OpenMed/multicare-articles huggingface dataset:
Acute bacterial encephalitis complicated with recurrent nasopharyngeal carcinoma associated with Elizabethkingia miricola infection: A case report
Authors: Xiaohuang Zhuo, Yongzhao Zhou, Ling Liu
Journal: Front Neurol (2023)
Keywords: elizabethkingia miricola, diagnosis, encephalitis, metagenomic next-generation sequencing, treatment
MeSH terms: Case Reports

Elizabethkingia miricola (E. miricola) is an extremely rare pathogenic bacterium, which causes serious infections in patients with primary immunodeficiency or tumors, and it is often misdiagnosed. E. miricola has rarely been known to cause a neurologic infection. We describe the first case of acute bacterial encephalitis associated with E. miricola infection in a man with recurrent nasopharyngeal carcinoma, which was successfully cured by antibiotics. The patient initially presented with recurrent episodes of fever and later showed impaired consciousness but these symptoms were alleviated with antibiotic therapy including cefoperazone/sulbactam. This study highlights that rapid and accurate pathogen detection via metagenomic next-generation sequencing and early use of appropriate antibiotics can improve the prognosis of patients with suspected neurologic E. miricola infection. Early treatment for underlying primary diseases can also significantly improve the outcomes of patients.
Pneumomediastinum as initial presentation of paralytic rabies: a case report
Authors: Pongtorn Kietdumrongwong, Thiravat Hemachudha
Journal: BMC Infect Dis (2005)
MeSH terms: Mediastinal Emphysema / complications, Mediastinal Emphysema / diagnosis, Rabies / complications, Rabies / diagnosis, Case Reports, Adolescent, Fatal Outcome, Humans, Male, Mediastinal Emphysema / pathology, Rabies / pathology

Background:
Rabies is readily diagnosed when it presents as the classic furious form. Paralytic and atypical forms can pose significant problems in diagnosis. Catastrophic incidents included 7 organ transplant recipients who died of rabies recently in United States and Germany. Although rabies remains top in the lists of differential diagnosis of encephalitis in rabies endemic area, its complication may divert physicians from making a relevant management. We encountered an unusual case of paralytic rabies who presented with spontaneous pneumomediastinum.
Case presentation:
A young male presented with fever and dysphagia. There was a history of fluctuating consciousness and aerophobia but they were absent or could not be demonstrated at the time of admission. He exhibited subcutaneous chest wall emphysema and was found to have pneumomediastinum which resulted in surgical intervention. He developed paralysis followed by seizures during postoperative period. Diagnosis was confirmed by demonstration of rabies RNA in saliva during the preterminal phase and by the autopsy. Over 200 hospital staff subsequently received rabies postexposure prophylaxis.
Conclusion:
Spontaneous pneumomediastinum can be a rare complication of rabies. It may lead clinicians to perform inappropriate treatment, particularly when phobic spasms are not present and agitation is not prominent. High level of awareness of rabies in any patient with confusion albeit subtle or with any obscure neurological presentations such as difficulty swallowing with no identifiable causes must be borne in mind.
Pulmonary Empty Spaces: Silicone Embolism-A Decade of Increased Incidence and Its Histological Diagnosis
Authors: Kirill Lyapichev, Felix Manuel Chinea, Julio Poveda, Jeniffer Pereda, Pablo A Bejarano, Monica T Garcia-Buitrago
Journal: Case Rep Pathol (2016)

Pulmonary embolism (PE) is a critical complication related to multiple disorders and different medical or cosmetic procedures. This case report presents two patients who were admitted for respiratory symptoms in the setting of previously receiving silicone injections for cosmetic purposes and were diagnosed with silicone pulmonary embolism. The relevance of including questions about all cosmetic procedures as a part of a medical history is highlighted, in particular about silicone injections. The diagnosis is confirmed by histological means. Additionally, our review showed the change of most common sites of silicone injections and a significant increase in cosmetic procedures causing silicone embolism during the past twelve years.
Preliminary evidence for performance enhancement following parietal lobe stimulation in Developmental Dyscalculia
Authors: Teresa Iuculano, Roi Cohen Kadosh
Journal: Front Hum Neurosci (2014)
Keywords: developmental dyscalculia, learning, neural compensation, rehabilitation, transcranial electrical stimulation
MeSH terms: Case Reports

