OpenMed/multicare-articles huggingface dataset:
Whole genome sequencing of extended-spectrum β-lactamase producing Klebsiella pneumoniae isolated from a patient in Lebanon
Authors: Sima Tokajian, Jonathan A Eisen, Guillaume Jospin, Anna Farra, David A Coil
Journal: Front Cell Infect Microbiol (2015)
Keywords: ctx-m-15, esbl, klebsiella pneumoniae, shv-11, whole genome sequencing
MeSH terms: Bacterial Proteins / metabolism, Klebsiella Infections / microbiology, Klebsiella pneumoniae / enzymology, beta-Lactamases / metabolism, Case Reports, Bacterial Proteins / genetics, Feces / microbiology, Female, Genome, Bacterial, Humans, Klebsiella pneumoniae / classification, Klebsiella pneumoniae / genetics, Klebsiella pneumoniae / isolation & purification, Lebanon, Middle Aged, Phylogeny, Sequence Analysis, DNA, beta-Lactamases / genetics, Bacterial Proteins, beta-Lactamases

Objective:
The emergence of extended-spectrum β-lactamase (ESBL)-producing bacteria is now a critical concern. The ESBL-producing Klebsiella pneumoniae constitutes one of the most common multidrug-resistant (MDR) groups of gram-negative bacteria involved in nosocomial infections worldwide. In this study we report on the molecular characterization through whole genome sequencing of an ESBL-producing K. pneumoniae strain, LAU-KP1, isolated from a stool sample from a patient admitted for a gastrointestinal procedure/surgery at the Lebanese Amrican University Medical Center-Rizk Hospital (LAUMCRH) in Lebanon.
Methods:
Illumina paired-end libraries were prepared and sequenced, which resulted in 4,220,969 high-quality reads. All sequence processing and assembly were performed using the A5 assembly pipeline.
Results:
The initial assembly produced 86 contigs, for which no scaffolding was obtained. The final collection of contigs was submitted to GenBank. The final draft genome sequence consists of a combined 5,632,663 bases with 57% G+C content. Automated annotation was performed using the RAST annotation server. Sequencing analysis revealed that the isolate harbored different β-lactamase genes, including bla oxa-1, bla CTX-M-15, bla SHV-11, and bla TEM-1b. The isolate was also characterized by the concomitant presence of other resistance determinants most notably acc(6')-lb-cr and qnrb1. The entire plasmid content was also investigated and revealed homology with four major plasmids pKPN-IT, pBS512_2, pRSF1010_SL1344, and pKPN3.
Conclusions:
The potential role of K. pneumonia as a reservoir for ESBL genes and other resistance determinants is along with the presence of key factors that favor the spread of antimicrobial resistance a clear cause of concern and the problem that Carbapenem-non-susceptible ESBL isolates are posing in hospitals should be reconsidered through systematic exploration and molecular characterization.
An egg in the leg: Case report of an osteochondrolipoma
Authors: Renaud Debras, Raf Sciot, Daphne Hompes, Friedl Sinnaeve, Hazem Wafa
Journal: SICOT J (2021)
Keywords: case report, lipoma, osteochondrolipoma, upper leg
MeSH terms: Case Reports

Osteochondrolipomas, a very rare combination of chondroid and osseous differentiation within lipomas, are typically found in the neck and head area. We present the case of an osteochondrolipoma in the thigh of a 54-year-old female, with matching histological and cytological correlation. To the best of our knowledge, this atypical location has only been reported once in the literature.
Case report: Adult-onset neuronal intranuclear inclusion disease with an amyotrophic lateral sclerosis phenotype
Authors: Masako Fujita, Tatsuya Ueno, Yasuo Miki, Akira Arai, Hidekachi Kurotaki, Koichi Wakabayashi, Masahiko Tomiyama
Journal: Front Neurosci (2022)
Keywords: amyotrophic lateral sclerosis, autopsy, muscle atrophy, neuronal intranuclear inclusion disease, sporadic
MeSH terms: Case Reports

