OpenMed/multicare-articles huggingface dataset:
HaNDL Syndrome Presenting with Thunderclap Headache
Authors: Melvin Parasram, Ashwin Malhotra, Andrea S Yoo, Saad A Mir
Journal: Case Rep Neurol Med (2021)
MeSH terms: Case Reports

Introduction:
Transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL) is defined as a secondary, nonvascular headache disorder characterized by the findings described in its name. Patients with HaNDL syndrome typically present with gradual onset migrainous headaches of moderate to severe intensity with transient neurological symptoms. Case Report. We discuss a patient who presented with thunderclap headache, recent transient neurologic deficits, and was ultimately diagnosed with HaNDL after an extensive neurologic evaluation.
Conclusion:
Thunderclap headache has very rarely been described in patients with HaNDL. After excluding emergent and secondary causes, HaNDL should be considered in patients with thunderclap-quality headaches, particularly when there is a history of transient neurological symptoms.
The First ongoing Pregnancy Following Comprehensive Aneuploidy Assessment Using a Combined Blastocenetesis, Cell Free DNA and Trophectoderm Biopsy Strategy
Authors: Jara Ben-Nagi, Rabi Odia, Xavier Viñals Gonzalez, Carleen Heath, Dhruti Babariya, Sioban SenGupta, Paul Serhal, Dagan Wells
Journal: J Reprod Infertil (2019)
Keywords: biopsy, blastocentesis, cell free dna
MeSH terms: Case Reports

Background:
The exact origin of cell-free DNA found in spent culture media or blastocoel fluid is currently unknown but with the potential to become an improved source of DNA for chromosomal analysis than trophectoderm biopsy samples, it provides a superior representation of the fetal genetic status. However, the genetic material contained within the blastocoel cavity may be more reliable to assessment of embryo euploidy in a clinical context than trophectoderm of cell-free DNA.
Case presentation:
This is the first UK case report where all three sources of DNA were analyzed in a clinical setting on 29 th January 2018 at the Centre for Reproductive and Genetic Health, London, leading to an ongoing clinical pregnancy.
Conclusion:
The experience from this case report suggests that removal of blastocoel fluid, sampling of spent culture media and trophectoderm biopsy can be carried out in parallel. Gathering genetic information from two to three independent samples of embryo DNA may provide enhanced diagnostic accuracy and may clarify cytogenetic status of mosaic embryos.
Sphingomonas paucimobilis infections in children: 24 case reports
Authors: Nuri Bayram, Ilker Devrim, Hurşit Apa, Gamze Gülfidan, Hande Namal Türkyılmaz, Ilker Günay
Journal: Mediterr J Hematol Infect Dis (2013)

Sphingomonas paucimobilis is a causative agent of infection in immunocompromised patients, and healthcare-associated infection. Although the infections associated with S.paucimobilis occurs rarely, it has been encountered with increasing frequency in clinical settings. In the current study we reported clinical features of the children with S.paucimobilis infection, and the antimicrobial susceptibilities of the isolated strains among the patients. This study was conducted in Dr. Behçet Uz Children's Hospital, Turkey, during the period of January 2005 and December 2012. The medical records of pediatric patients with positive cultures for S.paucimobilis were reviewed. Sphingomonas paucimobilis isolates were recovered from 24 pediatric patients. The median age was 4 years (ranging from 3 days infant to 15 years) and 58,3% were male. Eight (33,3%) of the patients were under 1 months of age. Among the patients; 13 (54,2%) infections were community related however 11(45.8%) infections were nosocomial infection. The median duration of hospital stay was 7 days (ranging from 4 to 22 days). The most effective antibiotics were fluoroquinolones, carbapenems, and trimethoprim/sulfamethoxazole. This is the first largest study in children to evaluate the clinical features of S. paucimobilis infections. Sphingomonas paucimobilis may cause infections in both previously healthy and immunocompromised children. Although variable antimicrobial regimens were achieved to the patients, there was no attributable fatality due to S.paucimobilis infections due to the low virulence of the bacteria.
Single-Docking Robotic-Assisted Radical Nephroureterectomy in Morbidly Obese Patient Post-Radical Cystectomy With Ileal Conduit: A Case Report
Authors: Bandar O Alsahn, Maher S Moazin, Raihanah S Al Khatem, Albaraa M Hariri, Fatimah A Alawami
Journal: Cureus (2023)
Keywords: radical cystectomy, robotic nephroureterectomy, surgical management, transitional cell carcinoma, urothelial cancer
MeSH terms: Case Reports

