OpenMed/multicare-articles huggingface dataset:
Gas-Forming Liver Abscess versus Emphysematous Hepatitis: A Radiologic Diagnostic Dilemma-A Case Report and Review of the Literature
Authors: Youssef Ghosn, Ali Abdallah, Mohammed Hussein Kamareddine, Amine Geahchan, Ahmad Baghdadi, Ziad El-Rassi, Abbas Chamseddine, Raja Ashou
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

A 38-year-old diabetic woman, with history of cholecystectomy and ventral hernia repair, was hospitalized due to sudden-onset abdominal pain and fever. Computed tomography revealed a mixed collection containing necrotic debris and emphysematous change in the left lobe of the liver mainly in segments II and III. These radiological findings suggested emphysematous hepatitis (EH). The patient's condition deteriorated rapidly, and she was rushed to the operating room for urgent exploratory laparotomy where debridement was performed. Intraoperatively the patient was found to have an abscess with incomplete capsule concurrent with hepatic necrosis suggesting the co-occurrence of abscess and EH. The patient survived and was discharged after 13 days. Relevant literature was reviewed, and to the best of our knowledge, EH is an extremely rare entity with limited data regarding its pathogenesis, causative organisms, and management. EH is a rapidly invasive disease process that can be fatal if appropriate therapeutic intervention is delayed. Initial presentations are usually subtle, thus high clinical and radiological suspicion is required for early diagnosis and management to decrease associated mortality and morbidity. We hence report the first successfully treated case of EH with review of the literature.
A Novel Minimally Invasive Reduction Technique by Balloon and Distractor for Intra-Articular Calcaneal Fractures: A Report of 2 Cases
Authors: M Prod'homme, S Pour Jafar, P Zogakis, P Stutz
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Treatment of displaced intra-articular fractures of the calcaneus remains a challenge for the orthopaedic surgeon. Conservative therapy is known to produce functional impairment. Surgical approach is plagued by soft-tissue complications and insufficient fracture reduction. We describe a minimally invasive technique that will hopefully improve these issues. We want to present our first experience through two cases. The first was a 46-year-old man who presented with a Sanders type IIBC calcaneal fracture, and the second was a 86-year-old woman with a type IIIBC calcaneal fracture. We introduced 2 Schanz screws in the talus and the calcaneus. After distraction, we introduced an inflatable balloon inside the calcaneus. By inflating the balloon, the articular surface was reduced by lifting it up. Then bone cement was injected in order to maintain the reduction. Additional screw fixation was used in the young patient. Postoperative imaging showed good congruence of the subtalar joint without leakage of cement, for the two cases. After 2 months, the patients had no pain and were without soft-tissue complications. We advocate this technique to perform a minimally invasive reduction and fixation of intra-articular calcaneal fractures because it preserves soft-tissues and provides good clinical results with early weight-bearing.
External iliac artery thrombosis associated with the ilio-inguinal approach in the management of acetabular fractures: a case report
Authors: Kajetan Klos, Ivan Marintschev, Joachim Böttcher, Gunther O Hofmann, Thomas Mückley
Journal: J Med Case Rep (2008)

Introduction:
The ilio-inguinal approach has come to be used routinely in the management of acetabular fractures involving the anterior wall. Thrombotic complications following surgery via this route are a serious, but rare, complication.
Case presentation:
We report the case of a 66-year-old male patient who slipped on an icy pavement and fell on his left hip. He sustained a comminuted acetabular fracture (a transtectal T-fracture with an incomplete posterior stem through the ischial tuberosity), and was operated on five days later, via an ilio-inguinal approach. In the recovery room, his left lower limb was found to be cool and pale. Immediate re-exploration showed a left external iliac artery thrombosis, and thrombectomy was performed. In the surgical management of acetabular fractures, thrombosis of a major pelvic artery is a rare but potentially devastating complication. We discuss the possible aetiology (initial vessel trauma versus iatrogenic, intraoperative arterial injury) and pathomechanism, and wish to draw attention to this complication and to recommend ways in which it can be prevented.
Conclusion:
We recommend circulation monitoring in patients with acetabular fractures, especially where nerve blocks and/or deep sedation/analgesia have been used. High-risk patients should be identified and subjected to intensive preoperative screening, including ultrasonography and if necessary angiography.
Septic Pulmonary Embolism Causing Recurrent Pneumothorax in an Intravenous Drug User without Right-Sided Valvular Vegetation in Infective Endocarditis
Authors: Mason Montano, Kevin Lee, Kushal Patel, Mutsumi Kioka
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

