OpenMed/multicare-articles huggingface dataset:
Congenital insensitivity to pain with anhydrosis: report of a family case
Authors: Smael Labib, Mohamed Adnane Berdai, Sanae Abourazzak, Mustapha Hida, Mustapha Harandou
Journal: Pan Afr Med J (2011)
Keywords: congenital insensitivity to pain, anesthesia, family case, hereditary, neuropathy, sensory and autonomic neuropathy
MeSH terms: Hereditary Sensory and Autonomic Neuropathies / genetics, Self Mutilation / etiology, Case Reports, Anesthesia / adverse effects, Anesthetics / administration & dosage, Anesthetics / adverse effects, Anesthetics / pharmacokinetics, Child, Preschool, Diarrhea / etiology, Female, Humans, Hypohidrosis / etiology, Male, Malignant Hyperthermia / etiology, Malignant Hyperthermia / prevention & control, Mouth Protectors, Pain Insensitivity, Congenital / etiology, Psychotherapy, Receptor, trkA / deficiency, Receptor, trkA / genetics, Siblings, Anesthetics, Receptor, trkA

Congenital Insensitivity to pain with anhydrosis (CIPA) is a rare inherited disease. It is classified as hereditary sensory and autonomic neuropathy type IV. Pain insensitivity and autonomic deficits are present, but touch and pressure sensitivity are unimpaired. Mental retardation is usually present. We report a family case of a 5 years old girl and 2 years old boy with congenital insensitivity to pain, while discussing the clinical features and the anesthetic strategy of such patients. Patients with Congenital Insensitivity to Pain with anhydrosis may undergo surgery because of susceptibility to trauma due to absence of pain. The clinical features may intrinsically possess anesthetic challenges.
Case Report: Septic Pericarditis With Achromobacter xyloxidans in an Immunosuppressed Dog
Authors: Kristina M Pascutti, Jacqueline K Dolan, Lauren T Porter, Shir Gilor, Autumn N Harris
Journal: Front Vet Sci (2022)
Keywords: apoquel, bacterial, canine, pericarditis, pyothorax
MeSH terms: Case Reports

A 5-year-old female spayed French Bulldog presented for anorexia and increased respiratory rate. On presentation, she was dyspneic with stridor and increased bronchovesicular sounds. Point-of-care ultrasound identified pericardial effusion. Thoracic radiographs identified pleural effusion, a wide cranial mediastinum, and multifocal unstructured interstitial pulmonary opacities. Bloodwork revealed a moderate leukocytosis characterized by a mature neutrophilia with a left shift, hypoalbuminemia, mildly increased alkaline phosphatase activity, and moderate hypokalemia. Thoracic CT findings revealed moderate pericardial and bilateral pleural effusion, mediastinal effusion, and moderate cranial mediastinal lymphadenopathy. Diagnostic thoracocentesis and pericardiocentesis revealed septic exudates with bacilli. Two days later, a median sternotomy and pericardiectomy were performed. Aerobic cultures of the effusions grew Achromobacter xylosoxidans ss deitrificans. The patient was treated with Amoxicillin-clavulanate and enrofloxacin for 12 weeks and clinically fully recovered. Achromobacter xylosoxidans has not been reported as a cause of purulent pericarditis and pyothorax in a dog. Uniquely, this patient is suspected of developing this infection secondary to immunosuppression.
A Rare Case of Glioblastoma Multiforme with Osseous Metastases
Authors: Rubens Barros Costa, Ricardo Costa, Jason Kaplan, Marcelo Rocha Cruz, Hiral Shah, Maria Matsangou, Benedito Carneiro
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Glioblastoma multiforme is the most common malignant primary central nervous system neoplasm in adults. It has a very aggressive natural history with a median overall survival estimated at 14.6 months despite multimodality treatment. Extracranial metastases are very rare with few case reports published to date. We report the case of a 65-year-old male who underwent maximal safe resection for a newly diagnosed brain mass after presentation with new neurologic symptoms. He then received standard postsurgical adjuvant treatment for glioblastoma. Subsequently, he underwent another resection for early progressive disease. Several months later, he was hospitalized for new-onset musculoskeletal complaints. Additional investigation revealed new metastatic osseous lesions which were initially felt to be a new malignancy. The patient opted for supportive care and died 12 days later. Despite choosing no treatment, he elected to undergo a bone biopsy to understand the new underlying process. Results were that of metastatic GBM and were reported after the patient expired. Physicians caring for patients with GBM and new nonneurologic symptoms may contemplate body imaging.
The economic burden of cervical cancer from diagnosis to one year after final discharge in Henan Province, China: A retrospective case series study
Authors: Qianhui Wu, Manman Jia, Hongmin Chen, Shaokai Zhang, Yang Liu, Kiesha Prem, Mengcen Qian, Hongjie Yu
Journal: PLoS One (2020)
MeSH terms: Papillomavirus Vaccines / economics, Uterine Cervical Neoplasms / economics, Research Support, Non-U.S. Gov't, Adult, Ambulatory Care / economics, China / epidemiology, Cost of Illness, Cost-Benefit Analysis / methods, Female, Health Expenditures, Hospitalization / economics, Humans, Inpatients, Middle Aged, Outpatients, Quality of Life / psychology, Quality-Adjusted Life Years, Retrospective Studies, Vaccination / economics, Papillomavirus Vaccines

