OpenMed/multicare-articles huggingface dataset:
Case Report: Initial Treatment Adjustments and Complications in Ovarian Cancer Patient With Inborn Error of Immunity
Authors: Jamila Mammadova, Anna Redden, Rachel Cruz, Boglarka Ujhazi, Maryssa Ellison, Tyra Gatewood, Carla Duff, Anthony Canella, Charurut Somboonwit, Chakrapol Sriaroon, Joseph F Dasso, Terry Harville, Roohi Ismail-Khan, Jolan E Walter, Sumai Gordon
Journal: Front Oncol (2022)
Keywords: antibody deficiency, case report, inborn error of immunity, ovarian cancer, primary immunodeficiency
MeSH terms: Case Reports

Background:
Patients with inborn errors of immunity (IEI) have increased risk of developing cancers secondary to impaired anti-tumor immunity. Treatment of patients with IEI and cancer is challenging as chemotherapy can exacerbate infectious susceptibility. However, the literature on optimal cancer treatment in the setting of IEI is sparse.
Objectives:
We present a patient with specific antibody deficiency with normal immunoglobins (SADNI), immune dysregulation (ID), and stage III ovarian carcinoma as an example of the need to modify conventional treatment in the context of malignancy, IEI, and ongoing infections.
Methods:
This is a retrospective chart review of the patient's clinical manifestations, laboratory evaluation and treatment course.
Results:
Our patient is a female with SADNI and ID diagnosed with stage III ovarian carcinoma at 60 years of age. Her ID accounted for antinuclear antibody positive (ANA+) mixed connective tissue diseases, polyarthralgia, autoimmune neutropenia, asthma, autoimmune thyroiditis, and Celiac disease. Due to the lack of precedent in the literature, her treatment was modified with continuous input from infectious disease, allergy/immunology and oncology specialist using a multidisciplinary approach.The patient completed debulking surgery and 6 cycles of chemotherapy. The dosing for immunoglobulin replacement therapy was increased for prophylaxis. Chemotherapy doses were lowered for all cycles preemptively for IEI. The therapy included carboplatin, paclitaxel, bevacizumab, and pegfilgrastim. The patient completed six-months of maintenance medication involving bevacizumab.Her treatment course was complicated by Mycobacterium avium-complex (MAC) infection, elevated bilirubin and liver enzymes attributed to excessive immunoglobulin replacement therapy, and urinary tract infection (UTI) and incontinence.Cancer genetic analysis revealed no targetable markers and primary immunodeficiency gene panel of 407 genes by Invitae was unrevealing. Lab tests revealed no evidence of Epstein-Barr Virus (EBV) infection. Post-chemotherapy imaging revealed no evidence of cancer for 1 year and 4 months, but the disease relapsed subsequently. The patient's lung scarring requires vigilance.
Conclusions:
Our patient with ovarian cancer and IEI required modified treatment and prevention of complications. In cases of IEI, optimal chemotherapy should be titrated to minimize immunosuppression yet treat cancer aggressively while decreasing the risk of infection with prophylactic antibiotics and prolonged post-treatment surveillance, including pulmonary evaluation.
Animal Bite Injuries in Children: Review of Literature and Case Series
Authors: Aviral Agrawal, Pradeep Kumar, Ruchi Singhal, Virendra Singh, Amrish Bhagol
Journal: Int J Clin Pediatr Dent (2017)
Keywords: animal bite injuries, dog bites, facial trauma
MeSH terms: Review

