OpenMed/multicare-articles huggingface dataset:
Gossypiboma: Spontaneous trans-urethral migration of a forgotten surgical gauze sponge 5 years post hysterectomy in grand multiparous post-menopausal woman
Authors: J T Enebe, C A Ilo, I J Ofor, K E Chukwubuike, C A Omeke, N V Udeozor, M N Nwankwo
Journal: Int J Surg Case Rep (2020)
Keywords: case report, gauze, gossypiboma, hysterectomy, maternal morbidity, transmigration, urinary bladder
MeSH terms: Case Reports

Introduction:
Gossypiboma denotes a mass of cotton retained in the body following surgery. Migration of gossypiboma from initial site is a rare entity and could pose some diagnostic difficulties. Migration of gauze sponge has been reported to occur in several organs of the body. There have been few reported cases but the true incidence may be much higher due to under reporting for fear of litigation.
Presentation of case:
We present an unusual case of a 58-year-old grand multiparous woman who had gauze retention for 5 years following a hysterectomy and presented with acute urinary symptoms. The gauze sponge transmigrated from the peritoneal cavity to the bladder and was partially extruded through the external urethral meatus. She had laparotomy for the removal of gauze sponge with good outcome.
Discussion:
Retained foreign body especially surgical sponges (gossypiboma) infrequently occurs and can be a source of great concern to the surgeon and patient. Foreign bodies inside the body cavities and organs can present with several non-specific clinical features that can make diagnosis difficult. Migration of surgical sponge (gauze, mops) into the urinary bladder is uncommon when compared to other abdominal and pelvic viscus. A gossypiboma in the peritoneal cavity creates a fistulous tract through the thick wall of the urinary bladder from long period of chronic inflammation as seen in the index case where the previous surgery was performed 5 years prior to onset of symptoms. Due to the non-specific presentations of gossypiboma, especially those in the bladder, several investigative modalities need to be employed to help make a prompt diagnosis. Most long-standing cases would require laparotomy due to the dense adhesions that occur around the site of the gossypiboma. Lack of appropriate diagnosis leaves the patient with recurrence of distressful symptoms and the consequent morbidities.
Conclusion:
Transmigration of a gauze sponge over 5 years from the peritoneal cavity into the urinary bladder and through the external urethral meatus following a hysterectomy is a rare occurrence and can present diagnostic difficulties. High index of suspicion, prompt diagnosis and management will help reduce the high morbidity that is associated with the condition as in the case reported.
A Rare Case of ALK-Positive Large B-Cell Lymphoma with CD33 Expression
Authors: Jessica Corean, K David Li
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK+ LBCL) is a very rare and aggressive subtype of diffuse large B-cell lymphoma characterized by ALK rearrangement. Immunophenotypically, the tumor cells are typically negative for common B-cell markers, T-cell markers, and CD30; however, they express markers of terminally differentiated B cells/plasma cells such as CD38, CD138, and MUM-1/IRF4. The diagnosis of ALK+ LBCL can be challenging, and often a large panel of immunostains is required to exclude other hematopoietic and nonhematopoietic neoplasms. To date, approximately 130-140 cases have been reported, but here we report the first known case of ALK+ LBCL with unusual CD33 expression.
Can training of health care workers improve data management practice in health management information systems: a case study of primary health care facilities in Kaduna State, Nigeria
Authors: Bilkisu Nwankwo, Mohammed Nasir Sambo
Journal: Pan Afr Med J (2018)
Keywords: data management, healthcare workers, practice, training
MeSH terms: Health Information Systems, Health Personnel / education, Management Information Systems, Primary Health Care / organization & administration, Multicenter Study, Adult, Health Personnel / standards, Humans, Inservice Training, Nigeria, Professional Competence