Background:
In China, the disease burden of cervical cancer remains substantial. Human papillomavirus (HPV) vaccines are expensive and not yet centrally funded. To inform immunization policy, understanding the economic burden of the disease is necessary. This study adopted a societal perspective and investigated costs and quality of life changes associated with cervical cancer from diagnosis to one year after final discharge in Henan province, China.
Methods:
Inpatient records of cervical cancer patients admitted to the largest cancer hospital in Henan province between Jan. 2017 and Dec. 2018 were extracted. A telephone interview with four modules was conducted in Jun.-Jul. 2019 with a 40% random draw of patients to obtain direct non-medical costs and indirect costs associated with inpatients, costs associated with outpatient visits, and changes in quality of life status using the EQ-5D-5L instrument. Direct medical expenditures were converted to opportunity costs of care using cost-to-charge ratios obtained from hospital financial reports. For each clinical stage (IA-IV), total costs per case from diagnosis to one year after final discharge were extrapolated based on inpatient records, responses to the telephone interview, and recommendation on outpatient follow-ups by Chinese cervical cancer treatment guidelines. Loss in quality-adjusted life years was obtained using the 'under the curve' method and regression predictions.
Results:
A total of 3,506 inpatient records from 1,323 patients were obtained. Among 541 randomly selected patients, 309 completed at least one module of the telephone interview. The average total costs per case associated with cervical cancer from diagnosis to one year after final discharge ranged from $8,066-$22,888 (in 2018 US Dollar) and the quality-adjusted life years loss varied from 0.05-0.26 for IA-IV patients.
Conclusions:
The economic burden associated with cervical cancer is substantial in Henan province. Our study provided important baseline information for cost-effectiveness analysis of HPV immunization program in China.
Empagliflozin-Associated Euglycemic Diabetic Ketoacidosis in a Patient With Type 2 Diabetes Mellitus
Authors: Sukhjinder Chauhan, AndreyI Manov, Gundip S Dhillon, Pinak Shah
Journal: Cureus (2023)
Keywords: canagliflozin, diabetes mellitus, dka, empagliflozin, euglycemic diabetic ketoacidosis, ketones, sodium-glucose cotransporter-2 (sglt-2) inhibitor, sodium-glucose cotransporter-2 (sglt2) inhibitors
MeSH terms: Case Reports

Euglycemic diabetic ketoacidosis (euDKA) is an uncommon condition, which is characterized by an elevated anion gap metabolic acidosis with ketonemia/ketonuria, in the presence of normal blood glucose levels. Common risk factors for the development of this condition include pregnancy, prolonged fasting, acute pancreatitis, and bariatric surgery. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been identified as a rare cause of euDKA. A recent literature review on PubMed found only 86 case reports of euDKA secondary to SGLT inhibitors published in the medical literature up to December 2022. Here, we present the case of a 43-year-old man who was taking empagliflozin, an SGLT-2 inhibitor. The patient was found to have euDKA, which was likely an adverse effect of his medication.
Recurrence of acute myeloid leukemia in cryptorchid testis: case report
Authors: Luccas Santos Patto de Góes, Roberto Iglesias Lopes, Octavio Henrique Arcos Campos, Luiz Carlos Neves de Oliveira, Alexandre Crippa Sant'Anna, Marcos Francisco Dall'Oglio, Miguel Srougi
Journal: Einstein (Sao Paulo) (2014)
MeSH terms: Cryptorchidism / surgery, Leukemia, Myeloid, Acute / surgery, Neoplasm Recurrence, Local / surgery, Orchiectomy / methods, Testicular Neoplasms / surgery, Case Reports, Biopsy, Bone Marrow Transplantation, Cryptorchidism / pathology, Humans, Leukemia, Myeloid, Acute / pathology, Male, Neoplasm Recurrence, Local / pathology, Testicular Neoplasms / pathology, Tomography, X-Ray Computed, Treatment Outcome, Young Adult

