OpenMed/multicare-articles huggingface dataset:
Conservative Management of Large Rectosigmoid Perforation under Peritoneal Reflection: Case Report and Review of the Literature
Authors: G G Akgul, E Yenidogan, Z Ozsoy, I Okan, H A Kayaoglu, S Tali, M Sahin
Journal: Case Rep Surg (2015)

Colonoscopy is accepted as the best method in diagnosis, treatment, and follow-up of colorectal diseases. As the amount of the usage of diagnostic and therapeutic colonoscopy rises, iatrogenic complications are more likely to be seen. The most important complications are perforations and bleeding. Whereas perforation is a complication that is seen rarely, because of the high ratio of morbidity and mortality, it should be analyzed more carefully. There is not a common view on the optimal treatment of colonoscopic perforation. Most cases require urgent surgery, and in some cases the iatrogenic perforation of colon can be managed by conservative methods. In this report, we present a rectosigmoid perforation under peritoneal reflection and conservative management of this case.
Cervicothoracic intradural arachnoid cyst misdiagnosed as motor neuron disease
Authors: P G Sämann, H Himmerich, T Merl, C Erös, M B Müller, J C Tonn, B Buchwald
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Recognizing syndromes which mimic ALS is crucial both to avoid giving this diagnosis erroneously and since there may be appropriate treatments. We report a 63-year-old woman diagnosed with possible ALS five years ago based on upper and lower motor neuron signs with typical electrophysiology and normal cranial MRI. At reassessment, spinal MRI revealed a cervicothoracic cyst with cord compression that was successfully treated neurosurgically. Histopathology confirmed an arachnoid origin as suspected from MRI. Spinal cysts may mimic ALS and need to be thoroughly excluded by appropriate imaging.
Intracoronary artery retrograde thrombolysis combined with percutaneous coronary interventions for ST-segment elevation myocardial infarction complicated with diabetes mellitus: A case report and literature review
Authors: Mingzhi Shen, Yichao Liao, Jian Wang, Xinger Zhou, Yuting Guo, Yingqiao Nong, Yi Guo, Haihui Lu, Rongjie Jin, Jihang Wang, Zhenhong Fu, Dongyun Li, Shihao Zhao, Jinwen Tian
Journal: Front Cardiovasc Med (2022)
Keywords: diabetes mellitus, intracoronary retrograde thrombolysis, myocardial infarction, reperfusion preconditioning, thrombosis
MeSH terms: Case Reports

Background:
The management of a large thrombus burden in patients with acute myocardial infarction and diabetes is still a worldwide problem.
Case presentation:
A 74-year-old Chinese woman presented with ST-segment elevation myocardial infarction (STEMI) complicated with diabetes mellitus and hypertension. Angiography revealed massive thrombus formation in the mid-segment of the right coronary artery leading to vascular occlusion. The sheared balloon was placed far from the occlusion segment and urokinase (100,000 u) was administered for intracoronary artery retrograde thrombolysis, and thrombolysis in myocardial infarction (TIMI) grade 3 blood flow was restored within 7 min. At last, one stent was accurately implanted into the culprit's vessel. No-reflow, coronary slow flow, and reperfusion arrhythmia were not observed during this process.
Conclusion:
Intracoronary artery retrograde thrombolysis (ICART) can be effectively and safely used in patients with STEMI along with diabetes mellitus and hypertension, even if the myocardial infarction exceeds 12 h (REST or named ICART ClinicalTrials.gov number, ChiCTR1900023849).
Ultrasound Utility in the Diagnosis of a Morel-Lavallée Lesion
Authors: Scott LaTulip, Rameshwar R Rao, Alan Sielaff, Nik Theyyunni, John Burkhardt
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Morel-Lavallée lesions are uncommon injuries that can be associated with significant comorbidities if not detected early. Rapid diagnosis in the Emergency Department could significantly improve patient outcomes. We describe the diagnosis of such a lesion through the use of ultrasound imaging in the Emergency Department to utilize a fast, cost-effective imaging technique that does not subject the patient to radiation exposure. Our patient received surgical consultation but improved with conservative management. Ultrasound findings associated with this lesion do not require specialized equipment and should be considered when evaluating soft tissue lesions using point of care ultrasound.
Case Report: Microscope-assisted surgery of C7 nerve root cyst with neurological symptoms
Authors: Shenshen Hao, Hongke Li, Shuai Liu, Yating Guo, Honglei Chen, Zhifang Zhang, Shengli Dong
Journal: Front Surg (2022)
Keywords: case report, cervical nerve root cyst, microscope-assisted surgery, neurological symptom, treatment
MeSH terms: Case Reports

