OpenMed/multicare-articles huggingface dataset:
A Solitary Choroidal Mass with Spontaneous Resolution
Authors: Fariba Ghassemi, Nazanin Ebrahimiadib, Hamid Riazi-Esfahani, Hassan Khojasteh, Zahra Mahdizad, Elias Khalili Pour
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Background:
To report an atypical case of a transient choroidal mass lesion with spontaneous resolution. Case Presentation. A solitary choroidal mass with an overlying neurosensory retinal detachment was seen in an otherwise healthy 31-year-old female. General physical examinations and serum chemistry were unremarkable. The patient had spontaneous resolution two weeks after initial examination without treatment.
Conclusions:
Inflammatory choroidal masses may be self-limited, but complete diagnostic measures must always be performed in these patients to distinguish between important causes such as tuberculosis, sarcoidosis, and tumors.
The successful use of inhaled nitric oxide in the management of severe hepatopulmonary syndrome after orthotopic liver transplantation
Authors: Joshua Santos, Philip Young, Igor Barjaktarevic, Catherine Lazar, Irawan Susanto, Tisha Wang
Journal: Case Reports Hepatol (2014)

Hepatopulmonary syndrome (HPS) is characterized by pulmonary vasodilation and subsequent hypoxemia in the setting of hepatic dysfunction. There is currently no pharmacologic intervention that has been shown to significantly affect outcomes and liver transplantation remains the mainstay of therapy. Unfortunately, patients undergoing liver transplantation are at high risk of significant hypoxemia and mortality in the early postoperative period. In the following case series, we present two cases of patients with severe HPS who underwent liver transplantation and experienced marked hypoxemia in the early postoperative period. In both cases, we successfully treated the patients with inhaled nitric oxide for their severe refractory life-threatening hypoxemia which led to immediate and dramatic improvements in their oxygenation. Although the use of inhaled nitric oxide in patients with HPS has been sporadically reported in pediatric literature and in animal studies, to our knowledge, our cases are the first recorded in adult patients.
Gastrobronchial Fistula after Robotic Repair of Traumatic Diaphragmatic Hernia
Authors: Jamie T Tung, Leah M Lucero, James W Davis, Lawrence P Sue
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Gastrobronchial fistulas are a rare occurrence in the literature. We report a case of a gastrobronchial fistula after robotic repair of a chronic traumatic diaphragmatic hernia. The patient had severe respiratory symptoms with multiple studies that were inconclusive. The fistula was ultimately discovered after an esophagogastroduodenoscopy (EGD). The patient underwent a left thoracotomy for takedown of his fistula and eventually recovered. Earlier EGD and a lower threshold for differential that included this diagnosis would have led to an earlier identification and treatment of a rare disease process.
Fulminant hepatic failure due to metastatic choroidal melanoma
Authors: Emmanuel Escobar-Valdivia, Roberto Monreal-Robles, Guillermo Delgado-García, Badir Hernández-Velazquez
Journal: Caspian J Intern Med (2017)
Keywords: acute liver failure, choroidal melanoma, fulminant liver failure, melanoma, metastatic melanoma
MeSH terms: Case Reports

Background:
Acute liver failure (ALF) as a consequence of metastatic disease is extremely uncommon. The liver is the most commonly affected organ by metastatic disease, but only a few cases of ALF in the setting of metastatic choroidal melanoma have been reported.
Case presentation:
We describe the case of a 47-year-old man with right upper quadrant pain, progressive jaundice, and unintentional weight loss. He also reported that he had experienced reduced left visual acuity which progressed to blindness over 2 months. On physical examination, we found a pigmented scleral lesion in the left eye. He had a coagulopathy and, during his hospital stay, he also developed encephalopathy. The diagnosis of ALF was therefore established and was later attributed to metastatic uveal melanoma. In addition, we briefly review the relevant literature.
Conclusion:
Liver metastasis should be kept in mind when assessing abnormal liver function tests in patients with uveal malignant melanoma.
Li-Fraumeni-associated pancreatic neuroendocrine tumour and XAF1 p.Glu134Ter risk modifier variant
Authors: Rachel P Riechelmann, Diogo C Soares, Carla Dias, Dirce M Carraro, Giovana T Torrezan
Journal: Ecancermedicalscience (2022)
Keywords: li–fraumeni, neuroendocrine tumour, pancreas neoplasm
MeSH terms: Case Reports