Introduction:
Reliable and accurate public health information is essential for monitoring, evaluating and improving the delivery of healthcare services. The objective of this study was to assess the effect of training health care workers on data management practice in health management information systems in primary health care (PHC) centers in Kaduna state.
Methods:
The study was quasi-experimental with baseline, intervention and end point components. It was carried out in two local government areas, a study and a control. Eleven PHC facilities were selected in each LGA. The intervention was carried out among 76 PHC workers in the study LGA. Data were collected using a health facility checklist and a focused group discussion (FGD) guide. Data analysis was done using SPSS version 20.0 and statistical significance of the difference between baseline and end-line data were determined using chi-square or fisher's exact test where applicable at p < 0.05.
Results:
There was a statistically significant increase in completeness of reporting (p = 0.02), overall accuracy rate (p < 0.001), timeliness rate of reporting (p = <0.001) and feedback (p = 0.012). No improvement was found in the control group. During the baseline FGDs, PHC workers in both study and control LGAs expressed difficulty in filling registers/forms, data analysis and use of data. At end point, those in the study LGA said their practice had improved but those in the control LGA still expressed difficulty in data management.
Conclusion:
Health management information system training achieved an improvement in the data management practice of PHC workers. In-service training and re-training should be done to improve data management practice of health workers.
COVID-19-Induced Fatal Thrombotic Thrombocytopenic Purpura in a Healthy Young Patient
Authors: Mariana Codevila Buere Pereira, Bruna Ruschel, Bruna Schneider, Vitor Salomão Gonçalves Melo de Melgar, Tatiana Helena Rech
Journal: Case Rep Crit Care (2022)
MeSH terms: Case Reports

Since the global coronavirus disease 2019 (COVID-19) pandemic began, findings indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might induce autoimmune disorders. Thrombotic thrombocytopenic purpura (TTP) is a devastating disease if not emergently treated. It presents with severe thrombocytopenia, microangiopathic hemolytic anemia, and neurologic findings with or without renal insufficiency. The antibody-mediated reduced activity of the disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) induces the accumulation of ultrahigh-molecular-weight multimers of von Willebrand factor, leading to platelet aggregation and thrombosis. TTP can be an unusual presentation of COVID-19 disease mediated by the virus-induced immune response. We report a case of a healthy young patient presenting with the classic TTP pentad a few days after a diagnosis of COVID-19 confirmed by a positive SARS-CoV-2 RT-PCR test. The patient was initially treated with high-dose methylprednisolone and fresh frozen plasma until she was transferred to a tertiary care facility and plasma exchange was available. She evolved with a malignant ischemic vascular accident and was declared brain-dead 24 hours after the first plasma exchange section.
Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy
Authors: Guilherme Henrique Ribeiro, Mariana Comparotto Minamisako, Inês Beatriz da Silva Rath, Aira Maria Bonfim Santos, Alyne Simões, Keila Cristina Rausch Pereira, Liliane Janete Grando
Journal: J Appl Oral Sci (2018)
MeSH terms: Anti-Infective Agents / therapeutic use, Chemoradiotherapy, Adjuvant / methods, Jaw Diseases / therapy, Low-Level Light Therapy / methods, Osteoradionecrosis / therapy, Photochemotherapy / methods, Evaluation Study, Adult, Aged, Dose-Response Relationship, Radiation, Female, Homeostasis / drug effects, Homeostasis / radiation effects, Humans, Jaw Diseases / pathology, Male, Middle Aged, Mouth Mucosa / drug effects, Mouth Mucosa / radiation effects, Osteoradionecrosis / pathology, Prospective Studies, Reproducibility of Results, Time Factors, Treatment Outcome, Wound Healing / radiation effects, Anti-Infective Agents

Background:
Osteoradionecrosis of the jaw (ORNJ) is the most severe and complex sequel of head and neck radiotherapy (RT) because of the bone involved, it may cause pain, paresthesia, foul odor, fistulae with suppuration, need for extra oral communication and pathological fracture. We treated twenty lesions of ORNJ using low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT). The objective of this study was to stimulate the affected area to homeostasis and to promote the healing of the oral mucosa.
Methods:
We performed aPDT on the exposed bone, while LLLT was performed around the bone exposure (red spectrum) and on the affected jaw (infrared spectrum). Monitoring and clinical intervention occurred weekly or biweekly for 2 years.
Results:
100% of the sample presented clinical improvement, and 80% presented complete covering of the bone exposure by intact oral mucosa.
Conclusion:
LLLT and aPDT showed positive results as an adjuvant therapy to treat ORNJ.
Mild encephalitis/encephalopathy with a reversible splenial lesion due to Plasmodium falciparum malaria: a case report
Authors: Momoko Mawatari, Tetsuro Kobayashi, Shinya Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Satoshi Kutsuna, Norio Ohmagari, Tomoyuki Noguchi, Yasuyuki Kato
Journal: Trop Med Health (2018)
Keywords: cerebral malaria, magnetic resonance imaging, mild encephalitis/encephalopathy with a reversible splenial lesion
MeSH terms: Case Reports

