OpenMed/multicare-articles huggingface dataset:
Not all anosmia and fever was COVID-19 infection: a case report
Authors: Niamien Patrice Koffi, Cherif El Asri Abad, Gazzaz Miloud, El Mostarchid Brahim
Journal: Pan Afr Med J (2020)
Keywords: anosmia, covid-19, case report, fever, fronto-ethmoid meningioma
MeSH terms: Anosmia / etiology, COVID-19 / diagnosis, Meningeal Neoplasms / diagnostic imaging, Meningioma / diagnostic imaging, Case Reports, Adult, Cough / etiology, Fever / etiology, Headache / etiology, Humans, Magnetic Resonance Imaging, Male, Meningeal Neoplasms / complications, Meningeal Neoplasms / surgery, Meningioma / complications, Meningioma / surgery, Morocco, Polymerase Chain Reaction, Tomography, X-Ray Computed

COVID-19 pandemic touch all part of world to the date more than fifteen millions of patients are infected by virus including about 1,388,926 deaths (European Centre for Disease Prevention and Control an agency of the European Union). Morocco has put in place strict containment measures to control the disease and prevent the saturation of health systems. One of the great difficulties is to quickly identify asymptomatic and paucisymptomatic cases which function as an important vector of contagion. Anosmia and fever are one of revealed mode for the young patient but is not all the case. We report one case in the sense. A 40-year-old man without medical history was admitted in the hospital after complaining 3 days ago clinical symptoms of fever, cough, headache and anosmia. Immediately, the patient benefits of COVID-19 protocol, measure of fever, nasal swab and polymerase chain reaction (PCR) test. Despite the negativity of PCR test of COVID-19, the patient was placed in isolation. Two days later, he presented a generalized seizures, then we performed a cerebral computed tomography scan (CT scan) which showed a bilateral frontal oedema. The cerebral magnetic resonance imaging (MRI) revealed the presence of 4x4x4 cm well enhanced meningeal extra axial mass of the anterior skull base with peri-tumoral oedema corresponding to an olfactory groove meningioma. The tumour was totally resected through a left fronto-lateral approach. The postoperative courses were uneventful with the persistence of totally anosmia.
Thoracic Compressive Myelopathy in a Patient With Takayasu Arteritis
Authors: Nandyal Chandrasekar, Manikandan Thandapani, Ramachandran Govindasamy, Satish Rudrappa, Balaji Vaithialingam
Journal: Cureus (2023)
Keywords: compressive myelopathy, decompressive laminectomy, immunotherapy, spastic paraplegia, takayasu arteritis
MeSH terms: Case Reports

Takayasu arteritis (TA), also known as occlusive thromboaortopathy, is a type of chronic inflammatory arteritis that primarily affects large vessels. Compressive thoracic myelopathy is a rare and distinct manifestation of TA. We present the case of a 60-year-old woman who developed gradually progressive spastic paraplegia over one year. Magnetic resonance imaging revealed a well-defined extra-dual, intensely enhancing ventrodorsal lesion with severe spinal cord impingement. The aortogram revealed dilatation of the aortic arch (with narrowing of arch vessels) and descending aorta, as well as a right paravertebral soft tissue mass at the D4 level. Given the likelihood of TA, the patient underwent decompressive laminectomy and spinal fusion due to severe spinal cord compression. The biopsy of the dural-based lesion revealed an inflammatory granuloma, and the patient was treated postoperatively with oral prednisolone and mycophenolate mofetil. After six months of immunotherapy, there was excellent neurological recovery and near-total resolution of the lesion.
Trifurcated Mental Foramina: A Cone-Beam Computed Tomography Incidental Finding During the Implant Treatment Planning
Authors: Rutvi Vyas, Anita Gohel
Journal: Cureus (2023)
Keywords: anatomical variation, anatomy, cone beam computed tomography – cbct, incidental finding, mental foramen
MeSH terms: Case Reports

