OpenMed/multicare-articles huggingface dataset:
Mycobacterium celatum pulmonary infection in the immunocompetent: case report and review
Authors: Claudio Piersimoni, Pier Giorgio Zitti, Domenico Nista, Stefano Bornigia
Journal: Emerg Infect Dis (2003)
MeSH terms: Lung Diseases / microbiology, Mycobacterium / isolation & purification, Case Reports, Review, Female, Humans, Immunocompetence, Lung Diseases / physiopathology, Middle Aged, Mycobacterium / pathogenicity

Mycobacterium celatum has been shown to cause disease in immunocompromised patients. We report a case of serious pulmonary infection caused by M. celatum in an apparently immunocompetent patient and review the characteristics of two other reported cases. Clinical and radiologic symptoms and signs included cough, malaise, and weight loss associated with cavitary lesions and pulmonary infiltrates. Although M. celatum is easy to detect in clinical specimens by liquid and solid media, it may be misidentified as a member of the M. tuberculosis complex or as M. xenopi. M. celatum pulmonary infection appears to respond to antimycobacterial chemotherapy, particularly with clarithromycin.
Tracheobronchoplasty and Diaphragmatic Plication under VV ECMO for Combined ECAC and Diaphragmatic Paralysis
Authors: Mehmet M Tatari, David Abia-Trujillo, Mathew Thomas, Neal M Patel, Sebastian Fernandez-Bussy, Britney N Hazelett, Margaret M Johnson
Journal: Case Rep Pulmonol (2021)
MeSH terms: Case Reports

The coexistence of expiratory central airway collapse and diaphragmatic paralysis presents a diagnostic and treatment challenge. Both entities are underrecognized causes of dyspnea, cough, sputum production, and orthopnea. Optimal treatment must be individualized and is best achieved by a multidisciplinary team. We present a case of a patient with profound functional impairment from dyspnea and hypoxemia due to expiratory central airway collapse, complicated by bronchiectasis from recurrent respiratory infections, and diaphragmatic paralysis.
Rupture of Hepatocellular Carcinoma after Transarterial Chemoembolization followed by Massive Gastric Bleeding
Authors: Kazuhiro Nishida, Alan Kawarai Lefor, Tomohiro Funabiki
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

Introduction:
Transarterial chemoembolization (TACE) is the first-line therapy for patient with unresectable hepatocellular carcinoma (HCC). Although TACE is a generally safe procedure, major complications can be occurred. We describe a patient with rupture of HCC after TACE followed by gastric bleeding.
Case presentation:
An 81-year-old man presented with worsening epigastric pain. He had been diagnosed with multiple HCC with nonalcoholic steatohepatitis and underwent TACE 19 days previously. A contrast enhanced computed tomography (CT) scan of the abdomen showed rupture of an HCC. He was treated nonoperatively and discharged on hospital day 18. Five weeks after TACE, he was emergently admitted with massive hematochezia and shock. A contrast enhanced CT scan demonstrated extrinsic gastric compression by an HCC lesion with extravasation of contrast into the stomach. Emergent upper gastrointestinal endoscopy showed a bleeding gastric ulcer with extraluminal compression which was successfully controlled by hypertonic saline-epinephrine injection. Due to tumor progression, he was discharged for palliative care and died six weeks after TACE.
Conclusion:
Rupture of HCC is a life-threatening complication after TACE with mortality rates up to 50%. After treatment of a ruptured HCC, extragastric compression and bleeding can occur due to direct compression by a primary lesion or intraperitoneal dissemination.
Progressive cerebellar degeneration revealing Primary Sjögren Syndrome: a case report
Authors: Emna Farhat, Mourad Zouari, Ines Ben Abdelaziz, Cyrine Drissi, Rahma Beyrouti, Mohamed Ben Hammouda, Fayçal Hentati
Journal: Cerebellum Ataxias (2016)
Keywords: antineuronal antibodies, ataxia, cerebellar atrophy, cyclophosphamide, degenerative, sjӧgren syndrome
MeSH terms: Case Reports