Nearly 7% of the population exhibit difficulties in dealing with numbers and performing arithmetic, a condition named Developmental Dyscalculia (DD), which significantly affects the educational and professional outcomes of these individuals, as it often persists into adulthood. Research has mainly focused on behavioral rehabilitation, while little is known about performance changes and neuroplasticity induced by the concurrent application of brain-behavioral approaches. It has been shown that numerical proficiency can be enhanced by applying a small-yet constant-current through the brain, a non-invasive technique named transcranial electrical stimulation (tES). Here we combined a numerical learning paradigm with transcranial direct current stimulation (tDCS) in two adults with DD to assess the potential benefits of this methodology to remediate their numerical difficulties. Subjects learned to associate artificial symbols to numerical quantities within the context of a trial and error paradigm, while tDCS was applied to the posterior parietal cortex (PPC). The first subject (DD1) received anodal stimulation to the right PPC and cathodal stimulation to the left PPC, which has been associated with numerical performance's improvements in healthy subjects. The second subject (DD2) received anodal stimulation to the left PPC and cathodal stimulation to the right PPC, which has been shown to impair numerical performance in healthy subjects. We examined two indices of numerical proficiency: (i) automaticity of number processing; and (ii) mapping of numbers onto space. Our results are opposite to previous findings with non-dyscalculic subjects. Only anodal stimulation to the left PPC improved both indices of numerical proficiency. These initial results represent an important step to inform the rehabilitation of developmental learning disabilities, and have relevant applications for basic and applied research in cognitive neuroscience, rehabilitation, and education.
A Case of Preeclampsia with Uterine Necrosis after Uterine Artery Embolization for Postpartum Hemorrhage
Authors: Midori Yoshikawa, Takahiro Seyama, Takayuki Iriyama, Seisuke Sayama, Tatsuya Fujii, Masatake Toshimitsu, Moto Nakaya, Ryo Kurokawa, Eisuke Shibata, Takeyuki Watadani, Keiichi Kumasawa, Takeshi Nagamatsu, Kaori Koga, Yutaka Osuga
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Uterine necrosis is a rare complication in uterine artery embolization (UAE) for postpartum hemorrhage (PPH). Preeclampsia (PE) is a condition characterized with systemic endothelial damage and intravascular volume depletion. Whether a patient with PE is at high risk for uterine necrosis after UAE for PPH has been unknown. A 30-year-old primipara woman was diagnosed with PE based on hypertension and proteinuria during delivery. UAE was performed for PPH after forceps delivery. After UAE, the patient presented with pleural effusion and massive ascites as well as persistent fever unresponsive to antibiotics. Ultrasonography and contrast-enhanced magnetic resonance imaging (MRI) led to the diagnosis of uterine necrosis, for which we performed total laparoscopic hysterectomy. It should be kept in mind that patients with PE associated with massive ascites may be at high risk for uterine necrosis after UAE due to decreased uterine perfusion. Therefore, it is important to pay attention to persistent symptoms such as fever and abdominal pain after UAE to diagnose uterine necrosis.
Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon
Authors: Takeshi Oshima, Junsuke Nakase, Hitoaki Numata, Yasushi Takata, Hiroyuki Tsuchiya
Journal: Case Rep Orthop (2015)

A multiple-ligament knee injury that includes posterolateral corner (PLC) disruption often causes palsy of the common peroneal nerve (CPN), which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.
Spinal Cord Injury at Birth, Expected Medical and Health Complexity in Chronic Injury Guided Anew by Activity-Based Restorative Therapy: Case Report
Authors: Laura Leon Machado, Kathryn Noonan, Scott Bickel, Goutam Singh, Kyle Brothers, Margaret Calvery, Andrea L Behrman
Journal: Front Psychol (2022)
Keywords: activity-based restorative therapies, case report, development, infancy, spinal cord injury
MeSH terms: Case Reports