The following report illustrates a case of a 36-year-old Caucasian male with intravenous drug use (IVDU) induced septic thrombophlebitis presenting with recurrent unilateral pneumothoraces from septic pulmonary embolism (SPE) without the presence of obvious right-sided valvular vegetation in infective endocarditis (IE), defined as tricuspid or pulmonary valve lesions. Pneumothorax (PTX) has been observed as a rare complication of SPE and is commonly associated with infective right-sided IE, IVDU, and intravascular indwelling catheters. However, this case is novel as it is the very rare documented case of recurrent, unilateral, spontaneous right PTX refractory to multiple chest tube placements in such a setting. Therefore, the absence of detectable right-sided valvular vegetation in IE does not obviate the risk of SPE-induced PTX in IVDU and further expands the realm of infectious and pulmonary consequences of SPE and IVDU.
About nystagmus transformation in a case of apogeotropic lateral semicircular canal benign paroxysmal positional vertigo
Authors: Paolo Vannucchi, Rudi Pecci
Journal: Int J Otolaryngol (2011)
MeSH terms: Case Reports

THERE ARE TWO FORMS OF LATERAL SEMICIRCULAR CANAL BENIGN PAROXYSMAL POSITIONAL VERTIGO: geotropic and apogeotropic. When the pathophysiological mechanism of the apogeotropic form is that of canalolithiasis, we can observe a transformation from an apogeotropic nystagmus into a geotropic one. Usually, this phenomenon happens simultaneously on both sides, thus enabling us to observe a right-beating paroxysmal positional nystagmus when the patient lies on the right side and a left-beating paroxysmal positional nystagmus on the left side. We describe a case in which the transformation occurred gradually, so that, after three head rotations from side to side in supine position, there was a right nystagmus beating toward the ground (geotropic) with the patient on the right side and a right nystagmus beating away from the ground (apogeotropic) on the left side. However, after further rotations we observed the nystagmus transformation also on the left side, with a geotropic nystagmus on both sides. The phenomenon of gradual transformation could happen because initially only a part of the debris moved from the anterior to the posterior aspect of the canal during head rotations.
Impact of Covid-19 on informal employment: A case study of women domestic workers in Khyber Pakhtunkhwa, Pakistan
Authors: Adnan Ahmad Dogar, Ikram Shah, Tahir Mahmood, Noor Elahi, Arif Alam, Urooj Gul Jadoon
Journal: PLoS One (2022)
MeSH terms: COVID-19 / epidemiology, Communicable Disease Control, Female, Humans, Pakistan / epidemiology, Policy, Social Support

COVID-19 indiscriminately impacted all the segments of the global society. Due to the unstructured job market, women in the informal sector were at high risk to experience the adverse effects of the pandemic. This paper aims to explore the impact of COVID-19 on women domestic workers and their families. Semi structured interviews conducted with fifty-four women domestic workers in three districts of Khyber Pakhtunkhwa, Pakistan were analyzed in five themes: disruption caused by lockdown, loss of livelihood, economic hardships, social support mechanism, and challenges faced during the pandemic. The study underlines that the pandemic left severe impacts on access to basic services, employment, food security at household level and pattern of expenditures. The plummeting economic activities led to sudden drops in earnings that forced families to sell their assets and incur debts. Respondents lamented over the social support system and considered it a necessary but not sufficient condition for uplifting the lives of the poor. Strains in marital relationships led to stress, anxiety and domestic violence among families. The utmost concern was the restoration of economic activities and urgent policy interventions to strengthen social safety measures for the vulnerable segments of society.
Mismatched transfusion of 8 AB0-incompatible units of packed red blood cells in a patient with acute intermittent porphyria
Authors: Burkard Rudlof, Burkhard Just, Robert Deitenbeck, Thomas Ehmann
Journal: Saudi J Anaesth (2011)
Keywords: incompatible transfusion, mixed field reaction, molecular genetic diagnostic, porphyria
MeSH terms: Case Reports

