OpenMed/multicare-articles huggingface dataset:
Zika Induces Human Placental Damage and Inflammation
Authors: Kíssila Rabelo, Luiz José de Souza, Natália Gedeão Salomão, Lara Nascentes Machado, Priscila Gomes Pereira, Elyzabeth Avvad Portari, Rodrigo Basílio-de-Oliveira, Flávia Barreto Dos Santos, Laura Dias Neves, Luciana Faes Morgade, David William Provance Jr, Luiza Mendonça Higa, Amilcar Tanuri, Jorge José de Carvalho, Marciano Viana Paes
Journal: Front Immunol (2020)
Keywords: cytokines, flavivirus, histopathology, immune response, ultrastructure
MeSH terms: Microcephaly / etiology, Placenta / pathology, Pregnancy Complications, Infectious / pathology, Zika Virus / pathogenicity, Zika Virus Infection / pathology, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antigens, Viral / analysis, Brain-Derived Neurotrophic Factor / biosynthesis, Brain-Derived Neurotrophic Factor / genetics, Brazil / epidemiology, Case-Control Studies, Cesarean Section, Collagen / biosynthesis, Collagen / genetics, Cytokines / biosynthesis, Cytokines / genetics, Disease Outbreaks, Female, Humans, Inclusion Bodies, Viral, Infant, Newborn, Male, Matrix Metalloproteinases / biosynthesis, Matrix Metalloproteinases / genetics, Placenta / metabolism, Placenta / virology, Pregnancy, Pregnancy Complications, Infectious / metabolism, Pregnancy Complications, Infectious / virology, Trophoblasts / ultrastructure, Trophoblasts / virology, Virus Replication, Young Adult, Zika Virus / immunology, Zika Virus / isolation & purification, Zika Virus / physiology, Zika Virus Infection / epidemiology, Zika Virus Infection / immunology, Antigens, Viral, Brain-Derived Neurotrophic Factor, Cytokines, Collagen, Matrix Metalloproteinases

In Brazil, an epidemic of Zika virus (ZIKV) infections was declared in 2015 that coincided with alarming reports of microcephaly in newborns associated with mother infection. Although the virus has placental tropism, changes in the tissue morphology and immunity of infected patients have not yet been elucidated. Here, we investigated the histopathological and ultrastructural changes along with the immunological profile and the BDNF expression in rare placental material. Tissues were obtained in the 2015-2016 Brazilian epidemic, of ten ZIKV-infected patients during pregnancy, five resulting in cases of fetal microcephaly and five non-microcephaly, compared to five non-infected control placentae. Viral antigens were only detected in samples from the ZIKV infected patients. Infected placentae presented histopathological severe damage, while the ultrastructural evaluation showed abnormal organelles, such as clusters of virus-like particles consistent with the ZIKV dimensions. Increased infiltration of CD68+ and TCD8+ cells, expression of MMPs, cytokines (IFN-γ and TNF-α) and other immunological mediators (RANTES/CCL5 and VEGFR-2) confirmed excessive inflammation and vascular permeability dysfunction. An evaluation of BDNF showed a decrease that could modulate neuronal damage in the developing fetus. The placental changes caused by ZIKV are not pathognomonic, however, the data provide evidence that this infection leads to severe placental injury.
Extrapelvic endometriosis located individually in the rectus abdominis muscle: a rare cause of chronic pelvic pain (a case report)
Authors: Anna Thanasa, Efthymia Thanasa, Evangelos Kamaretsos, Evangelos-Ektoras Gerokostas, Ioannis Thanasas
Journal: Pan Afr Med J (2022)
Keywords: rectus abdominis muscles, caesarean section, case report, diagnosis, treatment
MeSH terms: Chronic Pain / etiology, Endometriosis / complications, Endometriosis / diagnosis, Endometriosis / surgery, Muscular Diseases / diagnosis, Muscular Diseases / etiology, Muscular Diseases / surgery, Case Reports, Cesarean Section / adverse effects, Female, Humans, Middle Aged, Pelvic Pain / etiology, Pregnancy, Rectus Abdominis / pathology, Rectus Abdominis / surgery

