OpenMed/multicare-articles huggingface dataset:
Necrotizing Fasciitis Following Herpes Zoster Ophthalmicus in an Immunocompromised Patient
Authors: Grazia Maria Cozzupoli, Daniele Gui, Valerio Cozza, Claudio Lodoli, Mariano Alberto Pennisi, Aldo Caporossi, Benedetto Falsini
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

Necrotizing fasciitis (NF) is a rare infection that spreads rapidly along the subcutaneous soft tissue planes. NF rarely involves the periorbital region due to the excellent blood supply of this region. We report a case of periorbital necrotising fasciitis following herpes zoster (HZ) in an immunocompromised 70-year-old patient with a dramatically rapid evolution into septic shock. In our patient, the surprisingly rapid spread of the bacterial superinfection led the periorbital cellulitis to turn into frank NF within 2 hours, with an overwhelming evolution. Despite the prompt start of a systemic antibiotic therapy and the immediate surgical intervention, the patient had a septic shock; she was treated in ITU for 31 days and then discharged to a medical ward and eventually died for a mix of complications of the medical treatment and comorbidities. This case is unique because any documented cases of periorbital NF triggered by HZ had never led to a septic shock and death. Ophthalmologists should be aware that even common skin lesions caused by shingles can determine a dramatic clinical picture, in presence of predisposing factors.
The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report
Authors: Kathy Rock, Nariman Fattah, Diarmuid O'Malley, Enda McDermott
Journal: J Med Case Rep (2010)

Introduction:
Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism.
Case presentation:
We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma.
Conclusion:
In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.
Focal Xanthogranulomatous Pyelonephritis with Pulmonary Lesions on the Background of Type Two Diabetes Mellitus
Authors: Ahmad Enshaei, Arash A Boora, Diana Taheri, Zahra Changizi, Nahid Bahmani
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Focal Xanthogranulomatous pyelonephritis is a rare chronic inflammatory condition of kidneys which usually is associated with postrenal obstruction or renal stone leading to chronic bacterial infection and eventually chronic glomerular inflammation. About 90% of cases are of the diffuse type and associated with staghorn renal calculi. The case presented in this paper is of the focal type in a 58-year-old diabetic female. Interestingly she did not have symptoms or laboratory presentation of chronic renal bacterial infection except for elevated ESR. She sought medical attention due to severe pulmonary infection of the background of morbid obesity. Imaging studies revealed several pulmonary lesions and a large mass of the right kidney which was indistinguishable from renal malignancy. After surgical resection of the right kidney, the lesion is pathologically diagnosed to be a focal Xanthogranulomatous pyelonephritis. The pulmonary lesions were spontaneously resolved about three months following right nephrectomy.
Embryonal rhabdomyosarcoma of the adult urinary bladder: a rare case report of misclassification as inflammatory myofibroblastic tumor
Authors: Kelven Weijing Chen, Fiona Mei Wen Wu, Victor Kwan Min Lee, Kesavan Esuvaranathan
Journal: Case Rep Surg (2015)