Studies have demonstrated that up to 17% of patients with pancreatic neuroendocrine tumours (pNETs) present pathogenic germline variants (PGVs) in several different genes, irrespective of family cancer history. Li-Fraumeni syndrome (LFS) is an autosomal dominant cancer predisposition syndrome related to PGVs in the TP53 gene. A previous case of a pNET associated with LFS (c.1009C > T, p.R337C) has been reported. Here we report the first case of a patient with pNET and TP53 p.R337H and XAF1 p.E134* germline variants, expanding the knowledge of LFS and germline mutations in neuroendocrine tumours.
Takotsubo cardiomyopathy Afatinib-related in a non-small cell lung cancer patient: Case report
Authors: German E Ramos, Christian Caglevic, Juan F Bulnes, Sergio E Panay, Mario I Zapata, Andrés J Daniele, Manuel E Rodríguez
Journal: Front Cardiovasc Med (2022)
Keywords: afatinib, egfr mutation, nsclc, takotsubo (stress) cardiomyopathy, tyrosine kinase inhibition
MeSH terms: Case Reports

Endothelial Growth Factor Receptor (EGFR) mutations are frequently found among NSCLC patients. Second-generation Tyrosine Kinase Inhibitor (TKI) Afatinib is frequently used in this population of patients achieving better results than cytotoxic chemotherapy in terms of survival and progression. Afatinib-related cardiotoxicity has been rarely reported. Here we comment on a clinical case of a Takotsubo Cardiomyopathy Afatinib-induced in an NSCLC patient.
Novel Constrained Dual Mobility Hip Prosthesis to Combat Instability in Revision Total Hip Arthroplasty whilst Preserving Normal Function
Authors: Michael Jiang, Anton Lambers, Rodney Richardson
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

We present the case of a male patient with sepsis and a chronic discharging sinus in a multirevised total hip replacement. Following extensive debridement, the reimplanted hip became unstable. With the patient's long-term desire to return to work and ride a bicycle with his children, the patient agreed to proceed with a novel, custom-designed, constrained dual mobility liner which allowed unrestricted movement. In 2017, the patient underwent revision surgery with this novel dual mobility constrained prosthesis. The patient was very quickly able to regain independence. After 16 years of unemployment, he managed to return to gainful employment as a cleaner rapidly regaining function as well as finally being able to ride a bike with his children for the first time.
Case Report: Differential lung ventilation with jet ventilation via a bronchial blocker for a patient with a large thoracogastric airway fistula after esophagectomy
Authors: Wenqi Wu, Sibei Li, Xiuling Song, Xia Wang, Yong Wang, Chengyi Cai, Jiyong Wang, Yuhui Li, Wuhua Ma
Journal: Front Surg (2022)
Keywords: airway management, bronchial blocker, case report, single lumen endotracheal tube, thoracogastric airway fistula
MeSH terms: Case Reports

Background:
A thoracogastric airway fistula (TGAF) is a rare and potentially fatal complication of esophagectomy for esophageal and cardia carcinomas. Isolation of the fistula and pulmonary separation is necessary during the surgical repair of a tracheal fistula. However, currently, the reported airway management techniques are not suitable for patients with a large TGAF. This case study presents an alternative technique for performing differential lung ventilation in a patient with a thoracogastric airway fistula.
Case presentation:
A 70-year-old man was diagnosed with a thoracogastric airway fistula situated above the carina after esophagectomy, and a thoracoscope-assisted repair of the fistula and pectoralis major myocutaneous flap transplantation were scheduled. The patient could not tolerate one-lung ventilation and the complex intubating operation due to aspiration pneumonia and the size (3.5 cm × 1.7 cm) of the fistula. We, therefore, performed differential lung ventilation in which an extended 6.5#single-lumen endotracheal tube was inserted into the left main bronchus and a 9Fr bronchial blocker was placed in the right main bronchus by using the video-flexible intubation scope. The right lung was selectively inflated with jet ventilation, while positive pressure ventilation was maintained through the left endotracheal tube. The value of SPO2 remained above 95% throughout the operation.
Conclusion:
For patients with a large thoracogastric airway fistula, differential lung ventilation of a combination of positive pressure ventilation and jet ventilation is useful. Inserting an extended single-lumen endotracheal tube into the left main bronchus and a bronchial blocker into the right main bronchus could be another way of providing differential ventilation for patients with a large thoracogastric airway fistula.
Calmodulin 2 Mutation N98S Is Associated with Unexplained Cardiac Arrest in Infants Due to Low Clinical Penetrance Electrical Disorders
Authors: Juan Jiménez-Jáimez, Julián Palomino Doza, Ángeles Ortega, Rosa Macías-Ruiz, Francesca Perin, M Mar Rodríguez-Vázquez del Rey, Martín Ortiz-Genga, Lorenzo Monserrat, Roberto Barriales-Villa, Enrique Blanca, Miguel Álvarez, Luis Tercedor
Journal: PLoS One (2016)
MeSH terms: Brugada Syndrome / genetics, Calmodulin / genetics, Heart Arrest / etiology, Long QT Syndrome / genetics, Mutation / genetics, Tachycardia, Ventricular / genetics, Case Reports, Brugada Syndrome / complications, Cardiac Conduction System Disease, Child, Child, Preschool, Electrocardiography, Female, Genetic Predisposition to Disease, Heart Arrest / pathology, Humans, Infant, Long QT Syndrome / complications, Male, Pedigree, Penetrance, Phenotype, Tachycardia, Ventricular / complications, CALM2 protein, human, Calmodulin, Polymorphic catecholergic ventricular tachycardia