The mental foramen is a known skull anatomical structure located bilaterally on the mandible along the buccal cortical plate. It is located approximately between the roots of premolars in the anteroposterior dimension, and its supero-inferior level on the alveolar height varies in every individual. The position of the mental foramen is very crucial when surgical interventions are planned in the area. An accessory mental foramina can be very well detected in the three-dimensional (3D) imaging modality, especially in 3D volume rendering images. It can still be appreciated in two-dimensional (2D) imaging modalities such as a panoramic; however, at times it can be confused with periapical pathology, especially in cases where caries are present in the teeth. Three-dimensional imaging modality plays a critical role in identifying such anatomical variation, and hence, it is important to evaluate any surgical site in three dimensions prior to surgical intervention.
Idiopathic fibrosing mediastinitis
Authors: F D Manyeruke, R Perumal, G Symons, L Mottay
Journal: Afr J Thorac Crit Care Med (2021)
Keywords: fibrosing mediastinitis, haemoptysis, idiopathic fibrosing mediastinitis
MeSH terms: Case Reports

Fibrosing mediastinitis is rare in settings where histoplasmosis is not endemic. An idiopathic form of the disease may present with indistinguishable features and requires methodical exclusion of competing differential diagnoses. We report the case of a 30-year old female patient who presented with intermittent haemoptysis for the past 2 years with no constitutional symptoms. Computed tomography of the chest revealed a prominent right bronchial arterial circulation with a mass-like lesion, which encased and attenuated the right pulmonary trunk and adjacent structures. Endobronchial ultrasonography with transbronchial fine-needle aspiration showed a paucicellular aspirate with no evidence of malignancy or granulomas. Fungal infection, tuberculosis, sarcoidosis, IgG4-disease, and connective tissue disease were ruled out by appropriate serological, molecular, and microbiological tests. A diagnosis of idiopathic fibrosing mediastinitis was therefore made by exclusion and the patient was successfully treated with oral corticosteroids.
Canagliflozin on top of dual renin-angiotensin system blockade in a woman with partial acquired lipodystrophy, type 2 diabetes and severely proteinuric chronic kidney disease: a case report
Authors: Edoardo Biancalana, Giovanni Ceccarini, Silvia Magno, Valerio Ortenzi, Domenico Giannese, Ferruccio Santini, Anna Solini
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: canagliflozin, case report, dual renin-angiotensin system blockade, lipodystrophy, metreleptin, proteinuria
MeSH terms: Diabetes Mellitus, Type 2 / complications, Diabetes Mellitus, Type 2 / drug therapy, Lipodystrophy / drug therapy, Renal Insufficiency, Chronic / complications, Renal Insufficiency, Chronic / drug therapy, Sodium-Glucose Transporter 2 Inhibitors / therapeutic use, Case Reports, Adult, Canagliflozin / therapeutic use, Female, Humans, Proteinuria / complications, Proteinuria / etiology, Renin-Angiotensin System, Canagliflozin, Sodium-Glucose Transporter 2 Inhibitors

Sodium glucose cotransporter 2 inhibitors have proven strong efficacy in reducing end-stage renal disease in patients with type 2 diabetes. We are presenting here the case of a 40-year-old woman with acquired partial lipodystrophy, type 2 diabetes and essential hypertension complicated by chronic kidney disease and proteinuria in the nephrotic range. She first came to our attention in 2012; estimated glomerular filtration rate (eGFR) was 41.5 ml/min/1.73 m2 and total proteinuria was 375 mg/24h; she was treated with dual renin angiotensin system blocking. Proteinuria significantly increased during the following years, reaching a nephrotic range (>5 g/day). A kidney biopsy revealed a tubule-interstitial involvement compatible with type 2 diabetes. Leptin replacement therapy, started in 2018, improved glycaemic control and lipid profile, also determining a reduction in insulin total daily dose. In 2019, after the publication of the CREDENCE study, canagliflozin was started on top of losartan and ramipril. After an initial, expected eGFR drop, kidney function stabilized, and albuminuria significantly reduced (from 4120 to 984 mg/24h), while serum potassium showed only minimal increase. At last follow-up (2022) total proteinuria was still reducing (510 mg/24h), while kidney function was substantially unchanged (eGFR 40 ml/min/1.73 m2). This case report suggests that, despite not recommended in international guidelines, the use of SGLT2i in combination with dual renin angiotensin system blockade should be considered in specific conditions and under close clinical monitoring.
A Rare Ultra-Long-Term Complication of Occluder Recanalization Due to Spontaneous Perforation of Polyvinyl Alcohol Membrane of Atrial Septal Defect Occluder: A Case Report and Review of the Literature
Authors: Kun Xiang, Huanwei Zhuang, Qin Wu, Mi Tang, Jinfu Yang, Chengming Fan
Journal: Front Cardiovasc Med (2022)
Keywords: atrial septal defect, closure, occluder recanalization, surgery, ultra-long-term complication
MeSH terms: Case Reports