Amyotrophic lateral sclerosis (ALS) is one of the differential diagnoses of diseases that occur in adulthood and lead to progressive generalized muscle weakness. Neuronal intranuclear inclusion disease (NIID) is a disease in which histopathologically eosinophilic nuclear inclusion bodies are found in various systems. Both familial and sporadic forms of the disease have been reported. Most cases of sporadic NIID are of the dementia type, in which the main symptom is dementia at the first onset. Familial NIID is more diverse, with the main dominant symptoms being muscle weakness (NIID-M), dementia (NIID-D), and parkinsonism (NIID-P). Furthermore, recently, a GGC-repeat expansion in the Notch 2 N-terminal like C (NOTCH2NLC) gene, which produces a toxic polyglycine-containing protein (uN2CpolyG) in patients with NIID, has been associated with the pathogenesis of ALS. These results suggest that sporadic NIIDs may have more diverse forms. To date, no autopsy cases of NIID patients with an ALS phenotype have been reported. Here, we describe the first autopsy case report of a patient with sporadic NIID who had been clinically diagnosed with ALS. A 65-year-old Japanese man with no family history of neuromuscular disease developed progressive muscle atrophy and weakness in all limbs. The patient was diagnosed with ALS (El Escoriral diagnostic criteria: probable ALS, laboratory-supported ALS). He had no cognitive dysfunction or neuropathies suggestive of NIID. He required respiratory assistance 48 months after onset. He died of pneumonia at the age of 79 years. Postmortem examinations revealed neuronal loss in the spinal anterior horns and motor cortex. In these affected regions, eosinophilic, round neuronal intranuclear inclusions were evident, which were immunopositive for ubiquitin, p62, and uN2CpolyG. No Bunina bodies or TDP-43-positive inclusions were observed in the brain or spinal cord. Our findings suggest that a small proportion of patients with NIID can manifest a clinical phenotype of ALS. Although skin biopsy is commonly used for the clinical diagnosis of NIID, it may also be useful to identify cases of NIID masquerading as ALS.
Case Report: Ruptured Middle Cerebral Artery Aneurysm With Intrasylvian Hematoma Successfully Treated by Coil Embolization and Minimally Invasive Puncture and Drainage
Authors: Zhen Li, Quan Hu, Li Zhao, Huayun Huang, Shizhong Zhang, Limin Zheng, Guojun Wang
Journal: Front Neurol (2021)
Keywords: coil embolization, hematoma, minimally invasive puncture and drainage, outcomes, ruptured middle cerebral artery aneurysm
MeSH terms: Case Reports

Up to one-third (12-35%) of patients with aneurysmal subarachnoid hemorrhage experience intracerebral hematoma. Ruptured middle cerebral artery (MCA) aneurysm with hematoma is usually accompanied by progressive cerebral swelling with poor outcomes; however, it can be successfully treated by coil embolization and minimally invasive puncture and drainage. From February 2012 to March 2019, six surgeries for ruptured MCA aneurysms with intrasylvian hematoma were performed at our clinic. All patients had intracranial hematomas of <30 ml and GCS scores >8. The patients were treated by coil embolization and minimally invasive puncture and drainage. The aneurysms in all patients were completely embolized and the hematomas were mostly removed by minimally invasive puncture. The Glasgow outcome scale (GOS) scores of all patients were more than 4 at discharge when they discharged. Coil embolization and minimally invasive puncture and drainage are viable treatments for ruptured MCA aneurysms with hematomas, especially if the patient is too old, in a complicated state to undergo craniotomy, is unwilling to undergo craniotomy, or is at a greater risk of bleeding 3 days after surgery.
Dropped head syndrome due to myogenic atrophy - a case report of surgical treatment
Authors: Michihisa Zenmyo, Masahiko Abematsu, Takuya Yamamoto, Yasuhiro Ishidou, Setsuro Komiya, Kosei Ijiri
Journal: Diagn Pathol (2011)
MeSH terms: Movement Disorders / etiology, Muscle Weakness / etiology, Muscular Diseases / etiology, Neck Muscles / pathology, Case Reports, Research Support, Non-U.S. Gov't, Review, Aged, Atrophy / complications, Cervical Vertebrae / diagnostic imaging, Cervical Vertebrae / surgery, Humans, Kyphosis / diagnostic imaging, Kyphosis / etiology, Kyphosis / surgery, Male, Movement Disorders / diagnosis, Movement Disorders / surgery, Muscle Weakness / diagnosis, Muscle Weakness / surgery, Muscular Diseases / diagnosis, Muscular Diseases / surgery, Orthopedic Procedures, Syndrome, Tomography, X-Ray Computed, Treatment Outcome