Background:
Neurological complications from malaria cause significant morbidity and mortality. Severe cerebral malaria occurs as a result of intense sequestration of infected erythrocytes in the cerebral capillaries. However, the pathology of the reversible neurological symptoms remains unclear. We report the case of a patient with malaria who also had mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) causing transient neurological symptoms.
Case presentation:
A 55-year-old Japanese man was admitted to our hospital with acute fever upon returning from Nigeria. Blood smears and PCR analysis revealed ring forms in the erythrocytes, indicative of Plasmodium falciparum infection. He presented with dysarthria, expressive aphasia, and truncal ataxia, all of which were suggestive of cerebellar ataxia. He had no other signs or symptoms of severe malaria. Artemether/lumefantrine was started on the first day of illness. Although the parasites were undetectable on day 3 of illness, his neurological symptoms persisted. Brain magnetic resonance imaging (MRI) demonstrated a high-signal lesion in the splenium of the corpus callosum on diffusion-weighted images along with a decreased apparent diffusion coefficient. The neurological symptoms gradually improved by day 12. Brain MRI on day 16 showed complete regression of the splenic lesion. Therefore, the patient was diagnosed with MERS due to malaria.
Conclusions:
MERS often causes transient headaches, seizures, and/or impaired consciousness. The symptoms are compatible with the reversible symptoms of cerebral malaria.
Melanotic neuroectodermal tumor of infancy: Presentation of a case affecting the maxilla
Authors: Pooja Agarwal, Susmita Saxena, Sanjeev Kumar, Richi Gupta
Journal: J Oral Maxillofac Pathol (2010)
Keywords: benign neoplasm, maxilla, melanotic neuroectodermal tumor of infancy
MeSH terms: Case Reports

Melanotic neuroectodermal tumor of infancy is a rare, distinctive neoplasm of early infancy with rapid expansile growth and a high rate of recurrence. Most commonly, the lesion affects the maxilla of infants during the first year of life. One such case was diagnosed in the Department of Oral Pathology and Microbiology in Subharti Dental College, Meerut.
Cardiac Transthyretin Amyloidosis: Hidden in Plain Sight
Authors: Constantine N Logothetis, Joel Fernandez, Damian A Laber
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Amyloidosis is an underappreciated medical condition with symptoms camouflaging as common medical comorbidities leading to its underdiagnosis due to its systemic involvement. Despite common misconceptions, amyloidosis and its systemic comorbidities are more prevalent and treatable than previously acknowledged by the medical community. There are two major forms of amyloidosis: amyloid light-chain and transthyretin amyloidosis. Each of these have a distinct pathophysiology, diagnostic work-up, treatment, and prognosis. The patient described in this study was diagnosed with transthyretin cardiac amyloidosis months after presenting with heart failure of unknown etiology. Usually, clinicians presume that heart failure results from common comorbidities such as hypertension, diabetes, and hyperlipidemia. Here, the correct etiology was transthyretin cardiac amyloidosis. The patient had five admissions for heart failure symptoms prior to a physician identifying the etiology as cardiac transthyretin amyloidosis. After initiating the transthyretin stabilizer tafamidis, the patient did not experience another heart failure exacerbation. This vignette provides an example of the clinical presentation, diagnostic work-up, and treatment of a patient with cardiac transthyretin amyloidosis. The review of the literature focuses on the epidemiology, and clinical symptoms that should prompt an evaluation for cardiac amyloidosis as well as the diagnostic and therapeutic options are available. Transthyretin cardiac amyloidosis is a rare and underdiagnosed disease, while heart failure is a highly prevalent condition. This clinical vignette seeks to provide education and awareness to an overlooked medical disorder.
An Unusual Case of Extranodal Diffuse Large B-Cell Lymphoma Infiltrating Skeletal Muscle: A Case Report and Review of the Literature
Authors: Joseph Hatem, Agata M Bogusz
Journal: Case Rep Pathol (2016)