Percutaneous closure of atrial septal defect (ASD) has emerged as a feasible alternative strategy to surgical repair in many cardiac centers worldwide. Occluder recanalization due to device failure is a rare and severe complication that often occurs within weeks to years after ASD closure. We reported a rare ultra-long-term complication of occluder recanalization due to delayed spontaneous perforation of polyvinyl alcohol (PVA) membrane of ASD occluder after 18 years of ASD closure. Surgical removal of the faulty device and reconstruction of the atrial septum with a bovine pericardial patch was performed. The patient was discharged and recovered uneventfully without syncope or residual shunt. The cause of this rare complication of spontaneous PVA membrane perforation of the occluder has not been fully detected. To our knowledge, this is the first report about PVA membrane perforation of an occluder that occurred soon after ASD closure.
The many faces of trichotillomania
Authors: Preeti Parakh, Mona Srivastava
Journal: Int J Trichology (2010)
Keywords: trichotillomania, hair-loss, hair-pulling, obsessive-compulsive spectrum disorders
MeSH terms: Case Reports

Trichotillomania is a poorly understood complex disorder of multifaceted pathology which often requires an interdisciplinary approach for management. While sharing similarities with obsessive-compulsive disorder, compelling differences between these have also been noted. We present three cases of trichotillomania highlighting the remarkable variability seen in the presentation of this disorder. In doing so, we discuss on resolving the classificatory issues and call for a consensus on the understanding of the disorder.
Case Report: Trans-axillary Artery Access for Rescue Stent Implantation in an Infant With Retrograde Non-passable Aortic Coarctation
Authors: Julia Moosmann, Ariawan Purbojo, Susanne Eder, Sven Dittrich
Journal: Front Pediatr (2021)
Keywords: axillary artery access, coarctation of aorta, congenital heart defect, stent implantation, vascular access
MeSH terms: Case Reports

Primary surgical repair remains the traditional treatment for patients with critical duct-dependent coarctation of the aorta (CoA). Initial surgical repair might not be possible or associated with higher risks if additional comorbidities arise in small infants and neonates. Balloon angioplasty (BA) has been described as a rescue strategy for these children. We describe the feasibility of a palliative BA and rescue stent implantation via an alternative antegrade right-axillary artery approach in an initially inoperable infant with pneumonia and respiratory failure and severe CoA, where the stenosis was not passable by traditional retrograde femoral access. This case adds new aspects to the therapy of critical CoA: Stent implantation provides a bridge to surgery in critically ill infants and does not preclude successful surgical repair. Further, if the classic retrograde approach is not possible, the right axillary artery access should be considered as an alternative to pass the stenosis.
Case discussions of missed traumatic fractures on computed tomography scans
Authors: Amy J Spies, Maryna Steyn, Desiré Brits, Daniel N Prince
Journal: SA J Radiol (2022)
Keywords: diagnostic errors, emergency department, fracture misdiagnoses, radiology, traumatic fractures
MeSH terms: Case Reports

Radiological diagnostic errors are common and may have severe consequences. Understanding these errors and their possible causes is crucial for optimising patient care and improving radiological training. Recent postmortem studies using an animal model highlighted the difficulties associated with accurate fracture diagnosis using radiological imaging. The present study aimed to highlight the fact that certain fractures are easily missed on CT scans in a clinical setting and that caution is advised. A few such cases were discussed to raise the level of suspicion to prevent similar diagnostic errors in future cases. Records of adult patients from the radiological department at an academic hospital in South Africa were retrospectively reviewed. Case studies were selected by identifying records of patients between January and June 2021 where traumatic fractures were missed during initial imaging interpretation but later detected during secondary analysis or on follow-up scans. Seven cases were identified, and the possible causes of the diagnostic errors were evaluated by reviewing the history of each case, level of experience of each reporting radiologist, scan quality and time of day that initial imaging interpretation of each scan was performed. The causes were multifactorial, potentially including a lack of experience, fatigue, heavy workloads or inadequate training of the initial reporting radiologist. Identifying these causes, openly discussing them and providing additional training for radiologists may aid in reducing these errors.
Contribution:
This article aimed to use case examples of missed injuries on CT scanning of patients in a South African emergency trauma setting in order to highlight and provide insight into common errors in scan interpretation, their causes and possible means of mitigating them.
Histological diagnosis of madura foot (mycetoma): a must for definitive treatment
Authors: Kiran Alam, Veena Maheshwari, Shruti Bhargava, Anshu Jain, Uroos Fatima, Ershad Ul Haq
Journal: J Glob Infect Dis (2009)
Keywords: actinomycetoma, eumycetoma, madura foot
MeSH terms: Case Reports