Bladder cancer is considered the most prevalent malignancy affecting the urinary tract system. Urothelial carcinoma, also known as transitional cell carcinoma (TCC), can arise from the entire urinary tract, with the bladder considered the primary site of origin and representing 95% of all cases. The management of TCC of the upper urinary tract is mainly by nephroureterectomy (NU). To our knowledge, there are no data regarding single-docking robotic-assisted NU following cystectomy with an ileal conduit. Therefore, in this study, we are reporting a case of single-docking robotic-assisted NU in a patient who previously underwent open cystectomy with an ileal conduit. A case of a 57-year-old female diagnosed with bladder cancer 10 years ago and underwent several transurethral resections of bladder tumor (TURBT) sessions presented for the first time in 2019, complaining of hematuria and dropping in the hemoglobin, which was not improving with multiple TURBT. For that, the patient underwent an open radical cystectomy with an ileal conduit. During the follow-up in 2021, computed tomography (CT) of the pelvis and abdomen with intravenous (IV) contrast showed a 7 mm enhancing lesion in the right proximal ureter, which was suspicious of proximal ureter mass. In 2022, the patient was again seen in the outpatient clinic; a CT of the pelvis and abdomen with IV contrast was done and demonstrated a significant progression of the mass size to 2 x 1.5 cm, with no other intraabdominal or intrathoracic lesions. For that, she underwent a single-docking robotic-assisted NU. To conclude, performing a single-docking robotic-assisted NU in a patient who previously underwent open radical cystectomy with an ileal conduit is challenging due to multiple adhesion and altered anatomy. More studies need to be published regarding the long-term outcomes of such procedures.
Focal Seizures and Posterior Reversible Encephalopathy Syndrome as Presenting Signs of IgA Vasculitis/Henoch-Schoenlein Purpura-An Educative Case and Systematic Review of the Literature
Authors: Dominik Funken, Friedrich Götz, Eva Bültmann, Imke Hennies, Janina Gburek-Augustat, Julya Hempel, Frank Dressler, Ulrich Baumann, Christian Klemann
Journal: Front Neurol (2021)
Keywords: cns involvement, henoch-schönlein purpura (hsp), iga vasculitis, cerebral vasculitis, encephalopathy syndrome, review, small-vessel vasculitis, treatment

Background: IgA vasculitis/Henoch-Schoenlein purpura (IgAV/HSP) is a systemic small vessel vasculitis of unknown pathogenesis predominantly affecting children. While skin, GI tract, joints, and kidneys are frequently affected and considered, central nervous system (CNS) involvement of this disease is underestimated. Methods: We provide a case report and systematically review the literature on IgAV, collecting data on the spectrum of neurological manifestations. Results: We report on a 7-year-old girl with IgAV who presented with diplopia and afebrile focal seizures, which preceded the onset of purpura. Cranial magnetic resonance imaging was consistent with posterior reversible encephalopathy syndrome (PRES), showing typical focal bilateral parietal swelling and cortical and subcortical high signal intensities on T2-fluid attenuated inversion recovery (FLAIR) images predominantly without diffusion restriction. Cerebrospinal fluid analysis and blood tests excluded systemic inflammation or vasculitis. Interestingly, hypertension was not a hallmark of the developing disease in the initial phase of PRES manifestation. Renal disease and other secondary causes for PRES were also excluded. Supportive- and steroid treatment resulted in restitution ad integrum. Reviewing the literature, we identified 28 other cases of IgAV with CNS involvement. Severe CNS involvement includes seizures, cerebral edema, or hemorrhage, as well as PRES. Thirteen patients fulfilled all diagnostic criteria of PRES. The mean age was 11.2 years (median 8.0, range 5-42 years), with no reported bias toward gender or ethnic background. Treatment regimens varied from watchful waiting to oral and intravenously steroids up to plasmapheresis. Three cases showed permanent CNS impairment. Conclusion: Collectively, our data demonstrate that (I) severe CNS involvement such as PRES is an underappreciated feature of IgAV, (II) CNS symptoms may precede other features of IgAV, (III) PRES can occur in IgAV, and differentiation from CNS vasculitis is challenging, (IV) pathogenesis of PRES in the context of IgAV remains elusive, which hampers treatment decisions. We, therefore, conclude that clinical awareness and the collection of structured data are necessary to elucidate the pathophysiological connection of IgAV and PRES.
The successful detection of postpartum unruptured vaginal pseudoaneurysm using ultrasonography: a case report
Authors: Saki Gondo, Daichi Urushiyama, Toshiyuki Yoshizato, Shinichi Kora, Miyako Maehara, Haruhiko Kondo, Shingo Miyamoto
Journal: Springerplus (2014)
Keywords: contrast-enhanced computed tomography, pseudoaneurysm, puerperium, transvaginal ultrasonography, vagina