Background:
Cervical nerve root cysts are rare and easily missed or misdiagnosed in clinical practice. Although conventional surgery is effective for cervical nerve root cysts, it is limited by the small surgical field of view and operating range, relatively difficult procedure, and incomplete cyst resection. Microscope-assisted magnification of the surgical field of vision reduces the difficulty and ensures complete cyst resection.
Case presentation:
A 58-year-old male patient was diagnosed with a cervical nerve root sleeve cyst on the right C7 vertebra with neurological symptoms. Microscope-assisted surgery was used as treatment. The cyst was completely removed by the microscope-assisted surgery, with satisfactory patient recovery. The surgery did not produce complications, such as spinal cord neurovascular injury, and the patient's symptoms disappeared quickly after surgery. During the 2-year follow-up, there was no complication and no recurrence.
Conclusion:
Microscope-assisted surgery in treatment of the C7 nerve root cyst could achieve a complete resection.
Cryptic pulmonary cryptococcosis: An atypical presentation of pulmonary cryptococcosis in a HIV-infected patient
Authors: H M Maepa
Journal: Afr J Thorac Crit Care Med (2019)
Keywords: hiv, atypical, disseminated cryptococcus, pulmonary crptococcosis
MeSH terms: Case Reports

Pulmonary cryptococcosis is a fungal infection caused by inhalation of Cryptococcus gattii and/or C. neoformans spores. It mostly affects HIV-infected patients. This is a case report of a severely immunocompromised HIV-infected patient, presenting with respiratory symptoms and atypical chest X-ray features for pulmonary cryptococcosis. A serum cryptococcal latex antigen test is positive in a majority of HIV-infected patients with pulmonary cryptococcosis. This case report demonstrates the occurrence of a false negative serum cryptococcal latex antigen test, becoming positive with the development of an unmasking immune reconstitution syndrome (after antiretroviral therapy was commenced). This also resulted in the characteristic cryptococcal lung cavities observed on computed tomography chest images. Duration of fluconazole therapy should be individualised, and serial chest imaging (e.g. chest X-ray) should be performed to monitor treatment response.
Extrastriate visual cortex reorganizes despite sequential bilateral occipital stroke: implications for vision recovery
Authors: Amy Brodtmann, Aina Puce, David Darby, Geoffrey Donnan
Journal: Front Hum Neurosci (2015)
Keywords: fmri, hemianopia, plasticity, reorganization, stroke, visual cortex
MeSH terms: Case Reports

The extent of visual cortex reorganization following injury remains controversial. We report serial functional magnetic resonance imaging (fMRI) data from a patient with sequential posterior circulation strokes occurring 3 weeks apart, compared with data from an age-matched healthy control subject. At 8 days following a left occipital stroke, contralesional visual cortical activation was within expected striate and extrastriate sites, comparable to that seen in controls. Despite a further infarct in the right (previously unaffected hemisphere), there was evolution of visual cortical reorganization progressed. In this patient, there was evidence of utilization of peri-infarct sites (right-sided) and recruitment of new activation sites in extrastriate cortices, including in the lateral middle and inferior temporal lobes. The changes over time corresponded topographically with the patient's lesion site and its connections. Reorganization of the surviving visual cortex was demonstrated 8 days after the first stroke. Ongoing reorganization in extant cortex was demonstrated at the 6 month scan. We present a summary of mechanisms of recovery following stroke relevant to the visual system. We conclude that mature primary visual cortex displays considerable plasticity and capacity to reorganize, associated with evolution of visual field deficits. We discuss these findings and their implications for therapy within the context of current concepts in visual compensatory and restorative therapies.
Epidemic, Endemic, or Stewart-Bluefarb? When Several Forms of Kaposi Seem to Dispute Paternity
Authors: Hugues Adegbidi, Bérénice Dégboé, Fabrice Akpadjan, Nadège Agbessi-Mekoun, Christiane Koudoukpo, Alida Kouassi, Félix Atadokpede
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