Mycetoma, an uncommon chronic infection of skin and subcutaneous tissues in tropical countries is caused by true fungi (eumycetoma) or by filamentous bacteria (actinomycetoma). Since the treatment of these two etiologies is entirely different, a definite diagnosis after histopathological and microbiological examination is mandatory. We hereby present five cases of Madura foot.
Sigmoid Volvulus Complicating Postpartum Period
Authors: Kelsey E Ward, Erin Blake, Eduardo Gonzalez, Frederic Pieracci, Meredith Alston
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Background. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. Case. A 19-year-old patient, gravida 1 para 0 at 41 0/7 weeks of gestation, admitted for late-term induction of labor underwent an uncomplicated primary low transverse cesarean delivery for arrest of descent. Her postoperative period was complicated by sudden onset of abdominal pain and the ultimate diagnosis of sigmoid volvulus. Conclusion. Prompt surgical evaluation of an acute abdomen in the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality.
Occult Thyroid Carcinoma without Malignant Thyroid Gland Findings during Preoperative Examination: Report of Three Cases
Authors: Soji Toda, Hiroyuki Iwasaki, Nobuyasu Suganuma, Yoichiro Okubo, Hiroyuki Hayashi, Katsuhiko Masudo, Hirotaka Nakayama, Munetaka Masuda
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Occult thyroid carcinoma preceded by clinical manifestations and findings from extrathyroidal tumors is rare. The lack of malignant findings in the thyroid during the preoperative examination makes diagnosis difficult. We encountered a 71-year-old man with a primary ectopic thyroid carcinoma causing superior vena cava syndrome. Although no malignant findings were found in the thyroid gland, biopsy of bone metastases led to the diagnosis of thyroid cancer. HE staining of bone metastases revealed nuclear features of papillary carcinoma, and immunostaining was positive for thyroglobulin and PAX-8. The second case involved an 84-year-old man with a mediastinal tumor and suspected thyroid cancer because of high thyroglobulin levels in blood. The pathological tumor finding was papillary thyroid cancer. The last case was that of a 56-year-old woman lacking preoperative thyroid examination malignant findings, but with cervical lymph node metastasis. The thyroglobulin level of the lymph node puncture fluid was useful for preoperative diagnosis. We performed total thyroidectomy plus bilateral modified neck dissection. Pathology revealed a 1 mm papillary carcinoma in the left lobe. All of these cases were difficult to diagnose. However, we combined the results of various tests such as radiographic imaging, blood tests, and immunohistological tests to diagnose our patients.
Undiagnosed Chronic Granulomatous Disease, Burkholderia cepacia complex Pneumonia, and Acquired Hemophagocytic Lymphohistiocytosis: A Deadly Association
Authors: Maxime Maignan, Colin Verdant, Guillaume F Bouvet, Michael Van Spall, Yves Berthiaume
Journal: Case Rep Pulmonol (2013)

Background. Chronic granulomatous disease is a rare inherited disorder of the phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. The clinical course of the disease is marked by recurrent infections, including Burkholderia cepacia complex infection. Case Report. Here we report the case of a 21-year-old male hospitalized for a Burkholderia cepacia complex pneumonia. Despite the broad spectrum antibiotic treatment, fever continued and patient's condition worsened. Anemia and thrombocytopenia developed together with hypofibrinogenemia. The patient died of multiple organ dysfunction 17 days after his admission. Autopsy revealed hemophagocytosis, suggesting the diagnosis of acquired hemophagocytic lymphohistiocytosis. DNA analysis showed a deletion in the p47phox gene, confirming the diagnosis of autosomal recessive chronic granulomatous disease. Discussion. In addition to chronic granulomatous disease, recent findings have demonstrated that Burkholderia cepacia complex can decrease activity of the NADPH oxidase. Interestingly, hemophagocytic lymphohistiocytosis is characterized by an impaired function of the T-cell mediated inflammation which is partly regulated by the NADPH oxidase. Physicians should therefore pay particular attention to this deadly association.
Foramen of Winslow hernia years after a Ladd's procedure: A case report
Authors: Shadi Abu-Swis, Nir Cohen, Nadav Wallach, Adam Abo-Sharb, Gilbert Sebbag, Waleed Kian
Journal: Int J Surg Case Rep (2020)
Keywords: case report, foramen of winslow hernia, internal hernia, ladd”s procedure
MeSH terms: Case Reports