Introduction:
We report the first case of the successful detection of postpartum unruptured vaginal pseudoaneurysm using power- and pulsed-Doppler ultrasonography after delivery.
Case description:
A 38-year-old primiparous Japanese woman had a vaginal laceration with pulsatile bleeding after delivering by vacuum extraction. Transvaginal ultrasonography of the repaired vaginal wall showed an 18 × 20 mm hematoma within which a 6 × 7 mm pulsating anechoic mass was detected. Power-Doppler ultrasonography showed blood flow signals in the anechoic mass. Arterial waveforms detected in pulsed-Doppler mode were suggestive of unruptured pseudoaneurysm. Careful monitoring with contrast-enhanced computed tomography showed an increase in the size of the pseudoaneurysm on the fourth postpartum day. On the sixth postpartum day, massive vaginal bleeding occurred. Emergency angiography revealed strong staining with extravasation from the left vaginal artery, confirming the diagnosis of pseudoaneurysm. Embolization for hemostasis was successfully performed.
Discussion and evaluation:
As far as we know, our case is the first in which an unruptured vaginal pseudoaneurysm was diagnosed using ultrasonography. The differential diagnoses of pseudoaneurysm are arteriovenous malformations including arteriovenous fistula. This case had the typical ultrasonographic patterns of pseudoaneurysm in which the presence of one or two cystic masses in B-mode and color- and/or power-Doppler flow signals was demonstrated along with high-resistance arterial flow waveforms in pulsed-Doppler mode. Sequential examinations of contrast-enhanced CT showed ongoing development of the pseudoaneurysm. In retrospect, we could have performed angiography for embolization when the unruptured pseudoaneurysm was diagnosed, or at the latest when ongoing development of the pseudo-aneurysm was recognized, irrespective of whether symptoms were present.
Conclusions:
Ultrasonography is a non-invasive and clinically useful modality in the differential diagnosis of pseudoaneurysm. Contrast-enhanced computed tomography with or without ultrasonography can be useful for sequential monitoring of the size of unruptured pseudoaneurysms.
Papillary thyroid carcinoma presenting as miliary nodules on chest roentgenogram in the paediatric setting: A case report
Authors: Nandi Viljoen, Marc Hendricks, Eugenio Panieri, Alessandro Pietro Aldera
Journal: Int J Surg Case Rep (2020)
Keywords: endocrine pathology, lymphangitic carcinomatosis, papillary thyroid carcinoma
MeSH terms: Case Reports

Introduction:
Papillary thyroid carcinoma (PTC) is the most common carcinoma to occur in childhood with a peak incidence between 11-17 years, and typically presents with advanced locoregional disease. Pulmonary metastases are seen in up to 46% of cases and should enter the differential diagnosis of miliary nodules seen on chest roentgenogram, even in regions where tuberculosis is endemic.
Presentation of case:
An 11-year-old male presented with a short history of cough, shortness of breath and constitutional symptoms. Examination revealed cervical lymphadenopathy and diffuse bilateral nodular infiltrates on the chest roentgenogram. Investigation for Mycobacterium tuberculosis was negative and this initiated biopsy of a cervical lymph node. Histopathological examination revealed metastatic PTC. Ultrasonography and magnetic resonance imaging (MRI) were performed for preoperative staging. The patient subsequently underwent total thyroidectomy with selective neck dissection.
Discussion:
There are several potential causes when dealing with miliary nodules on chest roentgenogram. Thorough interrogation of the clinical, radiological, pathological and microbiological data is required to arrive at the correct diagnosis. Postoperative adjuvant therapy with radioactive iodine is recommended in children with metastatic disease, but this should be restricted preferably to a single dose to avoid the complication of pulmonary fibrosis.
Conclusion:
This case highlights the differential diagnostic considerations of a patient presenting with constitutional symptoms and a miliary pattern on chest roentgenogram. Carcinomas are uncommon in children but should not be forgotten.
Native Pulmonic Valve Endocarditis due to Mycobacterium fortuitum: A Case Report and Literature Review
Authors: Aaron M Mulhall, Renee S Hebbeler-Clark
Journal: Case Rep Infect Dis (2015)