Diffuse large B-cell lymphoma is extranodal in approximately 40% of cases, arising in nearly any organ system. DLBCL involvement of soft tissue and in particular skeletal muscle is extremely rare, comprising less than 1% of all extranodal non-Hodgkin lymphomas (NHL). We report a case of a 79-year-old man that presented with a DLBCL of the left triceps. In particular, we describe an unusual histologic appearance of pseudoglandular structures, resembling adenocarcinoma. We performed a review of lymphoma cases involving skeletal muscle diagnosed at our institution over the past 15 years as well as thorough PubMed review of the literature. We discuss the features of lymphoma involving skeletal muscle as it pertains to clinical characteristics, histologic subtype, tumor localization, diagnostic studies, therapy, and outcome. Finally, we highlight the diagnostic difficulties that can present in these rare and often challenging cases.
Hydralazine Induced Lupus Syndrome Presenting with Recurrent Pericardial Effusion and a Negative Antinuclear Antibody
Authors: Praneet Iyer, Ahmed Dirweesh, Ritika Zijoo
Journal: Case Rep Rheumatol (2017)
MeSH terms: Case Reports

Drug induced lupus erythematosus (DIL or DILE) is an autoimmune disorder caused by chronic use of certain drugs. We report a unique case of hydralazine induced lupus syndrome (HILS) with a negative antinuclear antibody in a female patient who was on hydralazine for a period of 1.5-2 years and developed recurrent pericardial effusion as a result of it. Initially her condition was managed with a pericardial window. The recurrence of a massive pericardial effusion necessitated a right hemipericardiectomy. After hydralazine was stopped, she never had any further episodes of pericardial effusion or tamponade.
A 33-year-old man with a facial rash
Authors: John Fleming, William A Lynn
Journal: PLoS Med (2004)
MeSH terms: Exanthema / etiology, Eye Diseases / virology, Kaposi Varicelliform Eruption / diagnosis, Staphylococcal Infections / complications, Case Reports, Acyclovir / therapeutic use, Adult, Antiviral Agents / therapeutic use, Drug Hypersensitivity, Eczema / complications, Eczema / diagnosis, Eye Diseases / microbiology, Eyelids / pathology, Face / pathology, Humans, Kaposi Varicelliform Eruption / drug therapy, Kaposi Varicelliform Eruption / microbiology, Male, Penicillins / adverse effects, Antiviral Agents, Penicillins, Acyclovir

A learning module based around the case of a man with ezema who presents with a rash around his ear and eye. Test your knowledge with our online quiz
Functional Band and Loop Space Maintainers in Children
Authors: V Vinothini, A Sanguida, A Selvabalaji, G S Prathima, M Kavitha
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Premature loss of teeth in children leads to space loss and affects arch integrity. The band and loop space maintainer is used in majority of patients requiring single tooth space maintenance in both primary and mixed dentitions. It preserves the proximal dimensions, but it is nonfunctional. This paper describes a method to modify the conventional band and loop space maintainer into a functional one and reports its clinical application and follow-up in five children.
Nasu-hakola syndrome: an unusual cause of pathological fractures
Authors: Jaykar R Panchmatia, Natasha Jiwa, Neil Soneji, John Paul Murphy
Journal: Case Rep Orthop (2012)
MeSH terms: Case Reports

Nasu-Hakola syndrome is a hereditary cause of pathological fractures. Uniquely, patients also develop neuropsychiatric symptoms and signs. The disease is ultimately fatal. We propose a management strategy for pathological fractures in sufferers based on the stage of the disease.
A rare case of isolated wound implantation of colorectal adenocarcinoma complicating an incisional hernia: case report and review of the literature
Authors: Aninda Chandra, Lester Lee, Fahad Hossain, Harnaik Johal
Journal: World J Surg Oncol (2008)
MeSH terms: Adenocarcinoma / secondary, Adenocarcinoma / surgery, Colorectal Neoplasms / complications, Colorectal Neoplasms / surgery, Hernia, Ventral / complications, Hernia, Ventral / surgery, Muscle Neoplasms / secondary, Case Reports, Review, Abdominal Wall / pathology, Adenocarcinoma / complications, Aged, 80 and over, Biopsy, Needle, Colectomy / methods, Colorectal Neoplasms / pathology, Female, Follow-Up Studies, Hernia, Ventral / diagnosis, Humans, Immunohistochemistry, Incidental Findings, Laparotomy, Muscle Neoplasms / pathology, Muscle Neoplasms / surgery, Risk Assessment, Time Factors, Treatment Outcome