Introduction:
Maxillofacial region in children is particularly vulnerable to animal bite injuries. These injuries may range from insignificant scratches to life-threatening neck and facial injuries. Children are the common victims, particularly of dog bites.
Materials and methods:
Three cases of animal bite injuries in children with their clinical presentation and their management are being presented along with review of literature. Surgical management included cleansing and primary closure of the wound. Rabies and tetanus prophylaxis were given.
Discussion:
The most common site of injury was the face. For the facial injuries, the most frequently affected area was the middle third (55%), also called as the "central target area." The small stature of children, the disproportionate size of the head relative to the body, their willingness to bring their faces close to the animal, and limited motor skills to provide defense are believed to account for this. The resulting soft-tissue injuries can vary in relation to their extent. Treatment involved initial surgical exploration, and secondary repair later depending on the severity of the injury.
Conclusion:
Prompt assessment and treatment can prevent most bite wound complications. Early management of such injuries usually guarantees satisfactory outcome. Prevention strategies include close supervision of child-dog interactions, better reporting of bites, etc.
How to cite this article:
Agrawal A, Kumar P, Singhal R, Singh V, Bhagol A. Animal Bite Injuries in Children: Review of Literature and Case Series. Int J Clin Pediatr Dent 2017;10(1):67-72.
Dedifferentiated soft tissue leiomyosarcoma with heterologous osteosarcoma component: case report and review of the literature
Authors: Raffaele Gaeta, Davide Matera, Francesco Muratori, Giuliana Roselli, Giacomo Baldi, Domenico Andrea Campanacci, Alessandro Franchi
Journal: Clin Sarcoma Res (2020)
Keywords: dedifferentiated, leiomyosarcoma, osteosarcoma, soft tissues
MeSH terms: Case Reports

Background:
Soft tissue dedifferentiated leiomyosarcoma with heterologous osteosarcomatous component is an extremely rare entity described in only few cases in the literature.
Case presentation:
We report the case of a 65-year-old male patient who, after initial inadequate surgery of a tumor of the left forearm, developed local recurrence that was treated with neoadjuvant chemotherapy, surgery and postoperative radiation therapy. Histologically the tumor showed an abrupt separation of two different patterns. One component consisted of interlacing fascicles of spindle cells with cigar-shaped nuclei strongly positive for smooth muscle actin, desmin and H-caldesmon. The other component consisted of a high-grade pleomorphic sarcoma with osteoid and chondroid matrix production, which positive for SATB2. Thus, a final diagnosis of dedifferentiated leiomyosarcoma was rendered. Fifteen months after treatment, the patient presented further local and distant relapse with pulmonary metastases and died 23 months after the first presentation.
Discussion and conclusions:
Dedifferentiated leiomyosarcoma is a highly malignant neoplasm with a poor outcome. Extensive sampling of soft tissue leiomyosarcomas is recommended to detect possible dedifferentiated areas as they represent a crucial prognostic parameter.
Gastrointestinal stromal tumors: a review of case reports, diagnosis, treatment, and future directions
Authors: Christopher B Tan, Wanqing Zhi, Ghulamullah Shahzad, Paul Mustacchia
Journal: ISRN Gastroenterol (2012)

Gastrointestinal stromal tumor (GIST) is a nonepithelial, mesenchymal tumor first described by Mazur and Clark in 1983. Since then, its molecular biology has been studied in great detail. Special interest in the role of tyrosine kinase in its regulation has been the target by different drug research. Mutation in c-kit exons 9, 11, 13, 17 and PDGFRA mutation in exons 12, 14, 18 are responsible for activation of gene signaling system resulting in uncontrolled phosphorylation and tissue growth. However, 5 to 15% of GISTs does not harbor these mutations, which raises additional questions in another alternate signaling pathway mutation yet to be discovered. Diagnosis of GISTs relies heavily on KIT/CD117 immunohistochemical staining, which can detect most GISTs except for a few 3% to 5% that harbors PDGFRA mutation. Newer staining against PKC theta and DOG-1 genes showed promising results but are not readily available. Clinical manifestation of GISTs is broad and highly dependent on tumor size. Surgery still remains the first-line treatment for GISTs. The advancement of molecular biology has revolutionized the availability of newer drugs, Imatinib and Sunitinib. Together with its advancement is the occurrence of Imatinib/Sunitinib drug resistance. With this, newer monoclonal antibody drugs are being developed and are undergoing clinical trials to hopefully improve survival in patients with GISTs.
Laparoscopic transgastric resection of a gastric leiomyosarcoma: report of a rare case
Authors: Nicolas Panzardi, Matias Mihura-Irribarra, Daniela Speisky, Joaquin Fernandez-Alberti, Mariana Toffolo Pasquini, Pablo Dezanzo, Daniel Enrique Pirchi
Journal: Ecancermedicalscience (2022)
Keywords: case report, gastric leiomyosarcoma, laparoscopic, transgastric resection
MeSH terms: Case Reports

