, mogamulizumab
MeSH terms: Graft vs Host Disease / drug therapy, Graft vs Host Disease / etiology, Hematopoietic Stem Cell Transplantation, Leukemia-Lymphoma, Adult T-Cell / drug therapy, Leukemia-Lymphoma, Adult T-Cell / pathology, Lymphoma, Case Reports, Adult, Humans, Recurrence, mogamulizumab

Mogamulizumab (MOG), a humanized monoclonal anti-CCR4 antibody, exerts strong antibody-dependent cellular cytotoxic effects on CCR4-positive adult T-cell leukemia/lymphoma (ATLL) cells. As CCR4 is highly expressed on regulatory T cells as well as ATLL cells, pre-transplant MOG induces severe graft-versus-host disease (GvHD). However, limited data are available on post-transplant use of MOG for relapsed ATLL. Here we describe the case of a patient with ATLL who experienced post-transplant relapse with involvement of peripheral blood, skin, lungs, and lymph nodes. Neither tacrolimus dose reduction nor cytotoxic chemotherapy was effective, but a single dose of MOG (1 mg/kg) induced complete remission. After treatment with MOG, leukemic cells in the peripheral blood rapidly disappeared, and the skin, lymph node, and lung lesions gradually regressed. Most notably, the long-term remission was accompanied by recurrence of moderate acute GvHD (grade II, skin stage 2, gut stage 1, liver stage 0). Our findings indicate that MOG can augment allogeneic immune-mediated anti-tumor reactions through graft-versus-ATLL (GvATLL) even during post-transplant relapse involving the lymph nodes and lungs, along with inducing GvHD.
Disseminated bronchiectasis in an adult with common variable immunodeficiency
Authors: Andrés Felipe Zea-Vera, Olga Lucia Agudelo-Rojas
Journal: Colomb Med (Cali) (2015)
Keywords: primary immunodeficiency, bronchiectasis, common variable immunodeficiency, hypogammaglobulinemia, recurring pneumonia
MeSH terms: Agammaglobulinemia / etiology, Bronchiectasis / diagnosis, Common Variable Immunodeficiency / diagnosis, Immunoglobulins, Intravenous / administration & dosage, Case Reports, Adult, Agammaglobulinemia / diagnosis, Bronchiectasis / drug therapy, Common Variable Immunodeficiency / drug therapy, Cough / etiology, Dyspnea / etiology, Fever / etiology, Follow-Up Studies, Humans, Male, Pneumonia / drug therapy, Pneumonia / etiology, Recurrence, Immunoglobulins, Intravenous

Primary immunodeficiencies (PID) are traditionally considered childhood diseases; however, adults account for 35% of all patients with PID. Antibody deficiencies, especially Common Variable Immunodeficiency (CVID), which have their peak incidence in adulthood, require a high suspicion index. Even though the estimated frequency of CVID is not high (1:25,000), high rates of under diagnosis and under reporting are very likely. The delay in diagnosis increases the morbidity and mortality; therefore, adult physicians should be able to suspect, identify and initiate management of individuals with PID. Here we report the case of a 37 year-old man presenting to the emergency room with dyspnea, fever and cough; he developed respiratory failure requiring mechanical ventilation. He complained of recurring pneumonia associated with widespread bronchiectasis since he was 18 years old. Serum immunoglobulins quantification showed severe hypogammaglobulinemia (total IgG <140 mg/dL; total IgA, 2.9 mg/dL; and total IgM <5 mg/dL). Treatment with Human Intravenous Immunoglobulin (IVIG) 10% was started, and with antibiotic treatment for severe pneumonia (during 14 days) was also prescribed. His clinical evolution has been favorable after one year follow-up. Common Variable Immunodeficiency (CVID) diagnosis was made.
Salvage Pelvic Lymph Node Dissection After Fluciclovine Positron Emission Tomography/Computed Tomography Detected Prostate Cancer Recurrence
Authors: Madeline Cancian, Jorge Pereira, Joseph F Renzulli 2nd
Journal: J Endourol Case Rep (2018)
Keywords: metastasis-directed therapy, metastatic prostate cancer, prostate cancer, robotic pelvic lymph node dissection
MeSH terms: Case Reports

