OpenMed/multicare-articles huggingface dataset:
Case Report: Invasive Fungal Infection and Daratumumab: A Case Series and Review of Literature
Authors: Francesca Farina, V Ferla, S Marktel, D Clerici, S Mastaglio, T Perini, C Oltolini, R Greco, F Aletti, A Assanelli, M T Lupo-Stanghellini, M Bernardi, C Corti, F Ciceri, M Marcatti
Journal: Front Oncol (2022)
Keywords: complications, daratumumab, fungal infection, mould, multiple myeloma
MeSH terms: Case Reports

Life expectancy of multiple myeloma (MM) patients has improved in last years due to the advent of anti-CD38 monoclonal antibodies in combination with immunomodulators and proteasome inhibitors. However, morbidity and mortality related to infections remain high and represent a major concern. This paper describes the "real life" risk of invasive fungal infections (IFI) in patients treated with daratumumab-based therapy and reviews the relevant literature. In a series of 75 patients we only observed three cases of fungal pneumonia. Unfortunately, the early signs and symptoms were not specific for fungal infection. Diagnostic imaging, microbiology and patient history, especially previous therapies, are critical in the decision to start antifungal treatment. Recognising the subgroup of MM patients with high risk of IFI can increase the rate of diagnosis, adequate treatment and MM-treatment recovery.
Cotard Delusion in the Context of Schizophrenia: A Case Report and Review of the Literature
Authors: Nicholas Bott, Corey Keller, Malathy Kuppuswamy, David Spelber, Joshua Zeier
Journal: Front Psychol (2016)
Keywords: cotard delusion, hyper-religiosity, schizophrenia, self-harm, traumatic brain injury (tbi), violence

Background:
The Cotard delusion (CD) is one of a variety of narrowly defined monothematic delusions characterized by nihilistic beliefs about the body's existence or life itself. The presence of CD within the context of schizophrenia is rare (<1%), and remains understudied.
Case:
'Mr. C' is a 58-year-old veteran with a prior diagnosis of schizophrenia, who presented with CD in the context of significant depression, suicidal ideation, violence, and self-harm behavior. He perseverated in his belief that he was physically dead and possessed by demons for several weeks. This delusion was reinforced by his religious belief that life was an attribute of God, and by inference, he as a human, was dead. His condition gradually improved over the course of treatment with Divalproex and quetiapine with discussions about the rationale for his belief. Upon discharge, Mr. C. demonstrated awareness of his fixation on death and an ability to redirect himself.
Discussion:
This case highlights the need to better understand the co-occurrence of CD in schizophrenia, their differentiation, the increased risk of violence and self-harm behavior in this presentation, and how specific events and religious factors can influence delusional themes of CD. Pharmacotherapy and aspects of cognitive-behavioral therapy may be effective in ameliorating these symptoms in CD.
Bilateral sphenoid sinus mucocele observed in Yaoundé-Cameroon: a case report
Authors: Antoine Siafa Bola, Yves Christian Nkouo Andjock, Emmanuel Nchinda Choffor, Eliane Nanci, Ignatius Ngene Esene, Francois Djomou
Journal: Pan Afr Med J (2021)
Keywords: sphenoid sinus mucocele, yaoundé, case report, marsupialisation, sinus cavity
MeSH terms: Mucocele / diagnostic imaging, Paranasal Sinus Diseases / diagnostic imaging, Sphenoid Sinus / diagnostic imaging, Case Reports, Adult, Cameroon, Drainage, Endoscopy, Female, Headache Disorders / etiology, Humans, Mucocele / surgery, Paranasal Sinus Diseases / surgery, Sphenoid Sinus / surgery, Tomography, X-Ray Computed, Vision Disorders / etiology