As infancy is characterized by rapid physical growth and critical periods of development, disruptions due to illness or disease reveal vulnerability associated with this period. Spinal cord injury (SCI) has devastating consequences at any age, but its onset neonatally, at birth, or within the first year of life multiplies its impact. The immediate physical and physiological consequences are obvious and immense, but the effects on the typical trajectory of development are profound. Activity-based restorative therapies (ABRT) capitalize on activity-dependent plasticity of the neuromuscular system below the lesion and when provided to children with SCI aim to improve the child's neuromuscular capacity, health and quality of life. This is a report of an infant with a cervical SCI at birth resulting in paralysis of leg and trunk muscles and paresis of arm and hands who was enrolled in an ABRT program at 3 years of age. After 59 sessions of ABRT, the child demonstrated significant improvements in trunk control and arm function, as well as social and emotional development. Despite the chronicity of injury and low expectations for improvement with therapeutic interventions, ABRT had a positive impact on the child's physical capacity and provided benefits across multiple developmental domains.
Elevated Intracranial Pressure Diagnosis with Emergency Department Bedside Ocular Ultrasound
Authors: D Amin, T McCormick, T Mailhot
Journal: Case Rep Emerg Med (2015)

Bedside sonographic measurement of optic nerve sheath diameter can aid in the diagnosis of elevated intracranial pressure in the emergency department. This case report describes a 21-year-old female presenting with 4 months of mild headache and 2 weeks of recurrent, transient binocular vision loss. Though limited by patient discomfort, fundoscopic examination suggested the presence of blurred optic disc margins. Bedside ocular ultrasound (BOUS) revealed wide optic nerve sheath diameters and bulging optic discs bilaterally. Lumbar puncture demonstrated a cerebrospinal fluid (CSF) opening pressure of 54 cm H2O supporting the suspected diagnosis of idiopathic intracranial hypertension. Accurate fundoscopy can be vital to the appropriate diagnosis and treatment of patients with suspected elevated intracranial pressure, but it is often technically difficult or poorly tolerated by the photophobic patient. BOUS is a quick and easily learned tool to supplement the emergency physician's fundoscopic examination and help identify patients with elevated intracranial pressure.
Management of Pediatric Tibial Nonunion following Osteotomy: A Case Series and Review of the Literature
Authors: Gautham Prabhakar, Nicholas Kusnezov, Emmanuel Eisenstein, John C Dunn, Amr Abdelgawad
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Pediatric tibial nonunion following corrective osteotomy is a rare complication that is not well understood. While adult nonunions have been linked to endocrine and metabolic aberrations, this has not been established in a pediatric population. Pediatric tibial nonunion has been shown to respond to debridement with revision fixation using dynamic compression plating, supplementary bone graft, and fibular osteotomy to allow compression. Necessity of referral for metabolic and endocrinology workup remains unclear in the pediatric population, though inflammatory markers should be obtained in each case to rule out infection. We present three consecutive cases of pediatric tibial nonunion following osteotomy over a five-year period and discuss the management.
Cardiac Amyloidosis: A Rare TTR Mutation Found in an Asian Female
Authors: Kristina Mouksian, Jessica Ammon, Drenda Pullen, Qiuhua Zhang, Neeraja Yedlapati, John Lynn Jefferies
Journal: J Cardiovasc Dev Dis (2023)
Keywords: amyloidosis, cardiomyopathy, diastolic heart failure, echocardiography, genetic disorders
MeSH terms: Case Reports