Endocarditis secondary to Mycobacterium fortuitum is a rare entity often involving prosthetic valves and rarely native valves. Pulmonic valve endocarditis secondary to any organism is rare. We report the first case of native pulmonic valve endocarditis secondary to M. fortuitum and a literature review of native valve M. fortuitum endocarditis.
Two Cases of Post-Traumatic Mucormycosis due to Mucor circinelloides: Salvage Therapy with a Combination of Adjunctive Therapies
Authors: A De Paepe, K Dams, D Robert, R Jacobs, G L Ten Kate, S Van Ierssel, H Jansens, M Lammens, A Van Beeck, P G Jorens
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Mucormycosis is a rare, emerging angioinvasive infection caused by ubiquitous filamentous fungi. In recent decades, an increase in cutaneous or post-traumatic mucormycosis has been reported. We describe two cases of post-traumatic wound infections with Mucor circinelloides, a mucor species only rarely reported as a cause of post-traumatic mucormycosis. Often considered lethal, management required a combination of medical and surgical therapies to achieve a favorable outcome in both cases.
A case of acute appendicitis due to intestinal schistosomiasis
Authors: Mugahid A Salih
Journal: Ann Med Surg (Lond) (2018)
Keywords: appendicitis, schistosomiasis
MeSH terms: Case Reports

Introduction:
Intestinal Schistosomiasis is a parasitic disease caused by Schistosoma mansoni or Schistosoma japonica. Sudan is considered one of the endemic areas of schistosomiasis and many studies were done as regard to the prevalence and impact of the disease. Schistosomal appendicitis is rare, particularly in developed countries compared to endemic areas.
Case report:
This is a case of 36 -year- old man with past history of schistosomiasis presented with features of intestinal obstruction to Ibrahim Malik teaching hospital in Khartoum-Sudan. Exploratory laparotomy revealed gangrenous appendix. Histopathology results came back as extensive necrosis of the appendix with multiple viable Schistosomal ova. Stool analysis revealed no ova. The patient received praziquantel therapy and now he is in a good condition.
Conclusion:
Clinicians and pathologist should be aware of schistosomal appendicitis, particularly in endemic areas like Sudan.
Unilateral twin ectopic pregnancy in a patient with a history of multiple sexually transmitted infections
Authors: Charles J Rolle, Clifford Y Wai, Roger Bawdon, Rigoberto Santos-Ramos, Barbara Hoffman
Journal: Infect Dis Obstet Gynecol (2006)
MeSH terms: Pregnancy, Ectopic / etiology, Pregnancy, Multiple, Sexually Transmitted Diseases / complications, Case Reports, Adult, Chlamydia Infections / complications, Chlamydia Infections / microbiology, Chlamydia trachomatis, Female, Gonorrhea / complications, Gonorrhea / microbiology, Herpes Genitalis / complications, Herpes Genitalis / virology, Herpesvirus 2, Human, Humans, Neisseria gonorrhoeae, Pregnancy, Sexually Transmitted Diseases / microbiology, Sexually Transmitted Diseases / virology, Syphilis / complications, Syphilis / microbiology, Treponema pallidum

Background:
The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2, and Treponema pallidum. The case illustrates the potential impact of sexually transmitted infections (STIs) on the risk of a twin ectopic pregnancy.
Case:
A 24-year-old primigravida, presented with an unknown last menstrual period, lower abdominal pain, watery vaginal discharge, and vaginal spotting. During this hospitalization, serum beta-HCG testing was 263 mIU/mL and transvaginal ultrasonographic examination suggested a nonviable unilateral twin ectopic pregnancy. At exploratory laparotomy, a 10 cm mass involving the right fallopian tube and ovary was excised. Pathological evaluation of the specimen identified a monochorionic, diamnionic twin ectopic pregnancy within the fallopian tube.
Conclusions:
Patients with a history of multiple (STIs) are known to be at risk for the development of chronic pelvic infection and postinflammatory scarring. The resulting distortion of the normal tubal anatomy leads to an increased risk of an uncommon presentation of ectopic pregnancy.
Utilization of Imaging to Identify a Benign Condition Mimicking Acute Appendicitis in a Child
Authors: Neelam Phalke, Zubin Mehta, Samrat Das
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: appendagitis, appendicitis, inflammation, omental infarct