Background:
Cerebellar ataxia represents a rare and severe complication of Sjӧgren syndrome (SS), especially with a progressive onset and cerebellar atrophy on imaging.
Case presentation:
We report the case of a 30-year-old woman, with a past history of dry eyes and mouth, who presented a severe cerebellar ataxia worsening over 4 years associated with tremor of the limbs and the head. Brain MRI showed bilateral hyperintensities on T2 and FLAIR sequences, affecting periventricular white matter, with marked cerebellar atrophy. Complementary investigations confirmed the diagnosis of primary SS (pSS). The patient was treated by methylprednisolone, Cyclophosphamid and Azathioprine. Her clinical and radiological states are stabilized after 2 years of following. Primary cerebellar degeneration is extremely rarely associated with pSS. Few cases of isolated cerebellar ataxia or belonging to a multifocal disease were reported in the literature, most of them characterized by an acute or rapidly progressive onset. Cerebellar atrophy was described in only three patients. There have been few clarifications of the pathogenesis of the neurological manifestations in pSS. Treatment is based on corticosteroids and immunosuppressive agents with no consensus of a specific therapy.
Conclusions:
Cerebellar ataxia due to pSS may exceptionally mimic a degenerative cerebellar ataxia, especially when the onset is progressive, which represents the particularity of our observation. The role of brain MRI and antibodies remains important for the differential diagnosis.
Case report: Long-term follow-up of two patients with LHON caused by DNAJC30:c.152G>A pathogenic variant-case series
Authors: Sanja Petrovic Pajic, Martina Jarc-Vidmar, Ana Fakin, Maja Sustar Habjan, Jelka Brecelj, Marija Volk, Ales Maver, Borut Peterlin, Marko Hawlina
Journal: Front Neurol (2022)
Keywords: 152 a>g (ptyr51cys) pathogenic variant, dnajc30
MeSH terms: Case Reports

Background:
We present the disease course and long-term follow-up of two patients who were phenotypically diagnosed with atypical Leber Hereditary Optic Neuropathy (LHON) 14 and 12 years ago, respectively, whereby whole exome sequencing revealed recently described recessive DNAJC30:c.152G>A 152 A>G (p.Tyr51Cys) homozygous pathogenic variant with significant spontaneous visual acuity recovery in one.
Case presentation:
Two presented unrelated males with atypical LHON with sequential visual acuity (VA) loss were followed for many years. Both patients had negative family history. At the presentation at ages 17 (Case 1) and 18 years (Case 2), both had reduced visual acuity (Snellen): (Case 1) right eye (RE):CF 3m, left eye (LE):0.6, (Case 2) RE:0.2, LE:0.15; and color vision (Ishihara): (Case 1) 1/15 and 13/15; (Case 2) 2/15 and 3/15. Both had hyperemic optic disks (PNO) and central scotoma in their visual fields. Electrophysiology in the acute phase showed reduced and delayed visually evoked potentials (VEP) P100 in both patients, with reduced N95 amplitude in Case 2, and initially normal N95 amplitude in Case 1. Fluorescein angiography showed no early leakage with some late pooling at optic disks. Extensive clinical workout, including brain magnetic resonance imaging (MRI), aquaporin 4 (Aq4), and anti-myelin oligodendrocyte protein (anti-MOG) antibodies, was negative. Intravenous corticosteroids did not improve vision. Both experienced further deterioration several months after the onset accompanied by thinning of the peripapillary retinal nerve fiber layer (RNFL). Genetic testing for typical LHON pathogenic variants and whole mitochondrial DNA (mtDNA) sequencing was negative. 1 year after the onset, modest VA improvement began in Case 2 and continued over the next 3 years. VA improved bilaterally to 0.7, color vision 15/15, and islands of vision appeared within the visual field scotoma. VEP P100 peak time shortened, and amplitude increased, despite further RNFL thinning on optical coherent tomography (OCT). The patient's visual function remained stable during the entire 12-year follow-up period. Case 1 experienced modest VA improvement to 0.1 with some improvement in the visual field seven years after the disease onset, remaining stable during the entire 14-year follow-up period. VEP P100 wave remained undetectable.
Conclusions:
Presented are two autosomal recessive LHON (arLHON, OMIM:619382) cases with the same DNAJC30:c.152G>A pathogenic variant and different degrees of spontaneous visual recovery despite progressive RNFL thinning during a long-term follow-up. This mutation should be screened in every atypical LHON patient.
Vaginal Hysterectomy with Anterior Four-Arm Mesh Implant Technique in the Surgical Treatment of a Woman with Total Pelvic Organ Prolapse and Urinary Incontinence: A Case Report and Review of the Literature
Authors: Gökmen Sukgen, Esra Saygılı Yılmaz, Eralp Başer
Journal: Case Rep Obstet Gynecol (2016)