We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment. Computed tomography revealed osseous contracture of cervical vertebral bodies in flexed position. Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment. Pathologic study confirmed myogenic atrophy in the cervical extensor muscles. We suggest that consideration for surgical management should be given to dropped head syndrome especially due to INEM.
In-situ and invasive carcinoma within a phyllodes tumor associated with lymph node metastases
Authors: Jeremy R Parfitt, Chris Armstrong, Frances O'malley, Joan Ross, Alan B Tuck
Journal: World J Surg Oncol (2004)

Background:
Phyllodes tumors (cystosarcoma phyllodes) are uncommon lesions in the female breast. Rarely, the occurrence of carcinoma within a phyllodes tumor has been reported in the literature, but has never been associated with lymph node metastases.
Case presentation:
A 26-year-old woman presented with a firm, mobile, non-tender mass in the left breast and palpable lymph nodes in the left axilla. The excised lesion appeared well circumscribed and lobulated, with variable fleshy and firm areas. Microscopic examination showed a circumscribed fibroepithelial lesion with a well developed leaf-like architecture, in keeping with a benign phyllodes tumor. The epithelial component showed extensive high grade ductal carcinoma in-situ (DCIS) and invasive carcinoma of no special type, located entirely within the phyllodes tumor. Subsequent axillary lymph node dissection revealed metastatic carcinoma in four lymph nodes.
Conclusions:
Although rare, phyllodes tumors may harbor DCIS and invasive carcinoma, with potential for lymph node metastasis.
Dental and Craniofacial Anomalies Associated with Axenfeld-Rieger Syndrome with PITX2 Mutation
Authors: Simone Dressler, Philipp Meyer-Marcotty, Nicole Weisschuh, Anahita Jablonski-Momeni, Klaus Pieper, Gwendolyn Gramer, Eugen Gramer
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Axenfeld-Rieger syndrome (ARS) (OMIM Nr.: 180500) is a rare autosomal dominant disorder (1 : 200000) with genetic and morphologic variability. Glaucoma is associated in 50% of the patients. Craniofacial and dental anomalies are frequently reported with ARS. The present study was designed as a multidisciplinary analysis of orthodontic, ophthalmologic, and genotypical features. A three-generation pedigree was ascertained through a family with ARS. Clinically, radiographic and genetic analyses were performed. Despite an identical genotype in all patients, the phenotype varies in expressivity of craniofacial and dental morphology. Screening for PITX2 and FOXC1 mutations by direct DNA-sequencing revealed a P64L missense mutation in PITX2 in all family members, supporting earlier reports that PITX2 is an essential factor in morphogenesis of teeth and craniofacial skeleton. Despite the fact that the family members had identical mutations, morphologic differences were evident. The concomitant occurrence of rare dental and craniofacial anomalies may be early diagnostic indications of ARS. Early detection of ARS and elevated intraocular pressure (IOP) helps to prevent visual field loss.
Anomalous origin of right coronary artery from distal left circumflex artery: a case study and a review of its clinical significance
Authors: Leili Pourafkari, Mohammadreza Taban, Samad Ghaffari
Journal: J Cardiovasc Thorac Res (2014)
Keywords: coronary angiography, coronary anomaly, myocardial infarction
MeSH terms: Case Reports