A 23-year-old male with a history of bone marrow transplant for acute myeloid leukemia. He presented a large mass in the right inguinal region 5 years ago. Upon physical examination, right-sided cryptorchidism was observed. The tumor markers alpha-fetoprotein and beta-HCG were within normalcy range and lactate dehydrogenase was raised. Computed tomography of the abdomen and pelvis revealed right testicular mass in contiguity with the inguinal canal to the ipsilateral retroperitoneum, associated with right hydronephrosis. Due to the risk of germ-cell tumor in undescended testicle, the patient underwent radical right orchiectomy. The pathological examination showed recurrence of acute myeloid leukemia in the testis. He was referred to oncology for adjuvant therapy. Our literature review found no similar cases described.
Paraneoplastic Pemphigus: A Striking Complication of Undiagnosed Lymphoma
Authors: Blake O Adnani, Kathleen O' Brien, Zaw W Myint, Brandon L Adler
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

A 49-year-old male with no past medical history presented with acute-onset painful mucosal erosions along with flaccid bullae on his trunk, scalp, and intertriginous areas. The patient initially underwent a skin biopsy which demonstrated suprabasilar acantholysis and lichenoid interface dermatitis. This was followed by a computed tomography scan which identified a large abdominal lymph node. Core needle biopsy of this node demonstrated follicular lymphoma. Lastly, indirect immunofluorescence (IIF) in rat bladder was positive (titer 1 : 10,240). This finding confirmed the diagnosis of paraneoplastic pemphigus (PNP) in the setting of follicular lymphoma. The patient's cutaneous disease was treated with a combination of intravenous immunoglobulin and methylprednisolone, along with intravenous rituximab, with a resolution of his cutaneous symptoms. His lymphoma was treated with six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), with an interval decrease in his tumor burden. PNP is an autoimmune-mediated mucocutaneous disease associated with underlying neoplasm, most commonly non-Hodgkin lymphoma or chronic lymphocytic leukemia. Affected patients develop variable autoantibodies to antigens on keratinocytes and the basement membrane zone. Severe intractable stomatitis is characteristic, in addition to polymorphous cutaneous eruptions including bullae and erosions. Mortality rates can reach up to 90% due to malignancy, sepsis, or bronchiolitis obliterans, an irreversible and often lethal cause of pulmonary insufficiency. We highlight PNP manifesting in a patient with lymphoma, who responded well to the skin- and malignancy-directed treatments. PNP is an exceedingly rare diagnosis that should be considered in a patient with intractable stomatitis.
A Nonseminomatous Germ Cell Tumor Presenting as a Mixed Cryoglobulinemic Vasculitis
Authors: Gabriel Cojuc-Konigsberg, Isabel Comte Natera, Blanca E López Graciano, Luis Gerardo Mosqueda López, José Alonso Rojo Ávila, Braulio Martínez, Juan C Ramírez-Sandoval
Journal: Case Rep Oncol Med (2022)
MeSH terms: Case Reports

Background:
Mixed cryoglobulinemia syndrome (MCS) is a rare entity with a variety of causes but has not been associated with testicular germ cell tumors. We present here a case of a patient with a nonseminomatous germ cell tumor (NSGCT) presenting as a type III mixed cryoglobulinemic vasculitis. Case Presentation. A 58-year-old male exhibited typical clinical features of vasculitis, including weakness, fatigue, palpable purpura, multiple mononeuropathy, and a low C4 level. An MCS diagnosis was confirmed by the presence of cryoglobulins (6%) with polyclonal IgM and IgG components and biopsy proven leukocytoclastic vasculitis. Concomitantly, a stage IIIC (TxNxM1bS1) germ tumor with marked elevation of serum beta-human chorionic gonadotropin (2764 mUI/mL) was diagnosed. An aggressive treatment was needed, including methylprednisolone pulses, plasmapheresis, rituximab, followed by orchiectomy, and chemotherapy (bleomycin/etoposide/cisplatin). After tumor resection and treatment, cryoglobulins decrease to 0%, suggesting a paraneoplastic origin of the vasculitis.
Conclusion:
To the best of our knowledge, this is the first case of MCS possibly attributable to a NSGCT. This case further elaborates on the presentation of mixed cryoglobulinemia vasculitis and adds to the published literature on the topic.
A successful antimicrobial regime for Chromobacterium violaceum induced bacteremia
Authors: James I Campbell, Nguyen Phu Huong Lan, Phan Tu Qui, Le Thi Dung, Jeremy J Farrar, Stephen Baker
Journal: BMC Infect Dis (2013)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Bacteremia / drug therapy, Chromobacterium / isolation & purification, Gram-Negative Bacterial Infections / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Bacteremia / microbiology, Bacterial Typing Techniques, Child, Preschool, Drug Therapy, Combination, Gram-Negative Bacterial Infections / microbiology, Humans, Male, Vietnam, Wounds, Penetrating / microbiology, Anti-Bacterial Agents