A mucocele is a cystic and expansive lesion of the sinus cavities. It is uncommon in the sphenoid sinus and its management is quite challenging especially in low to middle income countries like Cameroon. A 43-years-old female was referred to us by a neurologist for chronic headache and visual disturbances. The pain was unresponsive to analgesics. Physical examination was non-remarkable and a head CT scan realized showed a cyst-like lesion in the sphenoid sinus cavity. Surgical endoscopic treatment was proposed and realized with basic endoscopic instruments, consisting of opening the cavity with drainage of the mucocele. A large opening was made on the anterior wall of the sphenoid sinus, in order to ensure continuous drainage and prevent a recurrence. Sphenoid sinus mucocele is a rare condition, and its diagnosis can be difficult. Confirmation requires specific imaging and treatment is presently well established, but it can be managed with basic tools.
Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy
Authors: Imran Gani, Atbin Doroodchi, Kristina Falkenstrom, Holly Berry, Won Lee, Laura Mulloy, Muhammad Saeed, Rajan Kapoor
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Gastrointestinal mucormycosis is a rare infection in solid organ transplant recipients. Our patient, a 79-year-old male, presented with severe dysphagia and odynophagia about 2 weeks after receiving a renal transplant. An upper gastrointestinal (UGI) endoscopy revealed esophagitis and gastric ulceration, the cultures from which grew Rhizopus species. A usual treatment strategy should include Amphotericin B as monotherapy or in combination with Posaconazole or Isavuconazole for such infections. Our patient was treated with Isavuconazole monotherapy, in an effort to minimize renal toxicity from Amphotericin B to the new allograft. Unique to our case was a successful clinical response and resolution of UGI lesions with Isavuconazole monotherapy. Due to the vagueness of presenting symptoms, such infections can be easily missed in an immunocompromised patient which can have tragic outcomes. Prompt diagnosis and modulation of immunosuppression are essential to decrease mortality and morbidity. Isavuconazole is a novel agent and can be used as a monotherapy for such infections, especially in renal transplant recipients.
Acute Myeloid Leukemia in an Infant with t(8;19)(p11.2;q13) Translocation: Case Report and a Review of the Literature
Authors: Ashley C Eason, Silvia T Bunting, Jess F Peterson, Debra Saxe, Himalee S Sabnis
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Acute myeloid leukemia (AML) patients with t(8;16)(p11.2;p13) constitute a small subgroup with a distinct genetic and clinical profile. We present a unique case of a female infant with monocytic AML associated with t(8;19)(p11.2;q13.3), a rarely reported variation of t(8;16)(p11.2;p13). The patient presented with leukemia cutis and demonstrated erythrophagocytosis in the diagnostic bone marrow. She responded well to standard AML chemotherapy and is currently in remission. Here, we highlight her case as the youngest AML patient with t(8;19) described in the literature, discuss the significance and prognostic implications of this genetic variant, and review 8p11.2 fusion proteins in AML.
Ripretinib in combination with tyrosine kinase inhibitor as a late-line treatment option for refractory gastrointestinal stromal tumors: two case reports and literature review
Authors: Yefan Zhang, Zhen Huang
Journal: Front Pharmacol (2023)
Keywords: case report, gastrointestinal stromal tumor (gist), late-line treatment, refractory gist, ripretinib combination therapy
MeSH terms: Case Reports