Single coronary arteries are rare congenital anomalies in which the whole heart circulation is supplied by a coronary artery arising from a single ostium. Single left coronary artery with right coronary artery (RCA) originating from distal left circumflex artery (LCX) is a very rare anomaly with only few cases reported in the literature. We report a 44 years old male presenting with anterior myocardial infarction who was found to have a single left coronary artery during angiography. RCA had an abnormal origin arising from distal of a dominant LCX that retrogradely followed the course of a normal RCA to the base of the heart. A brief review of the reported cases with emphasis on the clinical significance of this unusual anomaly is presented.
Management of an unusual iliac fossa venous plexus
Authors: Irwin M Best
Journal: Case Rep Vasc Med (2011)
MeSH terms: Case Reports

Symptomatic iliac fossa and suprapubic varicosities are uncommon presentations in adults. Such presentations often point to acquired obstructive process to pelvic outflow or to the progression of venous insufficiency and reflux in the pelvic and gonadal veins. Less frequently, venous anomalies of the renal veins or IVC might be implicated. Furthermore, late presentations of congenital or acquired developmental abnormalities might become manifest. As this case illustrates, a thorough understanding of the underlying pathologic process and the anatomical derangement must be sought before any treatment is instituted. Unnecessary extirpation of these varicosities would simply have removed vital physiologic cross-pelvic collateral circulation from the lower extremity in the face of chronic iliac vein occlusion.
POCUS Allows for Rapid Elucidation of Acute Kidney Injury in a Patient with Progressive Multiple Myeloma
Authors: Liann Abu Salman, Nathaniel Reisinger
Journal: POCUS J (2022)
Keywords: pocus, acute kidney injury, hydronephrosis, multiple myeloma, plasmacytoma
MeSH terms: Case Reports

A 63-year-old man with past history of multiple myeloma recently started on a regimen of daratumumab, carfilzomib, and dexamethasone was referred to our emergency department for a rapidly rising serum creatinine as high as 10 mg/dL. He complained of fatigue, nausea, and poor appetite. Exam revealed hypertension, but no edema or rales. Labs were consistent with AKI without hypercalcemia or evidence of hemolysis or tumor lysis. Urinalysis and urine sediment were bland without proteinuria, hematuria, or pyuria. Initial concern was for hypovolemia or myeloma cast nephropathy. POCUS revealed no overt evidence of volume overload or depletion, instead revealing bilateral hydronephrosis. Bilateral percutaneous nephrostomies were placed with resolution of the AKI. Ultimately, referral imaging revealed interval progression of bulky retroperitoneal extramedullary plasmacytomas compressing the ureters bilaterally related to the underlying multiple myeloma.
Retrograde intubation in a case of ankylosing spondylitis posted for correction of deformity of spine
Authors: Chetankumar Raval, Heena Patel, Pranoti Patel, Utpala Kharod
Journal: Saudi J Anaesth (2010)
Keywords: difficult airway, retrograde intubation, ankylosing spondylitis
MeSH terms: Case Reports

Ankylosing spondylitis (AS) patients are most challenging. These patient present the most serious array of intubation and difficult airway imaginable, secondary to decrease or no cervical spine mobility, fixed flexion deformity of thoracolumbar spine and possible temporomandibular joint disease. Sound clinical judgment is critical for timing and selecting the method for airway intervention. The retrograde intubation technique is an important option when fiberoptic bronchoscope is not available, and other method is not applicable for gaining airway access for surgery in prone position. We report a case of AS with fixed flexion deformity of thoracic and thoracolumbar spine, fusion of posterior elements of cervical spine posted for lumbar spinal osteotomy with anticipated difficult intubation. An awake retrograde oral intubation with light sedation and local block is performed.
Lipid transfer protein syndrome in a Northern European patient: An unusual case report
Authors: E Albert, T Walsemann, J Behrends, U Jappe
Journal: Front Med (Lausanne) (2023)
Keywords: ltp, ltp syndrome, basophil activation test, exercise-induced anaphylaxis, food allergy, non-specific lipid transfer protein
MeSH terms: Case Reports