Background:
Transthyretin cardiac amyloidosis (ATTR) is a life-threatening, debilitating disease caused by abnormal formation and deposit of transthyretin (TTR) protein in multiple tissues, including myocardial extracellular matrix. It can be challenging to diagnose due to the myriad of presenting signs and symptoms. Additionally, numerous TTR mutations exist in certain ethnicities. Interestingly, our patient was discovered to have a very rare Gly67Ala TTR mutation typically not found in individuals of Asian descent. Recent advances in cardiovascular imaging techniques have allowed for earlier recognition and, therefore, management of this disease. Although incurable, there are now new, emerging treatments that are available for symptom control of cardiac amyloidosis, making early diagnosis vital for these patients, specifically their quality of life.
Case summary:
We outline a case of a 50-year-old Asian female who was initially hospitalized for nausea and vomiting and persistent orthostatic hypotension. She underwent a multitude of laboratory and imaging tests, resulting in a diagnosis of cardiac amyloidosis, which was confirmed to be due to a rare TTR mutation via genetic testing.
Conclusions:
Our objective is to describe various TTR mutations, existing diagnostic imaging modalities, and available treatments, as well as highlight the importance of early screening and awareness of cardiac amyloidosis, allowing for quicker diagnosis and treatment of this disease.
Huge Lymphangioma of the Esophagus Resected by Endoscopic Piecemeal Mucosal Resection
Authors: Dinghai Luo, Liping Ye, Weidan Wu, Haihong Zheng, Xinli Mao
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

We present an unusual case of a 41-year-old male patient with a large lymphangioma of the esophagus. Endoscopy revealed that the structure measured 60 × 10 mm in the mucosa and the submucosa and had a heterogenous echo pattern. The esophageal mass was successfully resected by endoscopic piecemeal mucosal resection. However, most esophageal lymphangiomas that are larger than 2 cm in diameter reported in the literature can be removed only through open surgery. Thus far, we know of no reported cases of endoscopic resection as a treatment for this case.
Clinical Challenges in the Diagnosis and Treatment of Temporal Bone Osteomyelitis
Authors: Liubov Kornilenko, Saulius Rocka, Svajunas Balseris, Irina Arechvo
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Temporal bone osteomyelitis is a serious life-threatening condition-a quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Changing trends of the disease make a differential diagnosis difficult. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. The diagnosis was based on clinical symptoms, otoscopic findings, and findings on computed tomography or magnetic resonance imaging. Neoplasm and granulomatous inflammation were excluded by multiple biopsies. The disease can develop in nondiabetic patients. The disorder might be related to the initial inflammatory process in the middle ear with further direct spreading of infection through defects in the bony walls to deep temporal bone structures. Imaging should be performed early to detect osteolytic lesions of the skull base. Surgery was used for the presence of bone sequestra and infratemporal abscess.
Listeria Cerebritis with Tumor Necrosis Factor Inhibition
Authors: Eileen Reilly, Justin Hwang
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Background:

Listeria monocytogenes is historically a central nervous system pathogen of consideration in the very young, very old, and immune suppressed. Diagnosis of Listeria is based on positive bodily fluid culture or PCR testing. Cerebral edema is nonspecific and can be a manifestation of vasculitis, trauma, anoxia, ischemia, infarction, malignancy, or an infectious process. A main mechanism of immune protection against Listeria is tumor necrosis factor (TNF). Lenalidomide, an immunosuppressant, inhibits TNF. Case Presentation. A 61-year-old female with diabetes mellitus 2 and multiple myeloma treated with stem cell transplant and immunosuppressant (lenalidomide) was found to have cerebral edema after presenting with headache for 3 weeks and new focal neurologic deficits. Vitals signs were stable, with no meningeal exam findings and unremarkable initial serum testing. Blood cultures on days 0 and 2 of hospitalization as well as cerebral spinal fluid cultures were negative for infectious organisms. PCR testing of CSF was also negative for microorganisms. Brain biopsy was scheduled but postponed due to outstanding prion testing. The patient's focal neurologic deficits worsened prompting administration of dexamethasone after extensive negative infectious disease workup. By day 6, gross neurologic function deteriorated prompting transfer to higher level of care where the patient spiked a fever and one set of blood cultures revealed Gram-positive bacillus. Aggressive antimicrobial therapy was initiated, excluding ampicillin; however, this was later added. Blood culture further identified Listeria monocytogenes. By day 17, the patient suffered demise. Autopsy revealed brain microabscess lesions consistent with Listeria.
Conclusion:
Clinicians should employ prophylactic antimicrobial treatment for Listeria when caring for those patients presenting with cerebral edema who are immune suppressed with TNF inhibition no matter the initial exam findings, serum testing, and/or radiologic interpretation. If initial workup is negative and brain biopsy is needed to determine the next course of action in the patient with cerebral edema, transfer the patient to a higher level of care if unable to complete biopsy at your facility in an expedient fashion.
Intrascrotal Abscess, Propionibacterium acnes and Staphylococcus cohnii ssp. cohnii: A Case Report and Review of the Literature
Authors: Masciovecchio Stefano, Alessandro Del Rosso, Pietro Saldutto, Giuseppe Paradiso Galatioto, Carlo Vicentini
Journal: Case Rep Urol (2012)