Purpose. We present a case report of a woman with total POP and SUI who was treated with a technique utilizing vaginal hysterectomy followed by the placement of a four-arm synthetic polypropylene mesh implant system. Methods. An 81-year-old grand-multiparous woman presented to our clinic complaining of a vaginally protruding mass and urinary incontinence. A surgical approach including vaginal hysterectomy, anterior four-arm mesh implant, posterior large segment vaginal enterocele repair, and perineoplasty with levator ani fixation was planned. Results. The patient was discharged home at the second postoperative day. Follow-up visits at the first, 3rd, and 6th months were normal. There was complete symptomatic relief and objective cure of the POP and urinary incontinence symptoms. Conclusion. We believe that anterior four-arm mesh implant and large posterior repair should be considered after vaginal hysterectomy. Future studies are needed to evaluate the utility of this technique for treatment of POP.
Multicentric spinal tuberculosis with sternoclavicular joint involvement: a rare presentation
Authors: Balaji Saibaba, Umesh Kumar Meena, Prateek Behera, Ramesh Chand Meena
Journal: Case Rep Pulmonol (2014)

Background. Tuberculosis is a chronic disease which may have varied presentations. Though pulmonary tuberculosis is the commonest, extrapulmonary tuberculosis involving skeletal system is often seen. Individuals with poor nourishment and immunological status are especially susceptible for disseminated and multicentric tuberculosis. Case Report. We here present a case of tuberculosis involving multiple anatomical locations in an immune-competent patient which was diagnosed with radiological studies and confirmed with histological examination. Patient was put on multidrug antitubercular therapy and responded well to the treatment with improvement in clinical and radiological picture. Clinical Relevance. This report of a rare case makes us aware of the varied presentations which tuberculosis can present with. It should be kept as a differential diagnosis in patients with cough and fever but not responding to conventional treatment. This is even more important in countries with poor socioeconomic conditions.
Chronic lymphocytic leukaemia during pregnancy: management and thoughts
Authors: Patricia Winckler, Anna Vanazzi, Maddalena Bozzo, Giovanna Scarfone, Fedro A Peccatori
Journal: Ecancermedicalscience (2015)
Keywords: chronic lymphocytic leukaemia, management, pregnancy
MeSH terms: Case Reports

Chronic lymphocytic leukaemia (CLL) is the most common leukaemia in the Western world. Despite this fact, its coexistence with pregnancy is extremely rare, with few cases reported in the literature. Given the rarity of this event, it is difficult to conduct large prospective trials to evaluate diagnostic, management, and outcome aspects. The existing evidence is limited to the few published cases and scarce data from reviews on haematological malignancies and pregnancy. Here, we report a case of a 36-year-old patient who had already finished treatment for CLL and was under surveillance when she got pregnant. We describe the evolution of the pregnancy and of the disease's behaviour as well as the oncological and obstetrical management. Being an indolent disease, CLL during pregnancy can be usually followed up without treatment, but infectious and autoimmune complications might have a significant impact on the pregnancy outcome. Therefore, pregnancy must be closely monitored in specialised centres.
Conjunctival squamous cell carcinoma with massive apoptosis and immune cell infiltration: A case report
Authors: Gang Du, Jun Qiao, Xunwen Lei, Ruiqin Han
Journal: Front Surg (2022)
Keywords: scc, apoptosis, case—based content filtering algorithm, conjunctival squamous cell carcinoma, immune cell infiltration
MeSH terms: Case Reports

This case reports a rare case of conjunctival squamous cell carcinoma in China. The elderly (86-year-old) female patient was diagnosed and treated effectively after three times of diagnosis. During this period, she was misdiagnosed and ineffective treatment for many times. Therefore, we propose to make an integrated diagnosis based on histopathological diagnosis, combined with a variety of diagnostic methods including MRI and CDFI, supplemented by updated multiple immunohistochemically techniques, so as to achieve the purpose of accurate diagnosis.
Synchronous early primary adenocarcinoma of both rectum and gallbladder. Report of a case
Authors: Timothy Sakellaridis, Stavros Mathioulakis, Christos Antiochos
Journal: Int Semin Surg Oncol (2005)