Gastric leiomyosarcoma is a rare type of tumour that is far less prevalent than gastrointestinal stromal tumours. We describe a case of a 42-year-old male patient who consulted for upper abdominal pain. Blood work revealed low haemoglobin levels, requiring red blood cell transfusions. An esophagogastroduodenoscopy was performed, showing a submucosal tumour with central ulceration in the greater gastric curvature. The patient underwent an endoscopic ultrasound with fine needle biopsy and the sample showed a spindle cell neoplasia. Computed tomography scan demonstrated absence of distant metastases. Upon multidisciplinary consensus, it was decided to perform surgery. A laparoscopic approach was conducted, where no peritoneal lesions were observed. Transgastric resection of the tumour was performed. Free tumour margins were achieved following oncologic criteria (minimum tumour manipulation and one-piece resection without damaging the tumour capsule). After exhaustive sampling, the final pathology report informed an 11 × 9 × 5 cm gastric leiomyosarcoma. Immunohistochemical examination showed positivity with smooth muscle actin, muscle-specific actin, calponin and desmin. The patient had an uneventful recovery, and 6 post-operative months' clinical, tomographic and endoscopic control informed no disease recurrence. To the best of our knowledge, there are less than 20 published cases of patients with diagnosis of gastric leiomyosarcoma. This study highlights the importance of reporting this entity, in order to contribute to the available literature concerning this topic.
It Takes a Village: The Importance of Neuropsychological Findings in a Collaborative Approach for a Patient with Congenital Central Hypoventilation Syndrome and Specific Phobia
Authors: Sarah Hamill Skoch, Bo Fu, Amanda L Stein, Samuel P Greenstein
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Congenital central hypoventilation syndrome (CCHS) is a life-threatening disorder characterized by respiratory symptoms such as hypoventilation during sleep, significantly reduced ventilatory and arousal responses, and sustained hypoxia. Patients with CCHS exhibit neurocognitive deficits due to structural abnormalities in the brainstem, cerebellum, and forebrain. Due to the potential for repeated hypoxemia and hypercarbia among patients with CCHS, neurocognitive functioning is often impaired. This is the first described report in which a patient with CCHS and specific phobia has been reported and highlights the importance of neuropsychological testing in directing treatment approaches. We report a case of a 26-year-old male, diagnosed with CCHS and specific phobia. This patient was overdue for a needed bronchoscopy to check his airway for abnormalities (recommended every 12-24 months). The patient had developed a specific phobia to procedures involving anesthesia. It was determined in the initial phase of treatment that the patient's neurocognitive status was impacting his ability to engage in psychiatric and psychosocial treatment. This patient's care consisted of neuropsychological testing, with medication consultation, and cognitive behavioral psychotherapy. Treatment involved consistent collaboration among the patient's treating clinicians as well as collaboration with the patient's family and team of nurses. At the conclusion of treatment, the patient had successfully completed his bronchoscopy and future treatment goals were identified. This case emphasizes the importance of a neuropsychological evaluation when there is a disconnect in a patient's information processing, as the results may be highly informative in directing treatment for patients with CCHS and specific phobia. The collaborative care we provided offers insights which may direct future interventions for patients with CCHS and improve their quality of life. Our case adds support to the recommendation that patients with CCHS and impaired psychosocial functioning should receive neuropsychological testing to best direct treatment.
Recovery of Severe Acute Kidney Injury in a Patient with COVID-19: Role of Lung Ultrasonography
Authors: Varun Madireddy, Daniel W Ross, Deepa A Malieckal, Shamir Hasan, Azzour Hazzan, Hitesh H Shah
Journal: POCUS J (2022)
Keywords: aki, covid-19, lung ultrasound, point of care ultrasound
MeSH terms: Case Reports