Background:
Calmodulin 1, 2 and 3 (CALM) mutations have been found to cause cardiac arrest in children at a very early age. The underlying aetiology described is long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT) and idiopathic ventricular fibrillation (IVF). Little phenotypical data about CALM2 mutations is available.
Objectives:
The aim of this paper is to describe the clinical manifestations of the Asn98Ser mutation in CALM2 in two unrelated children in southern Spain with apparently unexplained cardiac arrest/death.
Methods:
Two unrelated children aged 4 and 7, who were born to healthy parents, were studied. Both presented with sudden cardiac arrest. The first was resuscitated after a VF episode, and the second died suddenly. In both cases the baseline QTc interval was within normal limits. Peripheral blood DNA was available to perform targeted gene sequencing.
Results:
The surviving 4-year-old girl had a positive epinephrine test for LQTS, and polymorphic ventricular ectopic beats were seen on a previous 24-hour Holter recording from the deceased 7-year-old boy, suggestive of a possible underlying CPVT phenotype. A p.Asn98Ser mutation in CALM2 was detected in both cases. This affected a highly conserved across species residue, and the location in the protein was adjacent to critical calcium binding loops in the calmodulin carboxyl-terminal domain, predicting a high pathogenic effect.
Conclusions:
Human calmodulin 2 mutation p.Asn98Ser is associated with sudden cardiac death in childhood with a variable clinical penetrance. Our results provide new phenotypical information about clinical behaviour of this mutation.
Cognitive fluctuations in Parkinson's disease dementia: blood pressure lability as an underlying mechanism
Authors: David E Riley, Alberto J Espay
Journal: J Clin Mov Disord (2018)
Keywords: cognitive fluctuations, dementia with lewy bodies, dysautonomia, orthostatic hypotension, parkinson’s disease dementia
MeSH terms: Case Reports

Background:
Cognitive fluctuations refer to alterations in cognition, attention, or arousal occurring over minutes to hours, most commonly in patients with dementias associated with advanced Lewy body pathology. Their pathophysiologic underpinning remains undetermined.
Case presentation:
We documented serial blood pressure (BP) measurements in an 86-year-old man with Parkinson's disease dementia experiencing cognitive fluctuations during an office visit. This patient's associated dysautonomia included labile BP with orthostatic hypotension and nocturnal hypertension. A spontaneous episode of unresponsiveness occurred while his BP was 72/48. His mental status began to recover immediately as his BP increased to 84/56 when he was placed in a recumbent position; it fully returned to baseline when it reached 124/66 within 1 min. His heart rate remained in the mid-to-high 60s throughout. Subsequent treatment with midodrine markedly reduced the frequency of cognitive fluctuations.
Conclusions:
Paroxysmal hypotension may represent an explanatory mechanism for cognitive fluctuations, a common clinical feature in patients with Parkinson's disease dementia and dementia with Lewy bodies.
Possible SARS coronavirus transmission during cardiopulmonary resuscitation
Authors: Michael D Christian, Mona Loutfy, L Clifford McDonald, Kennth F Martinez, Mariana Ofner, Tom Wong, Tamara Wallington, Wayne L Gold, Barbara Mederski, Karen Green, Donald E Low, SARS Investigation Team
Journal: Emerg Infect Dis (2004)
MeSH terms: Cardiopulmonary Resuscitation / adverse effects, Severe Acute Respiratory Syndrome / transmission, Case Reports, Aerosols, Aged, Air Microbiology, Female, Humans, Infectious Disease Transmission, Patient-to-Professional, Ontario / epidemiology, Personnel, Hospital, Protective Devices / standards, Quality Control, Severe Acute Respiratory Syndrome / epidemiology, Severe Acute Respiratory Syndrome / prevention & control, Aerosols