Background: Multiple new systemic agents have been targeted to metastatic prostate cancer, with decreased progression of disease but no cure. Surgical management of metastatic disease has been gaining interest, primarily in the setting of high-risk prostatectomies. However, metastasis-directed surgical intervention has been employed in rare scenarios, especially in oligometastatic disease. We report here on a salvage robot-assisted pelvic lymph node dissection for a solitary metastatic site. Case Presentation: A 63-year-old Hispanic man who was initially treated with prostatectomy for intermediate risk cancer developed rapid biochemical recurrence. After salvage radiation, fluciclovine positron emission tomography (PET)/computed tomography (CT) scan showed a solitary pelvic lymph node metastasis. A robot-assisted laparoscopic pelvic lymph node dissection was carried out, with subsequent nadir of his prostate-specific antigen at 0.026. Conclusion: To our knowledge, this is the first report of salvage pelvic lymph node dissection after metastatic detection by fluciclovine PET/CT scan. Our patient experienced a complete biochemical response; however, it remains to be seen whether this will be a lasting response. Surgical resection of metastatic sites in prostate cancer offers a safe alternative to systemic therapy and avoids systemic side effects.
Isolation of Chlamydia abortus from a laboratory worker diagnosed with atypical pneumonia
Authors: Nieves Ortega, M Rosa Caro, M Carmen Gallego, Antonio Murcia-Belmonte, Daniel Álvarez, Laura Del Río, Francisco Cuello, Antonio J Buendía, Jesús Salinas
Journal: Ir Vet J (2016)
Keywords: atypical pneumonia, chlamydia abortus, human, oea, zoonoses

Background:
Identifying the aetiological agent of atypical pneumonia in human can sometimes be a tedious process, especially in cases where Mycoplasma pneumoniae, Legionella species and Chlamydia pneumoniae are ruled out. In such cases, a correct anamnesis of the patient is basic to clarify which pathogens might have produced the infection. For this reason, health professionals including veterinarians and laboratory personnel working with zoonotic pathogens should keep their doctors informed.
Case presentation:
A human case of atypical pneumonia linked to Chlamydia abortus is reported. A 47-year-old male, a veterinarian researcher into chlamydiae, developed respiratory symptoms, breathing problems and high fever. Serological analyses ruled out the involvement of several respiratory pathogens, such as M. pneumoniae, Legionella pneumophila, Rickettsia conorii and C. pneumoniae, and Chlamydia abortus was identified as the possible aetiological agent of the infection. The isolation of C. abortus from the patient's sputum and subsequent molecular analysis confirmed the presence of this microorganism.
Conclusion:
As far as we know, although C. abortus has not been previously described as capable of causing pneumonia in humans, this is the first reported case of atypical pneumonia in which C. abortus is thought to have played an aetiological role.
Accidental Insertion of a Broken Needle into the Pterygoid Mandibular Space during Inferior Alveolar Nerve Block: A Case Report
Authors: Kazuhiro Terada, Kenji Yamagata, Fumihiko Uchida, Satoshi Fukuzawa, Naomi Ishibashi-Kanno, Hiroki Bukawa
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

The incidence of needle breakage is estimated to be 0.000007%, and most needle breaks occur during inferior alveolar nerve block (IANB) administration and are localized to the pterygomandibular space. Although immediate surgical intervention is recommended for the removal of the fracture needles, intraoperative localization of a broken injection needle fragment can be challenging. Here, we present the case of a 36-year-old woman who underwent dental extraction of the left lower wisdom tooth under local anesthesia at a private office. At that time, a disposable 33G needle was broken and accidentally inserted into the pterygomandibular space during IANB. A broken injection needle was presented at the base of the left coronoid process of the mandible on computed tomography (CT). We successfully removed the broken injection needle using fluoroscopy and assisted endoscopy under general anesthesia.
Low-dose topiramate and hydrochlorothiazide-associated early acute myopia and angle narrowing: A case report
Authors: Chao Wu, Hong Pan, Shijun Feng, Xiaokun Wang, Zhaoqiang Liu, Bojun Zhao
Journal: Front Med (Lausanne) (2023)
Keywords: angle narrowing, drug–drug interaction, hydrochlorothiazide, short time, topiramate
MeSH terms: Case Reports