One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. The patient was managed medically and made a full recovery without surgical intervention. The aim of this case report is to review omental infarction and present a way of differentiating this disease from appendicitis, utilizing imaging, with the goal of avoiding surgical intervention. We also discuss the presentation and imaging findings of and another closely related condition-epiploic appendagitis. It is important to differentiate appendicitis from these 2 conditions as they can be often managed medically without surgical intervention.
First Reported Case of Hemopericardium Related to Dabigatran Use Reversed by New Antidote Idarucizumab
Authors: Steven Song, Joselle Cook, Clive Goulbourne, Matthew Meade, Louis Salciccioli, Jason Lazar
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Dabigatran, the first novel oral anticoagulant (NOAC) with a reversal agent, heralded a paradigm shift in the treatment of nonvalvular atrial fibrillation. The potential for life-threatening hemorrhagic events with the use of NOACs has been highly debated since the effectiveness of reversal agents such as idarucizumab is based primarily on pharmacologic data. It is known that cancer patients are at an increased risk of bleeding with anticoagulation, though specific studies demonstrating the risks or efficacy of NOACs in this population are lacking. We provide the first report of hemopericardium resulting in multiorgan failure related to dabigatran use that was successfully reversed by idarucizumab in a man with prostate cancer on chemotherapy.
Transmission Routes Analysis of SARS-CoV-2: A Systematic Review and Case Report
Authors: Huanjie Li, Yangyang Wang, Mingyu Ji, Fengyan Pei, Qianqian Zhao, Yunying Zhou, Yatian Hong, Shuyi Han, Jun Wang, Qingxi Wang, Qiang Li, Yunshan Wang
Journal: Front Cell Dev Biol (2020)
Keywords: covid-19, sars-cov-2, asymptomatic patients, eyes-oral transmission, transmission routes

The global outbreak of SARS-CoV-2 spread rapidly throughout the world which transmitted among humans through various routes. Asymptomatic (carriers) and possible fecal-oral transmission, resulted into a large-scale spread. These issues pose great challenges to disease diagnosis and epidemic control. We obtained data on 29 cases of COVID-19 patients in Jinan, China, and reported the clinical data of asymptomatic patients confirmed with stool samples positive. Some patients with gastrointestinal infections are secondary to pulmonary infections, and during the patients' recovery period, the virus may still existin the patient's gastrointestinal tract over 7 days. We combined with epidemiological and clinical data of asymptomatic patients to analyze the possible routes of viral transmission and infection, including eyes-nose, hands-eyes, fecal-oral, and eyes-oral, et al., thus first presented the two-way transmission through eyes-oral. Through associating infection symptoms with the transmission routes of virus and the patient course of the disease, we expect to provide guidelines for clinical diagnosis and the basis for suppressing the spread of the virus and antiviral treatment.
Progressive Multifocal Leukoencephalopathy after Three Consecutive Liver Transplantations
Authors: F Ozdemir, V Ince, A Baskiran, Z Ozdemir, Y Bayindir, B Otlu, S Yilmaz
Journal: Int J Organ Transplant Med (2015)
Keywords: immunocompromised host, jc virus, leukoencephalopathy, liver transplantation, viral load, progressive multifocal
MeSH terms: Case Reports

Progressive multifocal leukoencephalopathy (PML) is a lytic infection of the central nervous system caused by the reactivation of John Cunningham Virus (JCV) in severely immunosuppressed patients. Occurrence of PML after solid organ transplantations, especially after liver transplantation, is rare. If a patient has poor prognostic factors such as atypical radiological involvements or high viral load in cerebrospinal fluid (CSF), overall survival rates could be poor. Herein, we report on a patients who underwent liver transplantation three times and developed PML with unexpected radiological findings; he was also positive for JCV DNA with a high viral load. Although there are limited data about efficacy of cytarabine against JCV, it was given to the patient for five days. Despite the initiation of cytarabine and complete cessation of the immunosuppressive therapy, we lost the patient, unfortunately.