Foramen of Winslow hernias form 8% of all internal hernias. They present with non-specific findings and are often diagnosed late in disease progression. Delayed diagnosis of the hernia is associated with an estimated mortality of 50%. This rare event has yet to be described in the literature as a follow-up complication to a Ladd's procedure. Here, we present a young male patient with a surgical history of a Ladd's procedure with a chief complaint of an acute-onset, severe abdominal pain accompanied by episodes of emesis. Prompt clinical analysis, imaging and fluid resuscitation was conducted. A computed tomography (CT) scan showed a mesenteroaxial gastric volvulus and air was identified within the Falciform Ligament. Consequently, the patient underwent an exploratory laparotomy and the foramen of Winslow hernia was identified. An excision and anastomosis procedure was performed, and the cecum was fixed in the lower left quadrant. The procedure had no complications and the patient was discharged from the hospital on the fifth post-operative day. The purpose of this case report is to present an unusual patient who experienced a foramen of Winslow hernia involving the small bowel six years following a Ladd's procedure. While a causative relation cannot be made between these two events, we theorize that gastrointestinal hypermobility, being one of the three properties leading to herniation, played a role in both pathologies. Therefore, a vigilant surgeon should keep in mind that intra-abdominal congenital malrotation can put patients at greater risk for future herniation.
Novel compound heterozygous ASXL3 mutation causing Bainbridge-ropers like syndrome and primary IGF1 deficiency
Authors: Dinesh Giri, Daniel Rigden, Mohammed Didi, Matthew Peak, Paul McNamara, Senthil Senniappan
Journal: Int J Pediatr Endocrinol (2017)
Keywords: asxl3, bainbridge-ropers syndrome, igf-1 deficiency
MeSH terms: Case Reports

Background:
De novo truncating and splicing mutations in the additional sex combs-like 3 (ASXL3) gene have been implicated in the development of Bainbridge-Ropers syndrome (BRPS) characterised by severe developmental delay, feeding problems, short stature and characteristic facial features.
Case presentation:
We describe, for the first time, a patient with severe short stature, learning difficulties, feeding difficulties and dysmorphic features with a novel compound heterozygous mutation in ASXL3.Additionally the patient also has primary insulin like growth factor-1 (IGF1) deficiency. The mutations occur in exon 11 and proximal part of exon 12 and are strongly conserved at the protein level across various species. In-silico analyses using PolyPhen-2 and SIFT predict the amino acid substitutions to be potentially deleterious to the protein function. Detailed bioinformatics analysis show that the molecular defects caused by the two compound heterozygous mutations synergistically impact on two points of the molecular interaction network of ASXL3.
Conclusion:
We hypothesise that ASXL3 potentially has a role in transcriptional activation of IGF1 involved in signalling pathways that regulate cell proliferation and growth, which could be contributing to short stature encountered in these patients.
Vitiligo after diphencyprone for alopecia areata
Authors: Mario Cezar Pires, João Mauricio Martins, F Montealegre, Flávia Romero Gatti
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

The topical immunotherapy is used to treat alopecia areata and recalcitrant warts since the 1970s. Diphencyprone is a contact sensitizer used to treat dermatological conditions resulting from as altered immunological state, such as extensive alopecia areata, being partially effective and safe. Side effects include local eczema with blistering, regional lymphadenopathy and contact urticaria. Rare adverse effects include an erythema multiforme-like reaction, hyperpigmenttion, hypopigmentation, and vitiligo. We report a 30-year-old, Brazilian male who developed vitiligo lesions following DPCP therapy for alopecia areata.