Embryonal rhabdomyosarcoma (ERMS) of the adult urinary bladder is a rare malignant tumour. Inflammatory myofibroblastic tumour (IMT) of the bladder is a benign genitourinary tumour that may appear variable histologically but usually lacks unequivocal malignant traits. Techniques like flow cytometry and immunohistochemistry may be used to differentiate these two tumours. Our patient, a 46-year-old male, had rapidly recurring lower urinary tract symptoms after two transurethral resections of the prostate. He subsequently underwent a transvesical prostatectomy which showed IMT on histology. However, his symptoms did not resolve and an open resection done at our institution revealed a 6 cm tumour arising from the right bladder neck. This time, histology was ERMS with diffuse anaplasia of the bladder. Rapid recurrence of urinary symptoms with prostate regrowth after surgery is unusual. Differential diagnoses of uncommon bladder malignancies should be considered if there is an inconsistent clinical course as treatment approaches are different.
Cystic Lymphangioma of the Chest Wall in a 5-Year-Old Male Patient: A Rare and Atypical Localization-A Case Report and Comprehensive Review of the Literature
Authors: Dimitrios Patoulias, Ioannis Patoulias, Christos Kaselas, Maria Kalogirou, Chatzopoulos Kyriakos, Farmakis Konstantinos, Thomas Feidantsis, Papacrivou Eleni
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Lymphangioma is a benign congenital malformation. The extremely rare and atypical localization of a lymphangioma in the chest wall was the real motive for the present case study. A 5-year-old boy was admitted to the Emergency Department of the 1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, due to the presence of a mildly painful swelling in the left lateral chest wall, which was first noticed three months ago, after a blunt injury during sport. Physical examination revealed the presence of a palpable, spherical, painful, nut-sized subcutaneous lesion in the left lateral chest wall, respectively, with the anterior axillary line, at the height of the 6th to 7th intercostal space. Presence of ecchymosis on the overlying skin was also noticed. During palpation, we did not notice fluctuation, while transillumination was not feasible. Performance of ultrasonography, including Doppler color flow imaging, followed, depicting a subcutaneous cystic lesion, 2.1⁎3.2 cm in dimensions, without extension to the thoracic cavity. Scheduled surgical excision of the lesion was decided. Histopathological examination documented the diagnosis of cystic lymphangioma. Patient is still followed up on a 6-month basis. He remains asymptomatic, after 2 years, without indication of relapse.
Vaccine-Associated Disease Enhancement (VADE): Considerations in Postvaccination COVID-19
Authors: Rahajeng N Tunjungputri, Erpryta Nurdia Tetrasiwi, Merlinda Veronica, Jacub Pandelaki, Fera Ibrahim, Erni Juwita Nelwan
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Introduction:
The COVID-19 pandemic has entered a new phase with the roll-out of several vaccines worldwide at an accelerated phase. The occurrence of a more severe presentation of COVID-19 after vaccination may affect policymakers' decision-making and vaccine uptake by the public. Vaccine-associated disease enhancement (VADE) is the modified presentation of infections in individuals after having received a prior vaccination. Currently, little is known about the potential of vaccine-associated disease enhancement (VADE) following COVID-19 immunization. Case Illustration. We herewith report two patients admitted with confirmed COVID-19 pneumonia with a history of CoronaVac vaccination. The first patient with a relatively milder course of the disease had received two doses of CoronaVac, whereas the second patient with a more progressive course of the disease received only one dose before developing symptoms and being admitted to the hospital. Our observations suggest that vaccination could act in boosting the inflammatory process and reveal the previously asymptomatic COVID-19 illness. Theoretically, vaccines could induce VADE, where only suboptimal, nonprotective titers of neutralizing antibodies were produced or proinflammatory T-helper type 2 response was induced. Secondly, enhanced respiratory disease (ERD) could manifest, where pulmonary symptoms are more severe due to peribronchial monocytic and eosinophilic infiltration. Understanding VADE is important for the decision-making by the public, clinicians, and policymakers and is warranted for successful vaccination uptake.
Conclusion:
We report two cases of patients developing COVID-19 shortly after CoronaVac vaccination in which VADE is likely. We recommend that current vaccination strategies consider the measurement of neutralizing antibody titer as a guide in ensuring the safest strategy for mass immunization. Studies are needed to investigate the true incidence of VADE on vaccinated individuals as well as on how to differentiate between VADE and severe manifestations of COVID-19 that are unrelated to vaccination.
Peripheral Organs of Dengue Fatal Cases Present Strong Pro-Inflammatory Response with Participation of IFN-Gamma-, TNF-Alpha- and RANTES-Producing Cells
Authors: Tiago F Póvoa, Edson R A Oliveira, Carlos A Basílio-de-Oliveira, Gerard J Nuovo, Vera L A Chagas, Natália G Salomão, Ada Maria de Barcelos Alves, Ester M Mota, Marciano V Paes
Journal: PLoS One (2016)
MeSH terms: Chemokine CCL5 / physiology, Dengue / complications, Interferon-gamma / physiology, Tumor Necrosis Factor-alpha / physiology, Case Reports, Adult, Chemokine CCL5 / metabolism, Cytokines / metabolism, Cytokines / physiology, Dengue / immunology, Dengue / mortality, Female, Humans, Immunity, Cellular, Interferon-gamma / metabolism, Kidney / metabolism, Kidney / pathology, Liver / metabolism, Liver / pathology, Lung / metabolism, Lung / pathology, Male, Middle Aged, Tumor Necrosis Factor-alpha / metabolism, CCL5 protein, human, Chemokine CCL5, Cytokines, Tumor Necrosis Factor-alpha, Interferon-gamma