Infection of healthcare workers with the severe acute respiratory syndrome-associated coronavirus (SARS-CoV) is thought to occur primarily by either contact or large respiratory droplet transmission. However, infrequent healthcare worker infections occurred despite the use of contact and droplet precautions, particularly during certain aerosol-generating medical procedures. We investigated a possible cluster of SARS-CoV infections in healthcare workers who used contact and droplet precautions during attempted cardiopulmonary resuscitation of a SARS patient. Unlike previously reported instances of transmission during aerosol-generating procedures, the index case-patient was unresponsive, and the intubation procedure was performed quickly and without difficulty. However, before intubation, the patient was ventilated with a bag-valve-mask that may have contributed to aerosolization of SARS-CoV. On the basis of the results of this investigation and previous reports of SARS transmission during aerosol-generating procedures, a systematic approach to the problem is outlined, including the use of the following: 1) administrative controls, 2) environmental engineering controls, 3) personal protective equipment, and 4) quality control.
Veno-Arterial Extracorporeal Membrane Oxygenation for Septic Cardiomyopathy due to Legionella Pneumonia after Influenza Virus Infection
Authors: Motohiro Asaki, Takamitsu Masuda, Yasuo Miki
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

A 57-year-old man presented to the emergency department with fever and progressive altered level of consciousness of 5 days' duration. Three days before admission, influenza A was diagnosed at a clinic. On admission, his vital signs were unstable. Pneumonia was diagnosed through chest computed tomography, and urinary Legionella antigen test was positive. A diagnosis of septic shock due to Legionella and influenza pneumonia was made, and critical care management was initiated, including mechanical ventilation and vasopressors. However, tachycardia did not improve, left ventricular ejection fraction was 20%, and circulatory insufficiency progressed. Therefore, considering the involvement of septic cardiomyopathy and cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated for circulation assistance on day 3 since admission. Tachycardia and myocardial dysfunction improved by day 8, and VA-ECMO was withdrawn. Subsequently, nutrition management and rehabilitation were performed, and the patient was transferred to a recovery hospital on day 108. VA-ECMO may be beneficial when concomitant with circulatory assistance in uncontrollable cases of septic cardiomyopathy using catecholamines and β-blockers. It may be necessary to adopt VA-ECMO at an appropriate time before the patient progresses to cardiopulmonary arrest.
Vitiligo in a Patient With Kabuki Syndrome: Case Study and Review of the Literature
Authors: Karli Gage, Amanda S Weissman, Jeffrey McBride
Journal: Cureus (2023)
Keywords: autoimmune disease, child, genetic diseases, janus kinase inhibitors, vitiligo
MeSH terms: Case Reports

Kabuki Syndrome (KS) is a rare genetic disorder characterized by dysmorphic facial features, skeletal anomalies, dermatoglyphic abnormalities, intellectual disability, and short stature. Autoimmune disease can be seen more frequently in this patient population. Vitiligo is an autoimmune disease that is uncommonly reported in patients with KS. This report describes a case of vitiligo manifesting in a patient with KS and discusses the use of Janus kinase inhibitors as treatment.
Pancreatic cancer presenting with paraneoplastic thrombophlebitis--case report
Authors: Camelia Diaconu, Delia Mateescu, Alice Bălăceanu, Mădălina Marcu, Valeria Jianu, Adriana Stănică
Journal: J Med Life (2010)
MeSH terms: Pancreatic Neoplasms / drug therapy, Paraneoplastic Syndromes / etiology, Thrombophlebitis / etiology, Case Reports, Deoxycytidine / administration & dosage, Deoxycytidine / analogs & derivatives, ErbB Receptors / antagonists & inhibitors, Erlotinib Hydrochloride, Female, Gemcitabine, Humans, Liver Neoplasms / secondary, Middle Aged, Pancreatic Neoplasms / complications, Pancreatic Neoplasms / pathology, Quinazolines / administration & dosage, Quinazolines, Deoxycytidine, Erlotinib Hydrochloride, ErbB Receptors, Gemcitabine