Non-specific lipid transfer proteins (nsLTPs) as the primary sensitizer in plant-food allergic patients used to be seen primarily in the Mediterranean area. However, more recently, increasing numbers of clinically relevant sensitizations are being observed in Northern Europe. We herein report an unusual case of a woman who developed an anaphylactic reaction during a meal including a variety of different foods ranging from fruits and nuts to oats, wheat, and salmon. Allergy diagnostics showed no Bet v 1 sensitization but an nsLTP-mediated food allergy. Despite the much more prominent birch food syndrome in Central and Northern Europe, LTPs should be considered disease-causing agents, especially for patients developing severe reactions after consuming LTP-containing foods.
Intra-natal Torsion of Polydactyly
Authors: Sanjay Saraf
Journal: J Cutan Aesthet Surg (2011)
Keywords: polydactyly, polydactyly gangrene, polydactyly torsion, post-axial
MeSH terms: Case Reports

Post-axial polydactyly is a common congenital hand anomaly with a wide range of manifestations. We report here an unusual case of intra-natal torsion of duplicated small finger which presented as gangrene at birth.
Radial artery-second dorsal metacarpal vein arteriovenous fistula in the first interdigital space for hemodialysis: Utilization of the most peripheral site and autologous vein in the upper limb - A case report
Authors: Tsuyoshi Takashima, Yui Nakashima, Atsuhiko Suenaga, Masato Mizuta, Yuki Yamashita, Yuki Ikeda, Yasunori Nonaka, Makoto Fukuda, Shuichi Rikitake, Motoaki Miyazono, Kazuhisa Rikitake, Yuji Ikeda
Journal: Int J Surg Case Rep (2020)
Keywords: arteriovenous fistula, first interdigital space, hemodialysis, radial artery, second dorsal metacarpal vein, vascular access
MeSH terms: Case Reports

Introduction:
The creation of the first arteriovenous fistula (AVF) as far distally in the upper limb as possible is ideal. We developed a new operative technique for creating a radial artery-second dorsal metacarpal vein AVF in the first interdigital space. This technique involves the creation of the AVF using the most peripheral site and autologous vein in the upper limb.
Case presentation:
We herein describe the steps of this technique and its successful performance in a 71-year-old man with end-stage renal disease.
Discussion:
This technique has several advantages including preserving many future vascular access options and providing a long segment of arterialized vein for cannulation.
Conclusion:
We consider this technique to be a worthwhile option and recommend the use in patients with the proper vessels for the creation of the AVF.
Parsonage-Turner Syndrome
Authors: Elyn Van Snick, Bjorn Valgaeren, Bart Claikens
Journal: J Belg Soc Radiol (2023)
Keywords: parsonage-turner syndrome, denervation, infraspinatus muscle, magnetic resonance imaging
MeSH terms: Case Reports

Teaching Point: Magnetic resonance imaging is a valuable imaging tool in Parsonage-Turner syndrome, a rare neurological disorder that presents as acute denervation in the distribution of the brachial plexus.
Prolonged febrile illness due to CTX-M-15 extended-spectrum β-lactamase-producing Klebsiella pneumoniae infection in Nigeria
Authors: Oladipo A Aboderin, Olufemi Adefehinti, Babatunde W Odetoyin, Amadin A Olotu, Iruka N Okeke, Olugbenga O Adeodu
Journal: Afr J Lab Med (2012)
MeSH terms: Case Reports