Background:
Synchronous early primary cancers are rare and in addition synchronous adenocarcinoma of both rectum and gallbladder is extremely rare.
Case report:
We report an unusual case of synchronous early primary adenocarcinoma of rectum and gallbladder. The patient was a 72-year-old woman with complaints of bloody stools and constipation. An endoscopy revealed adenocarcinoma of the lower rectum. A through preoperative investigation showed also cholelithiasis. The patient underwent abdominoperineal resection and cholecystectomy. The histopathological diagnosis was well to middle differentiate adenocarcinoma of the gallbladder (T2, N0, M0; stage II) and middle differentiate adenocarcinoma of the rectum (T2, N0, M0; stage II).
Conclusion:
For the cases of extracolonic primary cancer associated with colorectal primary carcinoma, Warren and Gates' diagnostic criteria are used. All patients with colorectal carcinoma, should undergo a throughout preoperative examination to exclude the possibility of synchronous early primary cancers.
Ophthalmoplegia Due to Miller Fisher Syndrome in a Patient With Myasthenia Gravis
Authors: Roberta Brusa, Irene Faravelli, Delia Gagliardi, Francesca Magri, Filippo Cogiamanian, Domenica Saccomanno, Claudia Cinnante, Eleonora Mauri, Elena Abati, Nereo Bresolin, Stefania Corti, Giacomo Pietro Comi
Journal: Front Neurol (2019)
Keywords: gq1b, miller fisher syndrome, autoimmune diseases, myasthenia gravis, ophthalmoplegia
MeSH terms: Case Reports

Here, we describe a 79-year-old man, admitted to our unit for worsening diplopia and fatigue, started a few weeks after an episode of bronchitis and flu vaccination. Past medical history includes myasthenia gravis (MG), well-controlled by Pyridostigmine, Azathioprine, and Prednisone. During the first days, the patient developed progressive ocular movement abnormalities up to complete external ophthalmoplegia, severe limb and gait ataxia, and mild dysarthria. Deep tendon reflexes were absent in lower limbs. Since not all the symptoms were explainable with the previous diagnosis of myasthenia gravis, other etiologies were investigated. Brain MRI and cerebrospinal fluid analysis were normal. Electromyography showed a pattern of predominantly sensory multiple radiculoneuritis. Suspecting Miller Fisher syndrome (MFS), the patient was treated with plasmapheresis with subsequent clinical improvement. Antibodies against GQ1b turned out to be positive. MFS is an immune-mediated neuropathy presenting with ophthalmoplegia, ataxia, and areflexia. Even if only a few cases of MFS overlapping with MG have been described so far, the coexistence of two different autoimmune disorders can occur. It is always important to evaluate possible differential diagnosis even in case of known compatible diseases, especially when some clinical features seem atypical.
Alobar Holoprosencephaly with Cebocephaly in a Neonate Born to an HIV-Positive Mother in Eastern Uganda
Authors: Franck Katembo Sikakulya, Sonye Magugu Kiyaka, Robert Masereka, Robinson Ssebuufu
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Background:
Holoprosencephaly (HPE) is a rare cerebrofacial abnormality resulting from the complete or partial failure of the diverticulation and cleavage of the primitive forebrain. It has an incidence at birth of 1:16000. Case Presentation. We report a case of a 2600 g newborn female delivered by an HIV-infected mother in whom an antenatal ultrasound scan at 34 weeks' gestation reported features of fetal alobar holoprosencephaly. The neonate was born with cebocephaly, a monkey-like head, and did not survive for more than 30 minutes following delivery by caesarian section despite oxygen therapy.
Conclusion:
Alobar HPE with cebocephaly remains incompatible with life. In this resource-limited setting, the diagnosis was made clinically, and only an ultrasound scan was performed to confirm the diagnosis. Chromosomal analysis could have given more information.
Bellini duct carcinoma of the kidney masquerading as an iliac bone tumour in an adult Nigerian
Authors: Abdulkadir Ayo Salako, Tajudeen Adeniran Badmus, Innocent Ikem, Kayode Adelusola, Ayodele Elkanah Orimolade, Martin Chukwudum Igbokwe, Kelechi Mc'Clement Onuoha, Foluke Olanike Irabor
Journal: Pan Afr Med J (2017)
Keywords: bellini duct carcinoma, ile-ife, nigeria, iliac bone tumour
MeSH terms: Bone Neoplasms / diagnosis, Carcinoma, Renal Cell / diagnosis, Kidney Neoplasms / diagnosis, Case Reports, Adult, Carcinoma, Renal Cell / pathology, Carcinoma, Renal Cell / surgery, Humans, Kidney Neoplasms / pathology, Kidney Neoplasms / surgery, Male, Nephrectomy / methods, Nigeria, Pelvic Pain / etiology