The role of human herpes virus 8 (HHV8) is demonstrated in the occurrence of Kaposi's disease, but the role of cofactors is still hardly known. We report a case of Kaposi's disease which occurred 10 years after a local trauma in an HIV-positive patient from Central Africa. A 38-year-old female, from and living in Central Africa, consulted for angiomatous papulo-nodules associated with purple-colored macules and painful lymphoedema of the right leg and foot that had been developing for 6 months. She reported a history of posttraumatic lymphoedema of the affected limb as a result of a road accident that occurred ten years earlier. The mucous were healthy. There was no sign of systemic lesions. The diagnosis of Kaposi's disease was evoked with, in differential, a Stewart-Bluefarb syndrome-type of pseudo-Kaposi and an epidemic Kaposi disease. Retroviral serology was positive to HIV1 with a CD4 count of 600 cells/mm3. Histopathology of the lesions and duplex ultrasonography could not be performed. The rest of the biological assessment was without particularity. The diagnosis of epidemic Kaposi's disease associated with cofactors involved in endemic Kaposi's disease and Stewart-Bluefarb syndrome was retained. An antiretroviral treatment (emtricitabine, tenofovir, and efavirenz) allowed to obtain after 6 months a noticeable improvement of the lesions and a disappearance of the pain with however the persistence of a residual lymphoedema. This is a special case of Kaposi's disease that seems to involve several factors. The role of cofactors in Kaposi's disease remains to be elucidated.
Sclerotic Bone Metastasis in Pulmonary Adenocarcinoma
Authors: Riyadh Ali Mohammed Hammamy, Khalid Farooqui, Wisam Ghadban
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Pulmonary adenocarcinoma is one of the major types of lung cancers in which metastasis is very common and it accounts approximately to one-third of all primary pulmonary cancers. Although a minority of patients with lung cancer are asymptomatic, which gets usually detected in routine chest radiography, most of the patients present with some symptoms. Lung cancer metastasis may occur virtually in every organ system. Patients with non-small-cell lung cancer commonly have extrathoracic metastases to the adrenal glands, liver, brain, bones, and lymph nodes at presentation. Approximately one-third of patients with lung cancer will present with symptoms related to extrathoracic spread. Metastasis to the bone is not uncommon in lung cancer; however, osteoblastic bone metastasis is very rare. Here we present a 30-year-old female diagnosed to have pulmonary adenocarcinoma with multiple sclerotic bony lesions in the vertebra.
Severe exercise-induced anaphylaxis in a hot and humid area successfully treated with omalizumab: a case report
Authors: Hassan Mobayed, Maryam Ali Al-Nesf, Karla Robles-Velasco, Ivan Cherrez-Ojeda, Luis Felipe Ensina, Marcus Maurer
Journal: Front Allergy (2023)
Keywords: anaphylaxis, co-factors, diagnosis and management, exercise-induced anaphylaxis, omalizumab
MeSH terms: Case Reports

Exercise-induced anaphylaxis (EIA) is a rare disorder in which anaphylaxis occurs exclusively after physical activity. Here, we report a case of severe EIA where anaphylaxis was initially only induced by strenuous exercise. Suddenly the anaphylaxis got out of control to the degree that usual daily activities triggered it. Exposure to a hot and humid environment appeared to be a cofactor for the development of severe symptoms resistant to usual preventive measures. Treatment with omalizumab (anti-IgE) was initiated and resulted in marked improvement. We discuss unique aspects of this case in comparison to published information on the clinical features, triggering cofactors, diagnosis, and treatment of EIA.
Juvenile Polyposis Syndrome in a Young Girl from Northern Tanzania
Authors: Jay Lodhia, David Msuya, Abdallah Msemo, Huda Akrabi, Patrick Amsi, Deborah Mchaile, Kondo Chilonga
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Introduction. Juvenile polyposis syndrome is a rare autosomal dominant disorder in children characterized by multiple polyps in the gastrointestinal tract. A variety of clinical features manifest, including prolapse of a polyp or entire rectum, gastrointestinal bleeding, anaemia, and intussusception. This condition if left unmanaged promptly leads to fatal complications including the development of cancer of the bowel. Case Presentation. A 13-year-old girl with a history of mass protrusion per anus associated with bloody diarrhea. Colonoscopy showed multiple polyps in her large bowel. She underwent total colectomy with ileorectal anastomosis and did clinically well post surgery with no complications. Conclusion. Juvenile polyposis syndrome is an inherited condition with significant morbidity and a high risk of colon malignancy. It is important for early screening and diagnosis and hence management in its early stages as there are no specific standard guidelines for children.
Acanthosis Nigricans Presenting as Skin Tags: A Case Report
Authors: Ibrahim Alshareef, Sultan Assiri, Ashwaq K Alosaimi, Omar S Alhothali, Rola R Alsulami, Shahad Alkidaiwi, Khalid Al Hawsawi
Journal: Cureus (2023)
Keywords: acanthosis nigricans, an, dm1, skin tags, warts
MeSH terms: Case Reports