Background:
Chromobacterium violaceum is a proteobacterium found in soil and water in tropical regions. The organism rarely causes infection in humans, yet can cause a severe systemic infection by entering the bloodstream via an open wound.
Case presentation:
We recently identified a case of severe bacteremia caused by Chromobacterium violaceum at the Hospital for Tropical Diseases (HTD) in Ho Chi Minh City, Vietnam. Here, we describe how rapid microbiological identification and a combination of antimicrobials was used to successfully treat this life threatening infection in a four-year-old child.
Conclusions:
This case shows the need for rapid diagnosis when there is the suspicion of a puncture wound contaminated with water and soil in tropical regions. We suggest that the aggressive antimicrobial combination used here is considered when this infection is suspected.
Case report: Catecholamine cardiomyopathy in children with neuroblastoma
Authors: Xiaoyan Xu, Meiqi Liu, Yanmin Zhang, Jie Wang, Xi Lei, Juanli Wang, Yafei Zhou, Tao Wang
Journal: Front Pediatr (2023)
Keywords: catecholamine cardiomyopathy, children, hypertension, hypertrophic cardiomyopathy, neuroblastoma
MeSH terms: Case Reports

Introduction:
Many endocrine diseases, such as neuroblastoma (NB), can be linked with acquired cardiomyopathy and heart failure. Neuroblastoma's cardiovascular manifestations are typically hypertension, electrocardiogram (ECG) changes, and conduction disturbances.
Case presentation:
A 5-year-old 8-month-old girl was admitted to the hospital with ventricular hypertrophy and hypertension (HT) and heart failure. She had no previous history of HT. On color doppler echocardiography, the left atrium and left ventricle were enlarged. The left ventricular ejection fraction (EF) was as low as 40%, and the ventricular septum and left ventricular free wall were thickened. The internal diameters of both coronary arteries were widened. Abdominal computed tomography scan (CT) demonstrated an 8.7 cm × 7.1 cm × 9.5 cm tumor behind the left peritoneum. In urine catecholamines analysis, free-norepinephrine (f-NE), free-dopamine (f-DA), free-normetanephrine (f-NMN), free-3-methoxytyramine (f-3MT), vanillylmandelic acid (VMA), and homovanillic acid (HVA) levels were all greater than the normal range for 24 h except free-metanephrine (f-MN) and free-epinephrine (f-E). Based on these findings, we diagnosed her as NB complicated by catecholamine cardiomyopathy manifested by hypertrophic cardiomyopathy (HCM). Oral metoprolol, spironolactone, captopril and amlodipine furosemide, and intravenously injected sodium nitroprusside and phentolamine were employed for treating HT. After the tumor resection, the blood pressure (BP) and urinary catecholamine levels were all restored. After a follow-up of 7 months, echocardiography indicated normalization of ventricular hypertrophy and function.
Conclusion:
This is a rare report showing catecholamine cardiomyopathy in NB children. Tumor resection leads to a return to normal of the catecholamine cardiomyopathy manifested as HCM.
Lazarus Effect of High Dose Corticosteroids in a Patient With West Nile Virus Encephalitis: A Coincidence or a Clue?
Authors: A Arturo Leis, David J Sinclair
Journal: Front Med (Lausanne) (2019)
Keywords: west nile virus encephalitis, autoimmunity, neuroinflammation, neuroinvasive disease, post-infectious
MeSH terms: Case Reports