We report on a patient with acute intermittent porphyria, who received 8 AB0 incompatible units of packed red blood cells in an emergency situation. She never showed any signs of severe intravascular haemolysis. The patient died after four weeks because of a multi-organ failure caused from the malpractice of the porphyria. The problems of bedside testing, mixing field reaction, fresh frozen plasma and molecular-genetic determination of bloodgroup were discussed.
Macrophage Activation Syndrome as Onset of Systemic Lupus Erythematosus: A Case Report and a Review of the Literature
Authors: Guido Granata, Dario Didona, Giuseppina Stifano, Aldo Feola, Massimo Granata
Journal: Case Rep Med (2015)

Macrophage activation syndrome (MAS) is a potentially fatal condition. It belongs to the hemophagocytic lymphohistiocytosis group of diseases. In adults, MAS is rarely associated with systemic lupus erythematosus, but it also arises as complication of several systemic autoimmune disorders, like ankylosing spondylitis, rheumatoid arthritis, and adult-onset Still's disease. Several treatment options for MAS have been reported in the literature, including a therapeutic regimen of etoposide, dexamethasone, and cyclosporine. Here we report a case of 42-year-old woman in whom MAS occurred as onset of systemic lupus erythematosus.
Necrosis in the flexor hallucis longus muscle after subclinical leg compartment syndrome and tibial fracture: A case report
Authors: R Andri Primadhi, Gibran T Alpharian, Renaldi Prasetia
Journal: Int J Surg Case Rep (2020)
Keywords: ankle fusion, compartment syndrome, contracture, fhl, necrosis
MeSH terms: Case Reports

Introduction:
Compartment syndrome is a condition in which an increased pressure within one compartment results in decreased blood flow, preventing nutrition and blood supply from reaching nerve and muscle cells. Ongoing physiological cascades can progress to local and systemic manifestations. This article presents a case of subclinical compartment syndrome resulting in muscle necrosis and contracture. More specifically, this article highlights the presentation of a complicated and neglected case of subclinical compartment syndrome with a subsequent fixed equinus deformity and its management.
Presentation of case:
A 15-year-old high school student sustained a proximal tibia fracture during a motor vehicle accident. The compartment was not recognized until a period of follow-up. The patient later presented to our clinic with ankle equinus deformity. Further exploration found the contracture and necrosis of flexor hallucis longus (FHL) muscle. We excised the necrotic wound and performed an ankle fusion.
Discussion:
The patient had developed subclinical localized deep posterior compartment syndrome in the distal portion of the FHL muscle. As only a small portion of the muscle was involved, there was no retraction of the main muscle belly; however, the necrotic part can become fibrotic and adhere to the surrounding tissues. While subclinical compartment syndrome is not uncommon, the finding of isolated FHL muscle necrosis is rare. Thus, the management is still debatable.
Conclusion:
This article emphasized that neglecting compartment syndrome may result in undesired complications, which emphasizes the importance of an early diagnosis and treatment.
A case series report on successful management of patients with COVID-19-associated lymphopenia and potential application of PG2
Authors: Wei-Yao Wang, Yuan-Ti Lee, Yao-Tung Wang, Ji-Zhen Chen, Su-Yin Lee, Shih-Ming Tsao
Journal: Front Med (Lausanne) (2022)
Keywords: astragalus polysaccharides, covid-19, pg2, lymphopenia, neutrophil-to-lymphocyte ratio
MeSH terms: Case Reports

Background:
Lymphopenia and the resultant high neutrophil-to-lymphocyte ratio (NLR) are hallmark signs of severe COVID-19, and effective treatment remains unavailable. We retrospectively reviewed the outcomes of COVID-19 in a cohort of 26 patients admitted to Chung Shan Medical University Hospital (Taichung City, Taiwan). Twenty-five of the 26 patients recovered, including 9 patients with mild/moderate illness and 16 patients with severe/critical illness recovered. One patient died after refusing treatment.
Case presentation:
We report the cases of four patients with high NLRs and marked lymphopenia, despite receiving standard care. A novel injectable botanical drug, PG2, containing Astragalus polysaccharides, was administered to them as an immune modulator. The decrease in the NLR in these four patients was faster than that of other patients in the cohort (0.80 vs. 0.34 per day).
Conclusion:
All patients recovered from severe COVID-19 showed decreased NLR and normalized lymphocyte counts before discharge. Administration of PG2 may be of benefit to patients with moderate to severe COVID-19 and lymphopenia.
Ultrasound Imaging of Quadriceps Tendon in a Recreational Golfer
Authors: Shawn D Felton, Arie J Van Duijn
Journal: POCUS J (2021)
Keywords: golf, knee, point of care ultrasound, quadriceps tendon
MeSH terms: Case Reports