Acanthosis nigricans (AN) is a common chronic disorder that is characterized by velvety-like, hyperpigmented, hyperkeratotic plaques, typically in intertriginous areas. However, atypical presentations have been reported. Here we present a five-year-old boy presented with a one-year history of asymptomatic slowly progressing skin lesions. He is a known case of type 1 diabetes mellites on insulin treatment, otherwise healthy. The review of systems was unremarkable. No similar case was found in the family. Skin examination revealed multiple tiny non-scaly brownish papules on the medial aspects of the upper thighs, bilaterally. Differential diagnosis included skin tags, viral warts, and dermatosis papulose nigra (DPN). Dermoscopic findings revealed a velvety-like appearance on the papules and the normal skin surrounding the papules. A 2-mm punch skin biopsy of the papule revealed papillomatosis of the epidermis, and the granular layer was normal. The dermis was normal. On the basis of the above clinicopathological findings, specifically the velvety texture of the normal skin surrounding the papules, the patient was diagnosed with ANs. The parent was reassured, and we started the patient on daily tretinoin cream.
Superior performance of cone beam tomography in detecting a calcaneus fracture
Authors: Christian Lohse, Philip Catala-Lehnen, Marc Regier, Max Heiland
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2015)
Keywords: calcaneus fracture, computed tomography, cone beam computed tomography, trauma
MeSH terms: Case Reports

Cone beam computed tomography is a state-of-the-art imaging tool, initially developed for dental and maxillofacial application. With its high resolution and low radiation dose, cone beam tomography has been expanding its application fields, for example, to diagnosis of traumata and fractures in the head and neck area. In this study, we demonstrate superior and satisfactory performance of cone beam tomography for the imaging of a calcaneus fracture in comparison to conventional X-ray and computed tomography.
A case report of asymptomatic aortic thrombosis incidentally detected by computed tomography in apparently healthy subject with a history of cancer surgery
Authors: Tomonori Sugiura, Yasuaki Dohi, Sumiyo Yamashita, Shunsuke Murai, Nobuyuki Ohte
Journal: Thromb J (2016)
Keywords: aortic thrombosis, computed tomography, incidental, pharmacotherapy
MeSH terms: Case Reports

Background:
Aortic thrombosis is a rare disease and only a few cases of the disease, especially associated with chemotherapy for malignant diseases and/or blood diseases, have been previously reported. Although Virchow's triad for thrombogenesis, namely hypercoagulability, blood flow stasis, and vessel wall injury, is the major factor promoting the formation of thrombosis, the detailed mechanism of the disease has not been well established.
Case presentation:
We report a case of aortic thrombosis incidentally detected by computed tomography and then regressed by pharmacotherapy using warfarin. This case is an apparently healthy man in a postoperative state after lung cancer surgery with decreased protein-C activity.
Conclusions:
A case of aortic thrombosis without an obvious abnormality of the aorta was incidentally identified. A few cases of aortic thrombosis in healthy aortas have been reported to be associated with chemotherapy or blood diseases, however our present case did not had such a background. Although the detailed mechanism remains to be elucidated, this case suggests that aortic thrombosis can develop in apparently healthy subjects with a history of cancer surgery.
Case Report: A novel IRF2BP2 mutation in an IEI patient with recurrent infections and autoimmune disorders
Authors: Yiwen Pan, Guoguo Shang, Jing Li, Yuwen Zhang, Jianying Liu, Yuan Ji, Jing Ding, Xin Wang
Journal: Front Immunol (2023)
Keywords: irf2bp2, immune monitoring, inborn errors of immunity, metagenomic sequencing, whole genomic sequencing
MeSH terms: Autoimmune Diseases / diagnosis, Autoimmune Diseases / genetics, Reinfection, Case Reports, Autoantibodies, Autoimmunity, B-Lymphocytes, DNA-Binding Proteins, Humans, Transcription Factors, Autoantibodies, IRF2BP2 protein, human, DNA-Binding Proteins, Transcription Factors