Background: This case report presents two clinical cases of metastatic refractory gastrointestinal stromal tumor (GIST) with treatment history of 6-14 years. The follow-up treatment of both cases comprised ripretinib dose escalation and its combination with other tyrosine kinase inhibitors (TKIs). To the best of our knowledge, this is the first report that explored ripretinib combination therapy in the late-line treatment of GISTs. Case description: Case-1 represents a 57-year-old female patient who underwent surgical resection for retroperitoneal GIST in 2008. After tumor recurrence in 2009, imatinib was started with complete response for 8 years. Imatinib was followed by sunitinib and regorafenib treatment. In March 2021, due to progressive disease (PD), the patient started ripretinib (150 mg QD) and achieved partial response (PR). Six months later, the patient showed PD. Subsequently, ripretinib dose was increased (150 mg BID) followed by ripretinib (100 mg QD) and imatinib (200 mg QD) combination. CT performed in February 2022 revealed stable lesions with internal visible necrosis. Combination therapy achieved stable disease (SD) for 7 months. On further follow-up in July 2022, the patient showed PD and died in September 2022. Case-2: represents a 73-year-old female patient diagnosed with unresectable duodenal GIST with liver, lung, and lymph node metastases in 2016. After treatment with imatinib, followed by sunitinib, regorafenib, and imatinib rechallenge, ripretinib (150 mg QD) was administered in May 2021, and SD was achieved. Ripretinib dose was increased (200 mg QD) due to PD in December 2021. The tumor showed heterogeneous manifestations, with overall size increase and regression in right posterior lobe. In February 2022, ripretinib (150 mg) plus sunitinib (25 mg) QD was commenced. On follow-up in April 2022, the patient showed slightly improved symptoms with stable hematologic parameters. Combination therapy achieved SD for 5 months and the patient showed PD in July 2022 and discontinued the treatment later. The patient was in poor general condition and was receiving nutritional therapy until last follow-up in October 2022. Conclusion: This case report provides evidence that combination therapy of ripretinib with other TKIs could be an effective late-line treatment option for refractory GIST patients.
Tacrolimus Aggravated Tube Feeding Syndrome with Acute Renal Failure in a Pediatric Liver Transplant Recipient
Authors: R Kula, M Melter, J Kunkel, C Dörfler, S Alikadic, B Knoppke, R Zant
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Acute renal failure can be caused by calcineurin inhibitors (CNIs), due to arteriolopathy and altered tubular function. Within this context, we present the case of a 14-month-old liver transplant recipient who suffered an acute polyuric renal failure during a short episode of hypercaloric feeding. In our case, CNI-induced distal RTA led to nephrocalcinosis and therefore to secondary nephrogenic diabetes insipidus. The diet with high renal solute load consequently resulted in an acute polyuric renal failure with severe hypernatremic dehydration. In conclusion, a hypercaloric diet in children with potentially impaired renal function due to therapy with CNIs requires precise calculation of the potential renal solute load and the associated fluid requirements.
Recurrent giant pilomatrixoma of the face: a case report and review of the literature
Authors: Mohammed Nadershah, Ahmad Alshadwi, Andrew Salama
Journal: Case Rep Dent (2012)

Pilomatrixoma, also known as pilomatricoma, is a benign tumor that originates from the matrix of the hair root. It usually presents as a single, slow-growing subcutaneous or intradermal firm nodule with a general size of less than 3 centimeters (cm) in diameter. However, giant pilomatrixomas (more than 5 cm) have been reported infrequently. It is more common in females and usually presents during the first two decades of life (60%) as an asymptomatic, mobile, hard, elastic mass. Most of the cases are benign and affect the face. The authors report a rare case of a giant pilomatricoma of the cheek and discuss the surgical management of these lesions, histopathological findings, and review of the literature.
Chemotherapy and anti-HER2 therapy in metastatic breast cancer in pregnancy followed by surgical treatment
Authors: Julia Berwart, Fedro A Peccatori
Journal: Ecancermedicalscience (2019)
Keywords: breast cancer, pregnancy, primary tumour, stage iv, surgical treatment
MeSH terms: Case Reports

Between 5% and 10% of women have distant metastases when they receive a breast cancer (BC) diagnosis. Metastatic BC is associated with poor prognosis but advances in systemic treatments have improved survival rates in recent decades. Debates about local primary tumour management in metastatic stages continue, but multiple studies have shown that primary tumour surgery can be beneficial. BC is one of the most commonly diagnosed neoplasias during pregnancy. Treatment of pregnant BC patients should follow the standard treatment of young, non-pregnant patients as closely as possible. We present the case of a young, pregnant patient with metastatic BC with a complete clinical response to chemotherapy followed by surgical treatment.
Progressive skin necrosis of a huge occipital encephalocele
Authors: Yasir Andarabi, Farideh Nejat, Mostafa El-Khashab
Journal: Indian J Plast Surg (2008)
Keywords: necrosis, occipital encephalocele, torsion
MeSH terms: Case Reports

Objects:
Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life.
Methods:
A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems.
Conclusion:
Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested.
Epidermoid Cyst of the Tongue-A Rare Case
Authors: Mayuri Jain
Journal: Int J Clin Pediatr Dent (2019)
Keywords: epidermoid cyst, oral cavity, pathogenesis, tongue, ultrasonography
MeSH terms: Case Reports