The patient was a 69-year-old recreational golfer who injured his right . While walking between the 9th and 18th holes, he slipped on pine straw. Ultrasound images of the quadriceps tendon post-injury revealed a full-thickness tear of the Quadriceps tendon, Rectus Femoris and Vastus intermedius. The diagnosis was confirmed through MRI arthrogram imaging. The hypoechoic finding in the ultrasound exam demonstrated the imaging to be as precise in diagnosing a full thickness tear as the MRI. The patient underwent surgical repair of the Quadriceps Tendon and is currently progressing in rehabilitation.
Metastatic Renal Cell Carcinoma Presenting as Gastric Ulcer: Case Report and Literature Review
Authors: Alhareth Al Juboori, Satinder Kaur, Atigadda Reddy
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Renal cell carcinoma (RCC) accounts for approximately 3% of all adult malignancies. True gastrointestinal metastases, specifically to gastric wall, have been rarely observed. Herein we describe a case of delayed metastasis to gastric wall occurring more than a decade after previously curative nephrectomy for RCC. A 67-year-old male with history of right radical nephrectomy in 2001 for RCC was found to have an asymptomatic right lower lobe solitary lung mass upon routine follow-up in 2011, with final biopsy results showing metastatic RCC for which he was treated accordingly. In 2014, patient was evaluated for dyspepsia with microcytic anemia and underwent an esophagogastroduodenoscopy and colonoscopy. EGD revealed a solitary one-centimeter atypical ulcer in the posterior mid gastric body with biopsy results being consistent with metastatic RCC. Our literature review has yielded thirty-six reported cases of RCC in association with gastric wall metastases.
Reversal of tenofovir induced nephrotoxicity: case reports of two patients
Authors: Fatuma Some, Mathew Koech, Emily Chesire, Gabriel Kigen
Journal: Pan Afr Med J (2017)
Keywords: case report, hiv/aids, nephrotoxicity, reversal, tenofovir
MeSH terms: Anti-HIV Agents / adverse effects, Kidney Diseases / chemically induced, Tenofovir / adverse effects, Case Reports, Anti-HIV Agents / administration & dosage, Creatinine / metabolism, Humans, Male, Middle Aged, Tenofovir / administration & dosage, Anti-HIV Agents, Tenofovir, Creatinine

The use of the antiretroviral drug tenofovir has been associated with nephrotoxicity. However, the overall impact of this adverse effect has not comprehensively evaluated. Some researchers have reported that it is quite severe to warrant monitoring for renal toxicity, while others have concluded that the magnitude may not be that significant. We report two clinical cases seen in our renal clinic with high creatinine levels suggestive of nephrotoxicity who reverted back to normality upon withdrawal of tenofovir.
Medullary Thyroid Carcinoma With Elevated Serum CEA and Normal Serum Calcitonin After Surgery: A Case Report and Literature Review
Authors: Li Chen, Ke Zhao, Fuxin Li, Xianghui He
Journal: Front Oncol (2020)
Keywords: calcitonin (ctn), carcinoembryonic antigen (cea), management, medullary thyroid carcinoma (mtc), metastasis
MeSH terms: Case Reports

Background:
Medullary thyroid carcinoma (MTC) is a relatively rare malignant tumor subtype originated the parafollicular C cells of the thyroid gland, producing tumor markers including calcitonin (Ctn), carcinoembryonic antigen (CEA), and chromogranin A. Preoperative serum Ctn and CEA value is important for assessing disease burden, postoperative serum Ctn and CEA can help to determine whether there are recurrence and distant metastasis.
Case presentation:
We report a rare case in which the CEA level continued to increase and the Ctn value was normal after total thyroidectomy and central lymph node dissection in a MTC patient. The patient was asymptomatic during one and half year follow-up until lateral lymph node metastasis was revealed. However, the CEA level raised again after lateral neck lymph node dissection and bone metastases were found by 18F-FDG PET-CT.
Conclusion:
This case reminded us the recurrence of MTC should be suspected for patients with simply elevated CEA after surgery for MTC. Differential diagnosis of other malignant tumors and timely lymph node biopsy is of great significance for management.
A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome-Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
Authors: Seyed Saeid Sarkeshikian, Mohammad Reza Ghadir
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Introduction. Gastrinoma should be suspected when the peptic ulcer(s) is postbulbar, multiple, refractory, or recurrent, or ulcer is associated with nephrolithiasis, hypocalcaemia, or erosive esophagitis. The majority of gastrinomas are malignant. Case Presentation. The patient is a 41-year-old Iranian man who has been in good health until 36 months ago when duodenal perforation and two bouts of upper GI bleeding (GIB), each two months apart occurred. He also mentioned mild watery diarrhoea and decreased appetite. Serum gastrin level was elevated. Abdominal CT scan revealed pancreatic mass and three enhancing hepatic masses. CT-guided pancreatic biopsy revealed monotonous cells. Chemoembolization of hepatic metastases was done. New ct images 6 months later showed nearly total regressed hepatic and pancreatic lesions. Conclusion. Beside previously defined situations that take gastrinoma into account as the etiology of PUD, accumulation of PUD complications is highly suggestive of Zollinger-Ellisone syndrome (ZES). Regression of pancreatic primary after chemoembolization of hepatic metastases is unexplainable at the present time.
Prekallikrein deficiency presenting as recurrent cerebrovascular accident: case report and review of the literature
Authors: Esteban Uribe Bojanini, Arturo Loaiza-Bonilla, Agustin Pimentel
Journal: Case Rep Hematol (2012)