Introduction. The Propionibacterium acnes and the Staphylococcus cohnii ssp. cohnii are occasional pathogenic bacteria. The intrascrotal localization of the Propionibacterium acnes is exceptional. The Staphylococcus cohnii ssp. cohnii is not able to colonize the urogenital apparatus but it is the most frequently responsible for blood culture contamination even if it can sustain, in particular conditions, systemic infections. Case Presentation. We report the case of a 72-year-old man who is under observation for pain and swelling of the left hemiscrotum associated to high fever. The scrotal ultrasound shows the presence of a left intra-scrotal abscess with didymus, epididymis, and intact didymus-epididymis tunicae. The blood culture executed for evening fever during antibiotic therapy has underlined an infection with Propionibacterium acnes. A following blood culture has shown an increase in Staphylococcus cohnii ssp. cohnii. Due to fever the patient has undergone left orchifunicolectomy with inguino-scrotal toilet. The anatomical pathological examination has also shown the presence of nonspecific granulomatous inflammation compatible with Propionibacterium acnes infection. Conclusion. The onset of an intrascrotal abscess likely sustained by Propionibacterium acnes complicated by a possible systemic Staphylococcus cohnii ssp. cohnii suprainfection is an exceptional event that, in our case, has been resolved with surgical toilet.
Diphallia with associated anomalies: a case report and literature review
Authors: Pande Made Wisnu Tirtayasa, Robertus Bebet Prasetyo, Arry Rodjani
Journal: Case Rep Urol (2013)

Diphallia or penile duplication is an extremely rare congenital anomaly. It occurs once in every 5.5 million live births. The extent of penile duplication and the number of associated anomalies vary greatly, ranging from a double glans from a penis with no associated anomaly up to complete penile duplication associated with multiple anomalies. Here, we report a 12-year-old boy with complete bifid diphallia associated with bifid scrotum, epispadia, and pubic symphysis diastasis along with a review of the articles pertaining to this anomaly.
A misleading CMV myocarditis during the COVID-19 pandemic: case report
Authors: Sara Oualim, Amal Elouarradi, Sara Hafid, Abdelhamid Naitelhou, Mohamed Sabry
Journal: Pan Afr Med J (2020)
Keywords: covid-19, cytomegalovirus, immunocompetent, myocarditis
MeSH terms: Coronavirus Infections / diagnosis, Cytomegalovirus Infections / diagnosis, Myocarditis / diagnosis, Pneumonia, Viral / diagnosis, Case Reports, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Coronavirus Infections / epidemiology, Cough / etiology, Cytomegalovirus Infections / virology, Diagnosis, Differential, Dyspnea / etiology, Fever / etiology, Humans, Male, Middle Aged, Myocarditis / diagnostic imaging, Myocarditis / virology, Pandemics, Pneumonia, Viral / epidemiology, Tomography, X-Ray Computed

Coronavirus disease 2019 (COVID-19) has been reported as the possible cause of acute myocarditis. Myocarditis is an inflammatory heart disease mostly caused by viral infections. Cytomegalovirus (CMV) primary infection is often not suspected as a cause of myocarditis in immune-competent adults. We report the case of a 37-year-old male admitted with fever, cough and dyspnea. Chest CT showed typical ground-glass changes indicative of viral pneumonia. He was tested negative for COVID-19 but had biological markers that made us still suspect it. He had elevated troponin I level (up to 111.5 ng/mL) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF). He was diagnosed with CMV myocarditis with cardiac insufficiency and totally recovered without antiviral therapy. During the COVID-19 pandemic patients may develop myocarditis, still every myocarditis is not a COVID infection. Myocarditis linked to CMV infection may be rare, but life-threatening.