Background:
The reported case illustrates an instance of colonic adenocarcinoma presenting as an isolated tumour 3 1/2 years after open surgery. The presentation was in some respects unique as it was complicated by an incisional hernia and occurred in the anterior abdominal wall. A literature review was performed.
Case presentation:
An 83 year old lady initially underwent an extended right open hemicolectomy for a mid-transverse colonic adenocarcinoma (T4N2M0). No adjacent structures were involved. After adjuvant chemotherapy, she was kept under regular surveillance. A CT scan and colonoscopy at one year were normal. At 18 months investigations including an ultrasound scan of the liver and a radioisotope bone scan were all negative. Over three and half years later the patient presented with an incisional hernia. Repeat CT scan and tumour markers were reported as negative. At operation, a mass was found within the anterior abdominal wall complicating the incisional hernia. This mass was widely resected and a laparotomy performed. Histology confirmed an adenocarcinoma of colonic origin extending to one of the lateral margins. A post-operative PET scan confirmed the absence of intra-abdominal pathology.
Conclusion:
The literature regarding recurrence of colonic tumours after open surgery reports low incidences of this occurring within abdominal incisions. The literature indicates prognosis is poor, but the numbers are small and distinction is often not made between isolated recurrence and those with other sites of tumour recurrence. In order to avoid missing isolated wound implantation, careful consideration should be given to those who present with new pathology related to previous cancer surgery incisions, both clinically and radiologically.
An Atypical Presentation of Primary Hyperparathyroidism in an Adolescent: A Case Report of Hypercalcaemia and Neuropsychiatric Symptoms Due to a Mediastinal Parathyroid Adenoma
Authors: Roberta Minelli, Aniello Meoli, Alessandra Tiri, Umberto Fanelli, Rosanna Iannarella, Pierpacifico Gismondi, Susanna Esposito
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: hypercalcaemia, mediastinal parathyroid adenoma, neuropsychiatric symptoms, primary hyperparathyroidism, psychiatric disorders
MeSH terms: Adenoma / pathology, Hypercalcemia / pathology, Hyperparathyroidism, Primary / pathology, Mediastinal Neoplasms / pathology, Mental Disorders / pathology, Parathyroid Neoplasms / pathology, Case Reports, Research Support, Non-U.S. Gov't, Adenoma / complications, Adenoma / psychology, Adenoma / surgery, Adolescent, Female, Humans, Hypercalcemia / complications, Hypercalcemia / psychology, Hypercalcemia / surgery, Hyperparathyroidism, Primary / complications, Hyperparathyroidism, Primary / psychology, Hyperparathyroidism, Primary / surgery, Mediastinal Neoplasms / complications, Mediastinal Neoplasms / psychology, Mediastinal Neoplasms / surgery, Mental Disorders / complications, Mental Disorders / psychology, Mental Disorders / surgery, Parathyroid Neoplasms / complications, Parathyroid Neoplasms / psychology, Parathyroid Neoplasms / surgery, Prognosis

Psychiatric disorders are rare clinical manifestations of hypercalcaemia in the pediatric population, are relatively more frequent during adolescence and are often overlooked in cases of severe hypercalcaemia. We described the case of a 17-year-old girl affected by anorexia nervosa, depression and self-harm with incidental detection of moderate hypercalcaemia. Clinical, laboratory and instrumental tests demonstrated that hypercalcaemia was secondary to primary hyperparathyroidism (PHPT) due to a mediastinal parathyroid adenoma in the thymic parenchyma. After parathyroidectomy with robot-assisted surgery, we observed the restoration of calcium and PTH levels in addition to an improvement in psychiatric symptoms. This case demonstrates that serum calcium concentration should be evaluated in adolescents with neurobehavioural symptoms and in cases of hypercalcaemia PHPT should be excluded. Surgery represents the cornerstone of the management of PHPT and may contribute to improving quality of life and psychological function in these patients. However, the complexity of neurological involvement in cases of hypercalcaemia due to PHPT requires further investigations to establish the real impact of this condition on the neurocognitive sphere.
Primary Lymphangioma of the Palatine Tonsil in a 9-Year-Old Boy: A Case Presentation and Literature Review
Authors: Eleftheria Iliadou, Nektarios Papapetropoulos, Eleftherios Karamatzanis, Panagiotis Saravakos, Konstantinos Saravakos
Journal: Case Rep Otolaryngol (2016)

Primary lymphangiomas or lymphangiomatous polyps of the palatine tonsil are rare benign lesions that are described infrequently in the literature. The majority of the published cases concern adults. We report a case of a lymphangiomatous lesion of the right palatine tonsil of a 9-year-old boy. Our clinical suspicion was confirmed by the histological examination after tonsillectomy and the diagnosis of primary lymphangioma of the tonsil was made. In this case we discuss the clinical and histopathological features of this lesion and present a short review of the current literature.