We report the case of a woman with history of hypertension and hyperlipidemia presenting with recurrent episodes consistent clinically with cerebrovascular accidents (CVA), and MRI changes suggestive of ischemia versus vasculitis as their cause. No anatomical neurological, rheumatic, cardioembolic, or arteriosclerotic etiologies could be determined by extensive workup. Incidentally, the patient was found to have prolonged activated Partial Thromboplastin Time (aPTT) and a normal Prothrombin Time (PT); further testing revealed a prekallikrein deficiency. Since no other cause for the CVAs was established, and other prothrombotic states were ruled out, it is proposed that they are clinical manifestations derived from the prekallikrein deficiency, which in a patient with known cardiovascular risk factors could lead to thrombotic complications such as stroke.
Primary pleural benign myxoid schwannoma in an 18-year-old female: a case report and literature review
Authors: Hussam Abou Al-Shaar, Safi Qutob, Ahmed Abu-Zaid, Ayman Azzam, Tarek Amin, Shamayel Mohammed
Journal: Case Rep Oncol Med (2014)

Pleural schwannomas are exceedingly rare neoplasms of the thoracic cavity. To the best of our knowledge, less than 20 cases have been reported in the medical English literature. Herein, we report the case of primary pleural benign myxoid schwannoma in an 18-year-old female. The patient was originally referred to our tertiary care hospital for further management of right adrenal gland mass. Physical examination and all laboratory tests were normal. Contrast-enhanced computed tomography scan showed a 4.2 × 3.2 cm, heterogeneous noncalcified mass involving the right adrenal gland region. The right renal vein and inferior vena cava were intact. There was no pleural effusion, ascites, or lymphadenopathy. No pelvic masses were identified. Patient was scheduled for surgical resection. On laparotomy, the mass was not found in its radiologically expected location, and the right kidney and right adrenal gland were intact. The right-sided lower part of diaphragm was opened, and the mass was interestingly found inside the thorax attached to the pleura, and resected successfully. A final histopathological diagnosis of primary pleural benign myxoid schwannoma was established. At a postoperative 6-month followup, there was no radiological evidence of tumor recurrence. Furthermore, literature review on pleural schwannomas is also presented.
Case report: A longitudinal study of an unusual rapidly progressive dementia case
Authors: Xiaoyan Liu, Ziqi Fan, Xuanyu Chen, Yanyan Zhang, Fangping He, Xiaohua Ma, Qing Ke
Journal: Front Neurol (2023)
Keywords: iglon5, autoimmune encephalopathy, immunotherapy, psychosis, rapidly progressive dementia
MeSH terms: Case Reports

It is daunting to determine the etiology of rapidly progressive dementia (RPD), which includes metabolic, neoplastic, infectious, autoimmune, neurodegenerative and other conditions. Herein, we illustrate an unusual case of a patient primarily exhibiting RPD, overlapping sleep dysfunction, psychosis and abnormal movement, which was finally defined as anti-IgLON5 disease, a novel and rare autoimmune encephalopathy. Furthermore, we longitudinally described his cognitive and psychological performance in detail, and determined that early initiation of immunotherapy in this patient did not result in a good outcome. These data highlight anti-IgLON5 disease as a possible differential diagnosis in patients with RPD.