Endometriosis of the rectus abdominis muscle is an extremely rare form of extrapelvic localization of the disease. It is usually iatrogenic and develops after caesarean section or gynecological surgery. Preoperative diagnosis is very difficult and a challenge for gynecologists and surgeons; thus, the diagnosis is histological. The treatment of choice consists of wide local excision of the lesion on healthy margins. We cite a case of isolated endometriosis in the rectus abdominis muscles in a 46-year-old patient with a previous caesarean section, the diagnosis of which was made randomly when performing abdominal total hysterectomy for the treatment of chronic pelvic pain. Histological examination of the surgical specimen confirmed the diagnosis. Simultaneously, the surgical specimen of the uterus and ovaries was free of endometriosis. Postoperatively, the patient mentioned discharge of her symptoms. No further therapeutic intervention was deemed necessary, as it was considered that a complete resection of the endometrial tissue implantation from the muscles of abdominal wall was performed. The present case report lay emphasis on the significant difficulties involved in the preoperative diagnosis of endometriosis of the rectus abdominis muscle. Concurrently, it is pointed out that, despite its rarity, individual extrapelvic endometriosis located in the rectus abdominis muscle should be included among other pathological entities in the differential diagnosis of chronic pelvic pain in women of reproductive age, who gave birth by caesarean section or underwent gynecological surgery with abdominal or laparoscopic access.
Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy-Case Description with Literature Review
Authors: Jad A Degheili, Mazen M Mansour, Rami W Nasr
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Prostate cancer is the most common solid cancer among American men. Although there are various modalities for treatment, including radical prostatectomy among many others, the former is, nevertheless, not without any accompanied complications. Other than the well-known surgical complications such as erectile dysfunction, urinary incontinence, and voiding dysfunction, osteomyelitis of the symphysis pubis is not a well-understood complication, with various hypotheses explaining its pathogenesis. Although osteomyelitis of the pubis symphysis has been reported after endoscopic urological procedures such as transurethral resection of the prostate, it has rarely been reported after robotic surgeries. We hereby report, to the best of our knowledge, the first osteomyelitis of the pubis symphysis, after robotic prostatectomy, in a patient with prostate cancer and no previous radiation therapy.
Brain Metastasis Mimicking Brain Abscess in ALK-Positive Non-Small-Cell Lung Cancer
Authors: Toshio Sakatani, Hidenori Kage, Shunsaku Takayanagi, Kaoru Watanabe, Yoshihisa Hiraishi, Aya Shinozaki-Ushiku, Shota Tanaka, Tetsuo Ushiku, Nobuhito Saito, Takahide Nagase
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Brain metastasis frequently develops in non-small-cell lung cancer (NSCLC). Here, we report a patient who developed brain metastasis from ALK-positive NSCLC which mimicked brain abscess. He was admitted for suspected obstructive pneumonia nine months after curative lung resection. Head magnetic resonance imaging revealed a cavitary lesion, which was compatible with brain abscess but rare in brain metastasis. However, after treatment with antibiotics, the brain lesion increased in size. Aspiration of the liquid content of the brain lesion revealed cancer cells. When a brain lesion suggestive of abscess develops in a patient with ALK-positive NSCLC, aspiration may be necessary to differentiate metastasis from abscess.
Intrahepatic Reactive Lymphoid Hyperplasia: A Case Report and Review of the Literature
Authors: Samantha Seitter, Zachary D Goodman, Theodore M Friedman, Timothy R Shaver, George Younan
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Reactive lymphoid hyperplasia (RLH) is a rare and benign lesion found in organs of the gastrointestinal tract, skin, lung, orbit, and more rarely in the liver. Due to its similar appearance on imaging, it is hard to differentiate from primary liver malignancies. The following is a case report of a patient presenting with a suspicious liver lesion found to be RLH associated with primary biliary cirrhosis (PBC), after surgical resection.
Presentation of case:
A 54-year-old woman presented with nonspecific abdominal pain, and her workup included axial imaging of the abdomen that showed a suspicious lesion in her liver. After an extensive workup, which included a percutaneous biopsy, failed to confirm a diagnosis, a laparoscopic surgical resection was recommended.
Discussion:
RLH is a rare condition of the liver, presenting in a suspicious fashion and raising concerns for a primary liver malignancy. RLH should be considered in the differential diagnosis of small hepatic lesions in middle-age females in the absence of any significant risk factors for hepatocellular carcinoma (HCC). RLH tends to be associated with PBC of the liver.
Conclusion:
RLH of the liver is a rare, hard to diagnose, benign lesion. When intrahepatic, it cannot be easily differentiated from primary liver tumors and frequently requires surgical resection for pathological diagnostic confirmation.
Case report: Clearance of longstanding, immune-deficiency-associated, vaccine-derived polio virus infection following remdesivir therapy for chronic SARS-CoV-2 infection
Authors: William Hywel Bermingham, Benjamin Canning, Thomas Wilton, Michael Kidd, Dimitra Klapsa, Manasi Majumdar, Kavitha Sooriyakumar, Javier Martin, Aarnoud P Huissoon
Journal: Front Immunol (2023)
Keywords: cvid - common variable immunodeficiency disorders, immune deficiency associated vaccine derived poliovirus (ivdpv), polio, primary immune deficiencies (pid), remdesivir, vaccine derived poliovirus
MeSH terms: COVID-19 / complications, Immunologic Deficiency Syndromes, Poliomyelitis / drug therapy, Poliomyelitis / etiology, Poliomyelitis / prevention & control, Poliovirus Vaccine, Oral / adverse effects, Poliovirus, Case Reports, Research Support, Non-U.S. Gov't, COVID-19 Drug Treatment, Female, Humans, Male, Middle Aged, SARS-CoV-2, Poliovirus Vaccine, Oral, remdesivir