Purpose:
To report a unique case of topiramate and hydrochlorothiazide associated with acute myopia and angle narrowing.
Patients and methods:
A 34-year-old Asian woman presented with prominent binocular visual acuity decrease 6 h after taking only one dose of 25 mg topiramate, 25 mg hydrochlorothiazide, and 22.4 mg fluoxetine to lose weight. She was subsequently diagnosed with acute bilateral myopia and angle narrowing and was started on topical therapy.
Results:
Initial examination revealed a decreased visual acuity of 20/100 bilaterally, an elevated intraocular pressure of 23 mmHg in the right eye and 24 mmHg in the left eye, suprachoroidal effusions, and angle narrowing. After the discontinuation of these drugs and the use of IOP-lowering medication, the patient made full recovery.
Conclusion:
We speculate that there is a drug-drug interaction between topiramate and hydrochlorothiazide that may lead to the angle narrowing in a short time and at a low dose. Timely discontinuation of the drug usually leads to complete recovery within days to weeks.
Progressive cracking technique for phacoemulsification of superhard cataracts: a case report
Authors: Yun-E Zhao, Zhangliang Li, Pingjun Chang, Dandan Wang, Man Hu
Journal: Eye Vis (Lond) (2019)
Keywords: cataract, phacoemulsification, surgical technique
MeSH terms: Case Reports

Background:
Complete nuclear disassembly of superhard cataracts cannot always be achieved by phaco chop, which is considered one of the best techniques for dealing with hard cataracts. We present a phaco chop-progressive cracking technique to divide superhard cataracts completely.
Case presentation:
We presented a case of cataract with over Grade V nucleus sclerosis and very low density of corneal endothelial cell (812 cells/mm2). By performing the cataract surgery with our phaco chop-progressive cracking technique, the corneal endothelial cells were well protected and the patient's visual acuity was markedly improved from finger counting at 40 cm to 20/200 the day after surgery without obvious corneal edema.
Conclusions:
Although an initial learning curve was needed, this phaco chop-progressive cracking technique could be of particular benefit to the superhard cataract, especially in patients with low density of corneal endothelial cells.
Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone
Authors: Zahra Shahandeh, Hamid Shafi, Farahnaz Sadighian
Journal: Caspian J Intern Med (2015)
Keywords: renal staghhorn stone, staphylococcus cohnii subspecies urealyticum, uti
MeSH terms: Case Reports

Background:
Stphylococcus cohnii is an organism of coagulase negative species which is considered as normal flora. However, it has been isolated from urinary tract infections and surgical prostheses but its relation with staghorn stones has not been reported, yet.
Case presentation:
A 50-years-old woman presented with left renal staghorn stone in June 2014. She had bilateral staghorn stones 7 years ago. Staphylococcus cohnii subspecies urealyticum were detected from a removed stone. After 7 years, recurrence staghorn stone in her left kidney was diagnosed and patient underwent another surgery. The patient had several attacks of cystitis during these 7 years. The results of stone and urine cultures revealed staphylococcus cohnii subspecies urealyticum.
Conclusion:
This case report emphasizes a possible association between staphylococcus cohnii subspecies urealyticum infection and recurrence renal staghhorn stone.
Clinical and pathologic factors associated with survival in young adult patients with fibrolamellar hepatocarcinoma
Authors: Laura E Moreno-Luna, Oscar Arrieta, Jorge García-Leiva, Braulio Martínez, Aldo Torre, Misael Uribe, Eucario León-Rodríguez
Journal: BMC Cancer (2005)
MeSH terms: Carcinoma, Hepatocellular / mortality, Carcinoma, Hepatocellular / therapy, Liver Neoplasms / mortality, Liver Neoplasms / therapy, Adolescent, Adult, Age of Onset, Aged, Aged, 80 and over, Biopsy, Cell Proliferation, Disease-Free Survival, Humans, Liver / enzymology, Liver / pathology, Middle Aged, Models, Statistical, Prognosis, Retrospective Studies, Time Factors, Treatment Outcome