Introduction:
Epidermoid cysts are commonly found in various part of the body, but its occurrence in the oral cavity is relatively rare.
Case presentation:
Present case highlights the importance of involvement of epidermoid cyst within the tongue in 10-year-old child.
Discussion:
The occurrence of epidermoid cyst within the tongue is an extremely rare phenomenon and only few cases have been reported in the literature. Clinically they are painless, slowly growing mass causing difficulty in breathing, eating and swallowing Imaging modalities most importantly; ultrasonography helps in the evaluation of the lesion. However, histopathology remains the mainstay for definitive diagnosis in such conditions.
Conclusion:
From the present case, it is concluded that such type of cases needs to be reported as it highlights the importance of keeping the rarities in mind along with common lesions while making a diagnosis.
How to cite this article:
Jain M. Epidermoid Cyst of the Tongue-A Rare Case. Int J Clin Pediatr Dent 2019;12(1):80-82.
A Case of Markedly Elevated Isolated Alkaline Phosphatase in the Third Trimester of Pregnancy
Authors: Courtney T Connolly, Olivia Grubman, Zainab Al-Ibraheemi, Tatyana Kushner
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Background:
Alkaline phosphatase (ALP) is an enzyme produced by the liver, small intestine, bone, and kidneys as well as the placenta during pregnancy. ALP levels may increase up to twice the normal limit during pregnancy secondary to placental release and fetal bone growth. Rare case reports of extremely elevated levels of ALP during pregnancy have demonstrated possible association with adverse pregnancy outcomes.
Case:
The patient is a 36-year-old G2P1001 who was found to have extremely elevated ALP levels during pregnancy after presenting with bilateral lower leg swelling and rash after receiving the Pfizer COVID-19 vaccine. She subsequently developed intrahepatic cholestasis of pregnancy and preeclampsia. ALP peaked at 2,601 U/L immediately prior to delivery at 36 weeks 1 day. She was followed postpartum, and her ALP levels had nearly normalized by 15 weeks postpartum.
Conclusion:
Our case demonstrates a rare report of an extremely elevated level of ALP in the setting of multiple adverse pregnancy outcomes, including preterm delivery, preeclampsia without severe features, and intrahepatic cholestasis of pregnancy.
Modified anchor shaped post core design for primary anterior teeth
Authors: R Rajesh, Kusai Baroudi, K Bala Kasi Reddy, B H Praveen, V Sumanth Kumar, S Amit
Journal: Case Rep Dent (2014)

Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.
Airway Management and Anesthesia for Tracheal Resection in a 68-Year-Old: 3 Airways for the Price of 1
Authors: Klint J Smart, Iwan P Sofjan
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Subglottic tracheal stenosis can occur after prolonged intubation or tracheostomy. This stenosis can become severe and causes symptoms refractory to endoscopic interventions that require tracheal resection. This surgery presents unique anesthetic issues due to the airway anatomy, physiology, and shared airway management with the surgical team. We present the case of a 68-year-old patient who underwent cervical tracheal resection and reconstruction due to persistent symptoms despite balloon dilation and medical management with oxygen and heliox. Our anesthesia management involved several techniques that allowed the safe completion of this procedure. Firstly, we started the airway management with a combined size 4 Ambu® AuraStraight™ (Denmark) supraglottic airway device and flexible bronchoscopy to allow localization of the stenosis and dilation before endotracheal tube (ETT) placement. The conventional approach for this endoscopic evaluation phase is to use rigid bronchoscopy. Secondly, we used prior CT images to help guide our ETT tube size selection. Thirdly, we used total intravenous anesthesia during most of the procedure because of the intermittent apnea necessary to complete the tracheal resection. Lastly, extubation had to be done very carefully to minimize excessive patient neck movement and avoid any reintubation. Both could lead to a catastrophe with the newly reconstructed trachea.
Spontaneous intraoperative lumbar fracture leading to an unexpected correction in ankylosing spondylitis corrective surgery - a case report
Authors: Christoph-Eckhard Heyde, Stefan Glasmacher, Nicolas H von der Höh, Anna Völker
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2020)
Keywords: ankylosing spondylitis, corrective surgery, spine, spontaneous fracture
MeSH terms: Case Reports