The global polio eradication campaign has had remarkable success in reducing wild-type poliovirus infection, largely built upon the live attenuated Sabin oral poliovirus vaccine. Whilst rare, vaccine poliovirus strains may cause infection and subsequently revert to a neurovirulent type, termed vaccine-derived poliovirus (VDPV). Persistent, vaccine derived infection may occur in an immunocompromised host (iVDPV), where it is a recognised complication following receipt of the Sabin vaccine. This has significant implications for the global polio eradication campaign and there is currently no agreed global strategy to manage such patients.Here we describe a case of a 50-year-old man with common variable immune deficiency, persistently infected with a neurovirulent vaccine-derived type 2 poliovirus following vaccination in childhood. iVDPV infection had proven resistant to multiple prior attempts at treatment with human breast milk, ribavirin and oral administration of a normal human pooled immunoglobulin product. His iVDPV infection subsequently resolved after 12 days treatment with remdesivir, an adenosine analogue prodrug that is an inhibitor of viral RNA-dependent RNA polymerase, administered as treatment for a prolonged, moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. iVDPV from the patient, isolated prior to treatment, was subsequently demonstrated to be sensitive to remdesivir in vitro. Based on the observations made in this case, and the mechanistic rationale for use with iVDPV, there is strong justification for further clinical studies of remdesivir treatment as a potentially curative intervention in patients with iVDPV infection.
The Benefits of Early versus Late Therapeutic Intervention in Fabry Disease
Authors: Mónica Furlano, Elisabet Ars, Anna Matamala, Vicens Brossa, Joan Martí, Maria Del Prado-Venegas, Jaume Crespi, Esther Roe, Roser Torra
Journal: Case Rep Genet (2022)
MeSH terms: Case Reports

Background:
Fabry disease (FD) is an X-linked lysosomal storage disorder caused by pathogenic variants of the GLA gene. Heterozygous female patients may show much more variability in clinical manifestations, ranging from asymptomatic to full-blown disease. Because of this heterogeneous clinical picture in women, the diagnosis of FD has typically been delayed for more than a decade, and the optimal time to initiate treatment remains controversial. Case Presentation. Here, we present two unrelated female patients diagnosed with FD harbouring the same pathogenic GLA variant. We discuss the implications of initiating specific therapy at different stages of the disease, with and without organ involvement (early versus late therapeutic intervention).
Conclusions:
These clinical cases suggest that initiating specific treatment at an earlier age in women with FD may prevent organ involvement and associated clinical events.
The parotid gland, an unusual site of colorectal cancer metastasis
Authors: Paula Isabel G Francoa, Anna Pascual-Panganiban
Journal: Ecancermedicalscience (2023)
Keywords: case report, colorectal cancer, metastasis, parotid gland
MeSH terms: Case Reports