Background:
Fibrolamellar Carcinoma (FLC), a subtype of hepatocellular carcinoma (HCC), is a rare primary hepatic malignancy. Several aspects of the clinic features and epidemiology of FLC remain unclear because most of the literature on FLC consists of case reports and small cases series with limited information on factors that affect survival.
Methods:
We did a retrospective analysis of the clinical and histological characteristics of FLC. We also determined the rate of cellular proliferation in biopsies of these tumors. We assessed whether these variables were associated with survival.
Results:
We found 15 patients with FLC out of 174 patients with HCC (8.6%). Between patients with these neoplasms, we found statistically significant survival, age at onset, level of alpha fetoprotein, and an earlier stage of the disease. The 1, 3 and 5 year survival in patients with FLC was of 66, 40 and 26% respectively. The factors associated with a higher survival in patients with FLC were age more than 23 years, feasibility of surgical resection, free surgical borders, absence of thrombosis or invasion to hepatic vessels and the absence of alterations in liver enzymes. The size of the tumor, gender, cellular proliferation and atypia did not affect the prognosis.
Conclusion:
We concluded that FLC patients diagnosed before 23 years of age have worse prognosis than those diagnosed after age 23. Other factors associated with worse prognosis in this study are: lack of surgical treatment, presence of positive surgical margins, vascular invasion, and altered hepatic enzymes.
Psychogenic Nonepileptic Seizures (PNES) in the Setting of Trauma and Schizophrenia
Authors: Sikander Chohan, Ali Chohan, Muhamid Asif
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Psychogenic nonepileptic seizures (PNES) are nonepileptic events characterized by seizure-like manifestations without abnormal electrical activity in the brain. Our case report illustrates the diagnostic journey of a young female with a history of schizophrenia and childhood trauma who had an initial misdiagnosis of epilepsy. The etiology of PNES is complex. Major depressive disorder and generalized anxiety disorder are common comorbid conditions in these patients. Additionally, previous trauma has been linked as a predisposing factor for the development of PNES. Psychotic disorders, specifically schizophrenia, have only recently been associated with PNES. We explore this relationship in depth, while also underscoring the diagnostic and treatment challenges of PNES that clinicians must remain aware of.
Atypical Presentation of COVID-19 Leading to ARDS
Authors: Aquino Williams, Lance Alquran, Ummi Khan, Gabriela Bambrick-Santoyo, Roveena Goveas
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

A 60-year-old male was brought into the emergency department by EMS after he was found unresponsive by his neighbors. He was initially admitted to the hospital for chronic obstructive pulmonary disease exacerbation secondary to pneumonia. However, due to a sudden, rapidly progressing course of events, the patient was evaluated for COVID-19.
Lymphomatoid granulomatosis of central nervous system and lung driven by epstein barr virus proliferation: successful treatment with rituximab-containing chemotherapy
Authors: Ruben Fernandez-Alvarez, Me Gonzalez, Almudena Fernandez, Ap Gonzalez-Rodriguez, Jm Sancho, Francisco Dominguez, Carmen Fernandez
Journal: Mediterr J Hematol Infect Dis (2014)
MeSH terms: Case Reports

Lymphomatoid granulomatosis (LYG) is a very rare Epstein-Barr virus (EBV) associated B-cell lymphoproliferative disorder. We report the case of a 41-year-old man who presented with fever and respiratory symptoms. Computed tomography showed multiple nodules in both lung fields. Polymerase chain reaction (PCR) analysis for EBV was positive in bronchoalveolar lavage and biopsy of lung node yielded a diagnosis of LYG, grade III. Shortly after initiation of treatment with agressive chemotherapy, neurological deterioration appeared. Neuroimaging findings revealed hydrocephalus and PCR analysis of the cerebrospinal fluid (CSF) was positive for EBV. Treatment with intravenous rituximab led to rapid reduction of EBV load in CSF, along with clinical and radiological improvement. After completion of treatment with immunochemotherapy, an autologous stem cell transplantation was performed. Patient stays in remission 18 months after diagnosis.