Acute kidney injury (AKI) is recognized as a complication of COVID-19 among hospitalized patients. Lung ultrasonography (LUS) can be a useful tool in the management of COVID-19 pneumonia when interpreted correctly. However, the role of LUS in management of severe AKI in the setting of COVID-19 remains to be defined. We report a 61-year-old male who was hospitalized with acute respiratory failure from COVID-19 pneumonia. In addition to requiring invasive mechanical ventilation, our patient developed AKI and severe hyperkalemia requiring urgent dialytic therapy during his hospital stay. Our patient remained dialysis dependent despite subsequent recovery of lung function. Three days following discontinuation of mechanical ventilation, our patient developed a hypotensive episode during his maintenance hemodialysis treatment. A point of care LUS performed soon after the intradialytic hypotensive episode found no extravascular lung water. Hemodialysis was discontinued and the patient was initiated on intravenous fluids for one week. AKI subsequently resolved. We consider LUS an important tool in identifying COVID-19 patients that would benefit from intravenous fluids following recovery of lung function.
An Unusual Case of Campylobacter jejuni Gastroenteritis Presenting with Acute Reversible Encephalopathy in an Immunocompetent Host
Authors: Irma Huayanay, Leonardo Pozo, Salman Bangash, Denisse Ramirez, Luis Rosas, Renzo Arauco Brown
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Campylobacter jejuni gastroenteritis is the most frequent organism associated with acute infectious diarrhea worldwide. The clinical presentation involves fever, diarrhea, rigors, and myalgias. Other extraintestinal symptoms that have been described involve delirium and other neurological complications, and the most well-known is Guillain-Barré, where there is cross-reactivity between the gastrointestinal tract and the brain. Despite previously described multiple neurological complications, there is a lack of clinical data on the association of Campylobacter-related gastroenteritis with acute encephalopathy in immunocompetent patients. The type of population, immunocompetent stage, and unfamiliarity with the clinical presentation makes this a challenging diagnosis for clinicians. We report a case of Campylobacter gastroenteritis associated with acute encephalopathy in an immunocompetent patient.
Acute Vitreous and Intraretinal Hemorrhage with Multifocal Subretinal Fluid in Juvenile X-Linked Retinoschisis
Authors: Sidra Ibad, Carl S Wilkins, Alexander Pinhas, Vincent Sun, Matthew S Wieder, Avnish Deobhakta
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Purpose:
To report a rare case of spontaneous vitreous and intraretinal hemorrhage in a patient with juvenile X-linked retinoschisis which was managed conservatively.
Methods:
Single patient case report.
Introduction:
Juvenile X-linked retinoschisis (JXLR) most often occurs as a result of a genetic defect in the retinoschisin (RS1) gene, causing a separation between the ganglion cell layer and the nerve fiber layer. Spontaneous vitreous hemorrhage has been reported as an uncommon secondary consequence of JXLR. We present a case of spontaneous vitreous and diffuse macular intraretinal hemorrhages in a patient with JXLR which resolved with medical management alone.
Results:
A 23-year-old man with a history of juvenile X-linked retinoschisis presented to the ophthalmic emergency room complaining of acute onset of floaters in his right eye. On examination, the patient was found to have a new vitreous hemorrhage with diffuse intraretinal hemorrhages in his right eye, without new retinal tears or detachment. SD-OCT demonstrated multifocal pockets of subretinal fluid. The genetic testing panel revealed a hemizygous mutation in the RS-1 gene. He was managed conservatively on oral acetazolamide, with the resolution of the subretinal fluid and with both visual and symptomatic improvement.
Conclusions:
Spontaneous vitreous hemorrhage may rarely occur in patients with JXLR, even in the absence of acute retinal tear or detachment. This case demonstrates an atypical presentation of vitreous hemorrhage with diffuse intraretinal hemorrhage and new multifocal areas of subretinal fluid which improved without surgical intervention. Good outcomes may be achieved in these patients with conservative management alone, even in atypical presentations.
Case Report of Granulicatella adiacens as a Cause of Bacterascites
Authors: Molly C Cincotta, K C Coffey, Shannon N Moonah, Dushant Uppal, Molly A Hughes
Journal: Case Rep Infect Dis (2015)

Granulicatella adiacens is a Gram-positive coccus, formerly grouped with nutritionally variant Streptococcus, often found as commensal bacteria of the human oral cavity, urogenital tract, and gastrointestinal tract. Prior case reports have demonstrated Granulicatella spp. as a pathogen that can cause bacteremia and infective endocarditis particularly of prosthetic valves and pacemaker leads. Here, we report on a unique case of Granulicatella adiacens bacterascites in a 50-year-old male.
Paget Disease of the Vulva: Diagnosis by Immunohistochemistry
Authors: Andressa Gonçalves Amorim, Brunelle Batista Fraga Mendes, Rodrigo Neves Ferreira, Antônio Chambô Filho
Journal: Case Rep Dermatol Med (2015)