Bellini Duct Carcinoma (BDC) of the Kidney is a rare type of Renal Cell Carcinoma. It usually presents with features of local advancement or metastasis and rarely diagnosed incidentally. We present a case report of a young man who was found to have BDC of the Right Kidney following presentation with an iliac bone tumour. A 40 year old man presented to the Orthopaedic outpatient clinic on account of right sided pelvic pain and limping following a trivial fall at home. There was no antecedent history of loin pain, loin mass or haematuria. On evaluation, he was found to have a huge right iliac bone tumour invading the contiguous muscles. An incidental hypodense central ipsilateral renal mass with enlarged peri-hilar lymph nodes were found. He subsequently had right radical nephrectomy via a right sub-coastal approach and wide local excision of the Iliac bone tumour in two separate procedures. The resection margins were negative for tumour cells. Histology of the resected specimens were consistent with a metastatic right BDC of the kidney. He had a smooth post-operative recovery. One third of BDC of the kidney presents with metastasis. A high index of suspicion is required in order to diagnose BDC following such unusual presentations.
Elizabethkingia Meningoseptica Engodenous Endophthalmitis - a case report
Authors: Stephanie Ming Young, Gopal Lingam, Paul Anantharajah Tambyah
Journal: Antimicrob Resist Infect Control (2014)
Keywords: elizabethkingia meningoseptica, endogenous endophthalmitis, infections of the eye

Elizabethkingia meningoseptica is a nosocomial non-fermenting gram-negative bacillus that has an increasing prevalence in health care settings, especially in intensive care environments. While it has long been recognized as a rare but serious cause of neonatal meningitis and sepsis, its role as a cause of ocular pathology is not well-known. We report the first case of E. meningoseptica endogenous endophthalmitis caused by bacteraemia by the same organism. In view of its aggressiveness and virulence in the eye, and the high rate of misdiagnosis or missed diagnosis of endogenous endophthalmitis especially given its low incidence, we may wish to consider screening all cases of E. menigoseptica bloodstream infections for endophthalmitis in future, similar to how it has become routine to refer all patients with Klebsiella bacteraemia to ophthalmologists for screening for endophthalmitis in our local hospitals.
Removal of Polymer Clips From the Gallbladder Fossa in a Patient With Ehlers-Danlos Syndrome (EDS) to Treat Mast Cell Activation Syndrome (MCAS): A Case Report
Authors: Yitong Xiao, Dale A Calixte, Elizabeth Fry, Frederick Tiesenga
Journal: Cureus (2023)
Keywords: ehlers-danlos syndrome, foreign body removal, hypersensitive reaction, mast cell activation syndrome, noninvasive surgery
MeSH terms: Case Reports

Ehlers-Danlos syndrome (EDS) is a group of hereditary disorders characterized by fragility of connective tissue. Clinical manifestations of the disorder involve the skin, joints, blood vessels, and other internal organs. We report the case of a 29-year-old female suffering from EDS and mast cell activation syndrome (MCAS). Her history includes multiple orthopedic surgeries leading to the worsening of her symptoms. This was determined to be due to medical implants placed during her multiple procedures predisposing her to severe immunological reactions. This case report emphasizes the importance of meticulous surgical intervention when managing patients with EDS.
Restoration of endodontically treated molars using all ceramic endocrowns
Authors: Roopak Bose Carlos, Mohan Thomas Nainan, Shamina Pradhan, Roshni Sharma, Shiny Benjamin, Rajani Rose
Journal: Case Rep Dent (2013)

Clinical success of endodontically treated posterior teeth is determined by the postendodontic restoration. Several options have been proposed to restore endodontically treated teeth. Endocrowns represent a conservative and esthetic restorative alternative to full coverage crowns. The preparation consists of a circular equigingival butt-joint margin and central retention cavity into the entire pulp chamber constructing both the crown and the core as a single unit. The case reports discussed here are moderately damaged endodontically treated molars restored using all ceramic endocrowns fabricated using two different systems, namely, CAD/CAM and pressed ceramic.