Colorectal cancer commonly metastasises to the liver, peritoneum and lungs. With disseminated disease, it can spread to more unusual sites. Parotid gland metastasis usually originates from head and neck malignancies. We present a case of stage IV sigmoid colon adenocarcinoma with metastases to the left parotid. The patient was a 53-year-old Filipino man diagnosed with stage IV sigmoid adenocarcinoma with liver metastases in June 2021. He underwent laparoscopic sigmoidectomy and received eight cycles of chemotherapy with capecitabine and oxaliplatin with partial response of his liver lesions. Capecitabine monotherapy was then maintained. On September 2022, he experienced persistent left facial pain, with no relief after dental tooth extraction and antibiotics. A computed tomography (CT) scan revealed a 5 × 7 × 6 cm inhomogenous mass in the left parotid with destruction of the mandible. A fine needle biopsy was consistent with a high-grade carcinoma. After multidisciplinary discussions, a repeat core needle biopsy was deemed necessary to proceed with immunohistochemistry. With strong positivity for cytokeratin 20 (CK20), carcinoembryonic antigen, special AT-rich sequence-binding protein 2 and CAM 5.2, and weak positivity for CK7, the parotid mass was diagnosed as metastatic adenocarcinoma from the colon. He then received palliative radiation to the parotid mass for pain control. A gastrostomy tube was also inserted for nutritional support. Treatment with next-line chemotherapy (FOLFIRI regimen) was planned. Unfortunately, he contracted COVID-19 pneumonia and succumbed to respiratory failure. Pursuing the histologic diagnosis of this uncommon area of metastasis was necessary for appropriate treatment planning. Fostering multidisciplinary collaboration throughout the complex aspects of cancer care requires patient advocacy, leadership and effective communication. For our patient, it was essential to coordinate with surgery and pathology to maximise the diagnostic yield of a repeat biopsy while minimising complications and treatment delays.
Decomposition pattern and insect colonization in two cases of suicide by hanging
Authors: Valentina Bugelli, Mirella Gherardi, Martina Focardi, Vilma Pinchi, Stefano Vanin, Carlo Pietro Campobasso
Journal: Forensic Sci Res (2018)
Keywords: forensic science, decomposition, forensic entomology, forensic taphonomy, hanging, postmortem interval

Hanging is one of the most common methods of suicide worldwide. Despite the high incidence, only a little knowledge about the pattern of cadaver colonization by insects on hanging corpse is available. Different types of hanging can alter the body decomposition process as well as the pattern and rate of insect colonization. Two case studies where the hanging occurred with a similar postmortem interval of 34 days are described. The two bodies showed different patterns of insect colonization and decomposition scored using the Total Body Score (TBS) and the TBS for hanging (TBShang). The first case was about the body of a 24-years-old male, with mummification of the unclothed upper anatomical parts. A TBS of 14 and a TBShang of 18 were assigned. The second body, belonging to a 15-years-old male, was found pre-skeletonized lying on the ground with the skull disarticulated. A TBS of 31 and a TBShang of 32 were assigned. Average temperatures of (21.5 ± 2.5) °C for the first body and (25.1 ± 2.7) °C for the second body were recorded in the 34 days preceding the bodies' discovery for a total of 731 and 853 Accumulated Degree Days (ADD) respectively. According to previous studies, the different decomposition patterns were related to temperatures of exposition and to the diversity of arthropod community found on the bodies because of the different types of hanging: totally suspended vs. in contact with the soil. The limited insect activity caused by hanging explains the delay in decomposition of hanging bodies in which mummification can take place, especially on the upper body parts. In vertical body position, the body fluids accumulated in the lower body parts accelerating the desiccation of soft tissues on the upper parts. The effect of gravity can also explain the decrease of internal maggot mass as larvae easily fall from the hanging body to the drip zones below where they are unable to recolonize the body if totally suspended. Furthermore, in a hanging body a greater surface is exposed to wind and sun with a quicker skin drying preventing the additional Diptera colonization. This paper shows the weaknesses of scoring scales and regression models developed to predict ADD when irregular decomposition and mummification have not taken into account.
Case report: Localized xanthogranulomatous pyelonephritis in children: A case report and literature review
Authors: Qi-Fei Deng, Han Chu, Bo Peng, Xiang Liu, Yong-Sheng Cao
Journal: Front Pediatr (2022)
Keywords: diagnosis, partial nephrectomy, pediatric, treatment, xanthogranulomatous pyelonephritis
MeSH terms: Case Reports