Severe kyphotic deformity in patients with ankylosing spondylitis can be corrected surgically to achieve a better spinal alignment and an improved visual axis. Different surgical techniques are used today depending on the extent of ossification and the degree of kyphosis. It is well known that the underlying disease leads to distinct biomechanical changes of the spinal column causing an increased fracture risk especially in case of minor trauma. This includes manipulations during surgical procedures as well as during the required perioperative measures. We present the case of a 45-year-old patient with severe global kyphotic deformity due to ankylosing spondylitis. During the elective corrective surgery (pedicle subtraction osteotomy at the level of L3) the patient sustained a spontaneous fracture at L2/3. This fortunately nondisplaced wedge-shaped fracture in the sense of a Smith-Peterson osteotomy led to a spontaneous correction of the kyphosis. The described unexpected event required a change in the surgical strategy. Correction could be achieved using a two-stage surgical procedure without further drawbacks for the patient. This case report stresses the need of particular attention regarding the increased susceptibility of the spinal column in case of ankylosing spondylitis.
High-resolution MRI findings in patients with capsular warning syndrome
Authors: Lixin Zhou, Jun Ni, Weihai Xu, Ming Yao, Bin Peng, Mingli Li, Liying Cui
Journal: BMC Neurol (2014)
MeSH terms: Basal Ganglia Cerebrovascular Disease / diagnosis, Diffusion Magnetic Resonance Imaging / methods, Paresis / diagnosis, Case Reports, Basal Ganglia Cerebrovascular Disease / complications, Female, Humans, Male, Middle Aged, Paresis / complications, Syndrome

Background:
Capsular warning syndrome (CWS) is rare (1.5% of TIA presentations) but has a poor prognosis (7-day stroke risk of 60%). Up to date, the exact pathogenic mechanism of CWS has not been fully understood. We report the clinical presentations and high-resolution MRI (HR MRI) findings of two cases with capsular warning symptoms.
Case presentation:
Case 1 was a 63-year-old man with a history of hypertension with recurrent episodes of left hemiparesis and dysarthria lasting 10 ~ 30 minutes. Case 2 was a 54-year-old woman with repetitive episodes of transient left hemiparesis and dysarthria lasting about 10 minutes. Capsular infarctions on DWI were demonstrated in the territory of a lenticulostriate artery in both 2 patients. HR MRI disclosed atherosclerotic plaques on the ventral wall of the MCA where enticulostriate arteries were arisen from, although traditional digital subtraction angiography showed normal. Aggressive medical therapy with dual antithrombotic agents and statin was effective in these two cases.
Conclusion:
Our HR MRI data offer an insight into the pathophysiology of CWS which might be caused by atherosclerotic plaque in non-stenotic MCA wall. HR MRI might be a useful modality for characterizing atherosclerotic plaques in the MCA and detecting the pathophysiology of the CWS.
Case report: Exotropia in waardenburg syndrome with novel variations
Authors: Lijuan Huang, Maosheng Guo, Ningdong Li
Journal: Front Genet (2022)
Keywords: col11a2, pax3, sox10, exotropia, waardenburg syndrome
MeSH terms: Case Reports

Background: Waardenburg syndrome (WS) is a rare genetic disorder characterized by congenital sensorineural hearing loss and pigmentary abnormalities of the hair, skin and eyes. However, exotropia is rarely reported. The purpose of this study is to describe the clinical characteristics of three sporadic patients with WS and congenital exotropia and to investigate the disease-causing genes for them. Methods: Patients underwent detailed physical and ocular examinations. Ocular alignment and binocular status were evaluated. DNA was extracted and whole exome sequencing was performed to detect the pathogenic variations in the disease-causing genes for WS. Cloning sequencing was carried out for those indel variations. Results: Three unrelated patients were diagnosed with Waardenburg syndrome and congenital exotropia. Four novel variants, including c.136delA (p.I46Sfs*64) and c.668G>T (p.R223L) in PAX3, c.709dupC (p.Q237Pfs*119) in COL11A2, c.426G>A (p.W142X) in SOX10 gene, were detected in this study. Conclusion: Simultaneous presence of congenital exotropia and WS in our patients is suggested that WS could be involved in malfunction in the multiple nerve systems. Our genetic study will expand the mutation spectrum of PAX3, COL11A2 and SOX10 genes, and is helpful for further study on the molecular pathogenesis of WS.