West Nile virus (WNV) causes severe neuroinvasive disease in humans characterized by meningitis, encephalitis, and acute flaccid paralysis (poliomyelitis variant). In neuroinvasive disease, WNV infection of neurons resulting in neuronal loss is generally presumed to be the anatomical substrate for the high morbidity and mortality. However, on a molecular level, WNV infection also results in a significant upregulation of important proinflammatory molecules that have been reported to promote neuroinflammation and cytotoxicity. Currently, there is no specific treatment for the neurological complications of WNV infection. We present a 71-year-old woman who developed WNV infection that rapidly progressed to severe generalized weakness and encephalitis manifesting with bulbar signs (dysphagia, dysarthria) and persistent delirium and stupor. Consciousness remained impaired for 9 days and then she received a 5-day course of high-dose intravenous methylprednisolone (1,000 mg daily). After the first day, voluntary movement and spontaneous eye-opening increased and by the end of the second day, she was awake and responding to commands. Thereafter, she remained awake and responsive. Although the rapid improvement from stupor to wakefulness following treatment with an anti-inflammatory immunosuppressant could merely be coincidence, since these observations are of one patient, it may also provide a clue that in some cases of WNV neuroinvasive disease a post-infectious pro-inflammatory state, rather than neuronal loss, may also contribute to morbidity. Further clinical trials are warranted to determine if high dose corticosteroids and other drugs that can alter this neuro-inflammatory cascade may be potentially beneficial in the treatment of WNV neuroinvasive disease.
Biliobronchial fistula after liver surgery for giant hydatid cyst
Authors: Carmelo Loinaz, Teresa Hernández, Mercedes Mitjavila, Jaime Martín, Federico Ochando, Maria Lucia Madariaga, Beatriz Fernández, Pilar Hernández, José Rueda, María Ramos, Pedro Jiménez, Peter Vorwald, José María Fernández, Antonio Quintáns
Journal: HPB Surg (2011)

Background. Biliobronchial fistula (BBF) is a rare complication in the natural history of liver hydatid disease by Echinococcus granulosus. We present a case of BBF after resection of a giant liver hydatid cyst in a 72-year-old woman. Case Report. A total cystpericystectomy was done, leaving the left lateral section of the liver that was fixed to the diaphragm. Postoperatively, the patient developed obstructive jaundice. An ERCP showed an obstruction at the junction of the left biliary duct and the main biliary duct and contrast leak. At reoperation, the main duct was ischemic, likely due to torsion along its longitudinal axis. A hepatotomy was done at the hilar plate, and the biliary duct was dissected and anastomosed to a Roux-en-Y jejunal loop. She was discharged without complications. Five months later, the patient developed cholangitis and was successfully treated with antibiotics. However, she suffered repeated respiratory infections, and four months later she was admitted to the hospital with fever, cough, bilioptysis, and right lower lobe pneumonia. The diagnosis of BBF was confirmed with (99m)Tc Mebrofenin scintigraphy. At transhepatic cholangiography, bile duct dilation was seen, with a biliothoracic leak. She underwent dilatation of cholangiojejunostomy stricture with placement of an external-internal catheter. The catheter was removed 3.5 months later, and two years later the patient remains in very good condition. Conclusion. An indirect treatment of the BBF by percutaneous transhepatic dilation of the biliary stenosis avoided a more invasive treatment, with satisfactory outcome.
Late-Developing Supernumerary Premolars: Analysis of Different Therapeutic Approaches
Authors: Sergio Paduano, Roberto Rongo, Alessandra Lucchese, Domenico Aiello, Ambrosina Michelotti, Cristina Grippaudo
Journal: Case Rep Dent (2016)

This case series describes the different potential approaches to late-developing supernumerary premolars (LDSP). LDSP are supernumerary teeth (ST) formed after the eruption of the permanent dentition; usually they develop in the premolar region of the upper and lower jaw. The choice to extract or to monitor the LDSP depends on many factors and has to be carefully planned due to the several risks that either the monitoring or the extraction could provoke. These four cases of LDSP showed different treatment plan alternatives derived from a scrupulous assessment of the clinical and radiographic information.
Oral White Sponge Nevus: An Exceptional Differential Diagnosis in Childhood
Authors: Fatima Zahra Elfatoiki, Sophia Capatas, Hayat Dahbi Skali, Fouzia Hali, Hicham Attar, Soumia Chiheb
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

White sponge nevus is an autosomal dominant skin disorder characterized by white, irregular, diffuse plaques mainly affecting the oral mucosa. Histological findings of white sponge nevus are characteristic but not pathognomonic. We report a case of an oral white sponge nevus in a 6-year-old girl, which poses a problem in differential diagnosis with oral candidiasis. No treatment was performed because of the benign and asymptomatic nature of the lesions.