Introduction:
Inborn errors of immunity (IEI) are a heterogeneous group of disorders characterized by increased risk of infections, autoimmunity, autoinflammatory diseases, malignancy and allergy. Next-generation sequencing has revolutionized the identification of genetic background of these patients and assists in diagnosis and treatment. In this study, we identified a probable unique monogenic cause of IEI, and evaluated the immunological methods and pathogenic detections.
Methods:
A family with a member with a clinical diagnosis of IEI was screened by whole genomic sequencing (WGS). Demographic data, clinical manifestations, medical history, physical examination, laboratory findings and imaging features of the patient were extracted from medical records. Comprehensive immune monitoring methods include a complete blood count with differential, serum levels of cytokines and autoantibodies, T-cell and B-cell subsets analysis and measurement of serum immunoglobulins. In addition, metagenomic sequencing (mNGS) of blood, cerebrospinal fluid and biopsy from small intestine were used to detect potential pathogens.
Results:
The patient manifested with recurrent infections and autoimmune disorders, who was eventually diagnosed with IEI. Repetitive mNGS tests of blood, cerebrospinal fluid and biopsy from small intestine didn't detect pathogenic microorganism. Immunological tests showed a slightly decreased level of IgG than normal, elevated levels of tumor necrosis factor and interleukin-6. Lymphocyte flow cytometry showed elevated total B cells and natural killer cells, decreased total T cells and B-cell plasmablasts. WGS of the patient identified a novel heterozygous mutation in IRF2BP2 (c.439_450dup p. Thr147_Pro150dup), which was also confirmed in his father. The mutation was classified as variant of uncertain significance (VUS) according to the American College of Medical Genetics and Genomics guidelines.
Conclusion:
We identified a novel IRF2BP2 mutation in a family with a member diagnosed with IEI. Immune monitoring and WGS as auxiliary tests are helpful in identifying genetic defects and assisting diagnosis in patients with clinically highly suspected immune abnormalities and deficiencies in inflammation regulation. In addition, mNGS techniques allow a more comprehensive assessment of the pathogenic characteristics of these patients. This report further validates the association of IRF2BP2 deficiency and IEI, and expands IEI phenotypes.
Case Report: 84 year-old woman with alien hand syndrome
Authors: Ihtesham Aatif Qureshi, Daniel Korya, Darine Kassar, Mohammed Moussavi
Journal: F1000Res (2016)
Keywords: alien-hand syndrome, hemorrhagic stroke, headache, involuntary movements

Background: Alien hand syndrome [AHS] is a rare and ill-defined neurological disorder. It produces complex, goal-directed motion of one hand that is involuntarily instigated. This syndrome characteristically arises after brain trauma, brain surgery, stroke or encephalitis. We describe a case of AHS in a patient who had a previous episode of subarachnoid hemorrhage affecting the left frontal lobe and corpus callosum. Case presentation: An 84-year-old woman presented to the emergency department complaining of headaches and several episodes of her left arm moving as if it was groping around trying to grab at her own body. A computed tomography scan of the head demonstrated an acute left superior frontal hemorrhage with compression of the corpus callosum. Transcranial Doppler report showed no significant abnormality in the insonated vessels. After being stabilized for the acute bleed, she was treated with clonazepam 0.5 mgat night for the uncontrolled hand movements. Her movements resolved by her next month follow up. The diagnosis of AHS was made based on her clinical presentation, characterization of the movement and localization correlating with findings in neuroimaging. Conclusion: We document a rare neurologic disorder seen in patients presenting with a history of previous strokes and a typical description of involuntary and unintentional, uncontrolled unilateral arm movements with repetitive grasping. The present case has a combination of frontal and callosal lesions. These findings appear to support a potential destruction leading to the rare syndrome.