Context:
The complex of symptoms in pancreatic cancer is vague, which often delays presentation and diagnosis. Thrombophlebitis is an unusual presentation of pancreatic cancer, which appears more frequent in the cancer of the body and tail of the pancreas.
Case report:
We present a case of a 52-years-old woman who was admitted to the hospital for a superficial thrombophlebitis. At the abdomen ultrasound screening, multiple liver masses, relatively well defined, with a hypo-echoic center and a hyper-echoic periphery, were identified. The head of the pancreas was normal, the body and the tail could not be seen very well due to flatulence. After computed tomography, the diagnosis was "Pancreatic tumor with multiple hepatic metastases (stage IV)". After the histopathological examination, 1250 mg/m2 of Gemcitabine was started on day 1 and 8 every 28 days, plus 100 mg/day of Erlotinib (Tarceva), every day. At the end of the seventh month of treatment, the patient suffered an irreversible ischemic cardiac event.
Conclusion:
Superficial thrombophlebitis can be the initial manifestation of the pancreatic cancer. Gemcitabine and erlotinib is now a FDA approved regimen for patients with metastatic pancreatic cancer. While the search for the best gemcitabine based backbone for advanced pancreatic cancer continues, studies of anti-angiogenic agents alone or in combination with traditional chemotherapy, should be undertaken, as they may improve overall survival in this group of poor prognosis patients.
Case Report: Bocavirus Infection Radiologically Resembling a Congestive Heart Failure in a Patient with Metastatic Castration-Resistant Prostate Cancer
Authors: Javier David Benitez Fuentes, Alicia de Luna Aguilar, Paloma Flores Navarro, Alfonso Lopez de Sa Lorenzo, Carmen Toledano Rojas, Berta Laguna Fonseca, Richa Shah, Clara Frick, Alejandro Francisco Jimenez Ortega, Tania Rocha Iñigo, Natalia Vidal Cassinello
Journal: F1000Res (2022)
Keywords: bocavirus, case report, emerging communicable diseases, immunocompromised host, prostate cancer, respiratory tract infection
MeSH terms: Heart Failure / diagnostic imaging, Human bocavirus, Parvoviridae Infections / complications, Parvoviridae Infections / diagnosis, Parvoviridae Infections / epidemiology, Prostatic Neoplasms, Castration-Resistant, Case Reports, Anti-Bacterial Agents, Child, Humans, Male, Middle Aged, Anti-Bacterial Agents

Background: Human bocavirus (HBoV) is a viral pathogen from the genus Bocaparvovirus (family Parvoviridae, subfamily Parvovirinae) discovered in 2005. Most of available literature is about HBoV in children and adults with hematological malignancies and in otherwise healthy children with respiratory infections. Information regarding infection in the adult population with solid tumors is scarce. Case Report: We report the case of a 51-year-old male with metastatic castration resistant prostate cancer undergoing chemotherapy treatment who presented with fever, dyspnea, dry cough, and pleuritic pain. Imaging techniques showed signs of congestive heart failure. Symptoms, laboratory tests and echocardiography revealed a more probable infectious etiology. Antibiotic therapy was started. A polymerase chain reaction (PCR) test of nasopharyngeal exudate for respiratory viruses was positive for HBoV. The rest of the microbiological tests were negative. Bronchoalveolar lavage (BAL) was performed. Bacterial culture of BAL was negative while respiratory virus PCR confirmed positivity for HBoV. Antibiotic therapy was discontinued. The patient gradually recovered. Conclusions: Emerging infectious diseases are a notorious threat for immunocompromised populations such as solid tumor patients. This case is unique because to our knowledge this is the first case report article of HBoV in a solid tumor patient and because imaging techniques exhibited signs of congestive heart failure that did not correlate with the rest of the tests. It shows that unusual pathogens should be considered when managing serious clinical complications with uncommon presentations in cancer patients. Notable diagnostic efforts should be made to reach a diagnosis in these cases.