The objective of this paper is to report a case of extramammary Paget disease of the vulva, to describe its diagnosis, surgical treatment, and outcome, and to discuss the general characteristics of this pathology. This is a rare neoplasm, found principally in areas in which apocrine and eccrine glands are numerous. This case report is relevant to the literature since the differential diagnosis of extramammary Paget disease is difficult to be done only with the macroscopic appearance of the lesion and even with the microscopic characteristics, requiring further studies, immunohistochemistry, as to differentiate pathologies. The present report describes the case of a 63-year-old patient at the Santa Casa de Misericórdia Hospital in Vitória, Espírito Santo, Brazil, who presented with a hardened, ulcerated, and purplish lesion with hyperchromic and hypochromic spots, measuring 4 cm in diameter, located on the lower third of right labium majus, close to the vaginal fourchette. A right hemivulvectomy was performed, leaving wide margins all around. The patient progressed satisfactorily following surgery. Although extramammary Paget disease is rare, its incidence increases as a function of the patient's age. Patients should be followed up closely because of the risk of persistence and/or recurrence of the disease.
Draft genome sequence of Fermentimonas caenicola strain SIT8, isolated from the human gut
Authors: Mamadou Beye, Sofiane Bakour, Sory Ibrahima Traore, Jaishriram Rathored, Noémie Labas, Didier Raoult, Pierre-Edouard Fournier
Journal: Stand Genomic Sci (2018)
Keywords: fermentimonas caenicola, genome, human gut, microbiota
MeSH terms: Case Reports

We report the properties of a draft genome sequence of the bacterium Fermentimonas caenicola strain SIT8 (= CSUR P1560). This strain, whose genome is described here, was isolated from the fecal flora of a healthy 28-month-old Senegalese boy. Strain SIT8 is a facultatively anaerobic Gram-negative bacillus. Here we describe the features of this organism, together with the complete genome sequence and annotation. The 2,824,451-bp long (1 chromosome but no plasmid) contains 2354 protein-coding and 46 RNA genes, including four rRNA genes.
Primary Carcinoid Tumor of the Testis: A Case Report and Review of the Literature
Authors: Rawad Abou Zahr, Khalil Chalhoub, Elias Mansour, Camil Chouairy, Georges Ghazal, Joe Nohra
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Carcinoid tumors usually arise in the gastrointestinal tract. Immunocytohistochemical and radiologic studies are important in detecting the primary tumor site. Primary carcinoid tumors of the testis are particularly rare with a high malignant potential warranting long-term follow-up. We present the case of a primary carcinoid tumor of the testis with long-term surveillance.
Pregnancy and Accelerated Phase of Myeloid Chronic Leukemia Treated with Imatinib: A Case Report from a Developing Country
Authors: Lydie Ocini Ngolet, Innocent Kocko, Alexis Elira Dokekias
Journal: Case Rep Hematol (2016)

Background. Chronic myeloid leukemia is a hematological malignancy caused by expression of BCR-ABL tyrosine kinase oncogene, product of the t(9;22) Philadelphia translocation. Accelerated phase of this disease marks the onset of advanced rapidly progressive disease unresponsive to many therapies. Pregnancy limits broad number of therapies on patients because of their potential teratogenic effects. We report the case of a pregnant 34-year-old patient on accelerated phase successively managed by imatinib. She achieved a safe pregnancy and delivered at 39 weeks a healthy baby without congenital abnormalities. Our case is unusual because of the accelerated phase of the disease. Case Presentation. A 34-year-old African female with history of chronic phase of myeloid leukemia on imatinib, lost to follow-up for 4 months, presented to the hematological department for abdominal discomfort. Accelerated phase of chronic myeloid leukemia was diagnosed. Complete hematological response was achieved on high doses of imatinib. At the completion of 39 weeks, she delivered a healthy child without congenital anomalies. Conclusion. Despite its teratogenic and embryotoxic effects, front line imatinib is the only effective, well-tolerated treatment for patient on accelerated phase that can be offered to patients in sub-Saharan countries.