We report on an 8-year-old patient with septicaemia unresponsive to therapy for five weeks. Undetected, extended-spectrum β-lactamase (ESBL) production by the infecting Klebsiella strain was regarded as responsible for treatment failure. Intravenously administered imipenem during the sixth week led to sustained resolution of fever. Resource-limited hospitals can incur prohibitive costs from ESBL-producer infections because of diagnostic limitations and consequent treatment failure involving prolonged supportive therapy.
Case Report: Pulmonary metastases of malignant meningioma
Authors: Suhail Basunaid, Frits M E Franssen, Ryan Accord, Myrurgia Abdul Hamid, Shekar Mahesh, Brigitta G Baumert, Olaf E M G Schijns
Journal: F1000Res (2013)

Meningioma accounts for approximately one-third of primary central nervous system tumors. Most meningiomas are benign, although up to one third are classified as atypical or malignant. We describe a 63-year Caucasian male presenting with pleural metastases from an intracranial meningioma. Distant metastases from meningiomas are infrequently found in clinical practice and mostly are associated with atypical or malignant meningiomas. There is no standard treatment; however surgical resection of both the primary and metastatic lesions is the safest therapy. The overall prognosis of atypical meningiomas is poor. Our patient died one week after discharge from our hospital.
EPIDEMIOLOGY AND TREATMENT OF MONTEGGIA LESION IN ADULTS: SERIES OF 44 CASES
Authors: Roberto Suarez, Antonio Barquet, Rodrigo Fresco
Journal: Acta Ortop Bras (2016)
Keywords: monteggia's fracture, surgical procedures, operative, wounds and injuries

Objective:
To analyze the epidemiology, treatment and outcome of a series of adult patients with Monteggia lesion treated in Uruguayan institutions.
Methods:
This is a retrospective article, we retrospectively identified from two Uruguayan institutions 44 adult patients with Monteggia lesion and analyzed their characteristics including Bado classification, associated injuries, treatment modality and outcome (Morrey score).
Results:
Using Bado classification, 23 cases (52%) were type II, 12 (27%) type I, seven (16%) type IV and two cases (5%) type III. Associated lesions were radial head fractures, found in 15 patients, coronoid ipsilateral fractures in seven patients, and neurological injuries in four. Radial head dislocation was reduced in 93% of the cases with closed maneuvers. Ulna fractures underwent open reduction and internal fixation in all 30 cases using 3.5 mm DCP plates. Complications after surgery occurred in 21 cases. Revision surgery was done in 15 cases. Outcomes after primary and revision surgery were good or excellent in 37 cases.
Conclusions:
In our series we observed that Monteggia lesion in adults is a serious injury with a high number of complications that often require revision surgeries. Level of Evidence IV, Retrospective Study, Case Series.
Acute myocarditis following administration of BNT162b2 vaccine
Authors: Mhd Baraa Habib, Tahseen Hamamyh, Ahmed Elyas, Mohammed Altermanini, Mawahib Elhassan
Journal: IDCases (2021)
Keywords: bnt162b2, covid-19, covid-19, coronavirus disease 2019, myocarditis, pfizer-biontech, sars-cov-2, sars-cov-2, severe acute respiratory syndrome coronavirus 2, vaccine
MeSH terms: Case Reports

The wide use of vaccines was linked with rare but serious complications in adults, causing a global concern. Here, we describe a young male patient, who presented with acute myocarditis, three days after the second dose of BNT162b2 vaccine.
A case of severe asymptomatic aortic coarctation in an adult female
Authors: Spyros Tsikrikas, Charalampos Charalampous, Konstantinos P Letsas
Journal: Case Rep Cardiol (2011)
MeSH terms: Case Reports

Coarctation of the aorta is typically a disease of childhood and early adulthood, and there is a reduced life expectancy in patients who have not undergone correction. Survival to older age is rare, due to severe cardiovascular complications. We describe the case of a woman first diagnosed with coarctation of aorta at an advanced age.