Background:
Xanthogranulomatous pyelonephritis (XGPN), which is featured by inflammatory destruction of renal parenchyma and fibrosis of kidney, occurs mainly among adults, sporadically among children and rarely among infants. Recurrent urinary tract infections, kidney stone-induced obstructive nephropathy, malnutrition, abnormal lipid metabolism, hypoimmunity, lymphatic obstruction and congenital urinary abnormalities may all cause XGPN among children. Its primary treatment is radical nephrectomy.
Case description:
In this study, we describe a rare case of XGPN in a 7-year-old boy infected with Staphylococcus aureus (S. aureus). The child presented with symptoms including recurrent fever, urine culture negative. The postoperative pathology confirmed XGPN. Besides, partial nephrectomy was performed.
Conclusion:
XGPN, as a special type of chronic pyelonephritis, is a rare pyelonephritis requiring surgical treatment. Early diagnosis and treatment are crucial to reducing its morbidity and mortality. Although radical nephrectomy is the primary therapeutic option for patients with XGPN, partial nephrectomy surgery should be considered for focal XGPN, aiming to preserve residual renal function in children as far as possible.
FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures overlaying anti-N-methyl-D-aspartate receptor encephalitis: a case report and literature review
Authors: Jia-Xin Yang, Miao-Miao Yang, Yu-Juan Han, Cai-Hong Gao, Jie Cao
Journal: Front Immunol (2023)
Keywords: flair, mog ab-positive cce, anti-n-methyl-d-aspartate receptor encephalitis, demyelinating disease, symptoms
MeSH terms: Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications, Systematic Review, Case Reports, Autoantibodies, Humans, Magnetic Resonance Imaging, Neoplasm Recurrence, Local / complications, Seizures / complications, Autoantibodies

Background:
FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) has been identified increasingly frequently in recent years. However, this rare MOG antibody disease may coexist with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARe), in an overlap syndrome with unknown clinical features and prognosis.
Methods:
We report a new case of this overlap syndrome and present a systematic review of similar cases in the literature to provide information on the clinical presentation, MRI features, EGG abnormalities, treatment, and prognosis of patients with this rare syndrome.
Results:
A total of 12 patients were analyzed in the study. The most common clinical manifestations of FLAMES overlaid with anti-NMDARe were epilepsy (12/12), headache (11/12), and fever (10/12). Increases in intracranial pressure (median: 262.5 mmH2O, range: 150-380 mmH2O), cerebrospinal fluid (CSF) leukocyte count (median: 128×106/L, range: 1-610×106/L), and protein level (median: 0.48 g/L) were also observed. The median CSF anti-NMDAR antibody titer was 1:10 (1:1-1:32), while the median serum MOG antibody titer was 1:32 (1:10-1:1024). Seven cases exhibited unilateral cortical FLAIR hyperintensity, and five cases (42%) had bilateral cortical FLAIR hyperintensity, including four cases involving the bilateral medial frontal lobes. Of the 12 patients, five showed lesions at other sites (e.g., the brainstem, corpus callosum, or frontal orbital gyrus) before or after the development of cortical encephalitis. EEG showed slow waves in four cases, spike-slow waves in two cases, an epileptiform pattern in one case, and normal waves in two cases. The median number of relapses was two. Over a mean follow-up period of 18.5 months, only one patient experienced residual visual impairment, while the remaining 11 patients had good prognoses.
Conclusion:
FLAMES alone is difficult to distinguish from overlap syndrome based on clinical features. However, FLAMES with bilateral medial frontal lobe involvement suggests the presence of the overlap syndrome.
Grisel's syndrome associated with mumps: A case report
Authors: Yanrong Shen, Lixia Yang, Xiaoliang Liu, Yawen Xie, Xiaohui Dai, Chuan Wang
Journal: Front Pediatr (2022)
Keywords: grisel's syndrome, atlanto-axial subluxation, case report, etiology, mumps
MeSH terms: Case Reports

Grisel's syndrome (GS) is defined as atlantoaxial rotatory subluxation/fixation not associated with trauma or bone disease, usually following head and neck infection/inflammation or ear, nose, and throat (ENT) surgery. Many conditions could lead to Grisel's syndrome, of which mumps is rarely to be seen. This report discusses a case of GS in children with Type I atlantoaxial joint subluxation and previously diagnosed mumps. A 6-year-old boy who had cervical pain and torticollis for 2 weeks was admitted to our hospital. There was no trauma and he had not had ENT surgery but was diagnosed with mumps 2 weeks previously due to swelling of the left cheek and cervical lymph node. Physical examination and computed tomography confirmed a diagnosis of Grisel's syndrome with an ADI (atlanto-dens interval) of 1.6 mm. The patient then received occipito-mandibular traction for 6 days and recovered. No recurrence was observed at 1 year follow-up. Physicians should raise awareness of this rare complication of mumps to avoid life-threatening neurological impairments owing to Grisel's syndrome.