Dengue disease is an acute viral illness caused by dengue virus (DENV) that can progress to hemorrhagic stages leading to about 20000 deaths every year worldwide. Despite many clinical investigations regarding dengue, the immunopathogenic process by which infected patients evolve to the severe forms is not fully understood. Apart from differences in virulence and the antibody cross reactivity that can potentially augment virus replication, imbalanced cellular immunity is also seen as a major concern in the establishment of severe dengue. In this context, the investigation of cellular immunity and its products in dengue fatal cases may provide valuable data to help revealing dengue immunopathogenesis. Here, based in four dengue fatal cases infected by the serotype 3 in Brazil, different peripheral organs (livers, lungs and kidneys) were studied to evaluate the presence of cell infiltrates and the patterns of local cytokine response. The overall scenario of the studied cases revealed a considerable systemic involvement of infection with mononuclear cells targeted to all of the evaluated organs, as measured by immunohistochemistry (IHC). Quantification of cytokine-expressing cells in peripheral tissues was also performed to characterize the ongoing inflammatory process by the severe stage of the disease. Increased levels of IFN-γ- and TNF-α-expressing cells in liver, lung and kidney samples of post-mortem subjects evidenced a strong pro-inflammatory induction in these tissues. The presence of increased RANTES-producing cell numbers in all analyzed organs suggested a possible link between the clinical status and altered vascular permeability. Co-staining of DENV RNA and IFN-γ or TNF-α using in situ hibridization and IHC confirmed the virus-specific trigger of the pro-inflammatory response. Taken together, this work provided additional evidences that corroborated with the traditional theories regarding the "cytokine storm" and the occurrence of uneven cellular immunity in response to DENV as major reasons for progress to severe disease.
Bilateral Trichotillomania of Eyelashes Triggered by Anxiety due to Nocturnal Enuresis: A Case Report
Authors: Shoko Ubukata, Tatsuya Mimura, Emiko Watanabe, Koichi Matsumoto, Makoto Kawashima, Kazuma Kitsu, Mai Nishio, Atsushi Mizota
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

Purpose:
Trichotillomania is a behavioral and mental disorder and is characterized by a recurring habit of pulling out one's hair. The differential diagnosis between trichotillomania and other hair loss conditions such as alopecia areata is difficult for ophthalmologists. We report a rare case of bilateral trichotillomania of the eyelashes that was triggered by anxiety about nocturnal enuresis.
Case report:
A healthy 9-year-old Japanese boy presented with a bilateral loss of his eyelashes. His parents had believed that his loss of eyelashes was due to alopecia, an autoimmune disorder that results in hair loss, of the eyelashes. Our initial examination revealed that he had suffered from nightly nocturnal enuresis from childhood and was scheduled to go on a school trip the following month. He feared that his school mates might find out about his enuresis, and he said that the anxiety was the cause of the eyelash trichotillomania. The trichotillomania was resolved by discussion among the student, his family, teacher, and school counselor.
Conclusion:
To the best of our knowledge, this is the first report of eyelash trichotillomania caused by anxiety about nocturnal enuresis. Ophthalmologists should be aware that a patient without eyelashes may not be due to alopecia but some anxiety-producing events. In addition, discussion of the anxiety-producing factor among the parents, teacher, and school counselors can resolve the trichotillomania.
Calcified Leiomyomata Presenting as Recurrent Pregnancy Loss
Authors: Mohammad Marwan Alhalabi, Ameer Kakaje, Marwan Alhalabi
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Recurrent spontaneous abortion (RSA) is a problem that faces women for a variety of reasons. Although leiomyomata is relatively common, calcified leiomyomata which is called "womb stones" is a very rare cause of RSA. These womb stones are correlated with retained products from conception and osseous metaplasia. We report a very rare case of a large calcified leiomyomata which caused secondary infertility and pregnancy loss of 7 pregnancies due to spontaneous abortions.
Case report: Transplantation of human induced pluripotent stem cell-derived cardiomyocyte patches for ischemic cardiomyopathy
Authors: Shigeru Miyagawa, Satoshi Kainuma, Takuji Kawamura, Kota Suzuki, Yoshito Ito, Hiroko Iseoka, Emiko Ito, Maki Takeda, Masao Sasai, Noriko Mochizuki-Oda, Tomomi Shimamoto, Yukako Nitta, Hiromi Dohi, Tadashi Watabe, Yasushi Sakata, Koichi Toda, Yoshiki Sawa
Journal: Front Cardiovasc Med (2022)
Keywords: clinical trial, human induced pluripotent stem cell-derived cardiomyocyte, ischemic cardiomyopathy, regenerative therapy, transplantation
MeSH terms: Case Reports

Despite major therapeutic advances, heart failure, as a non-communicable disease, remains a life-threatening disorder, with 26 million patients worldwide, causing more deaths than cancer. Therefore, novel strategies for the treatment of heart failure continue to be an important clinical need. Based on preclinical studies, allogenic human induced pluripotent stem cell-derived cardiomyocyte (hiPSC-CM) patches have been proposed as a potential therapeutic candidate for heart failure. We report the implantation of allogeneic hiPSC-CM patches in a patient with ischemic cardiomyopathy (ClinicalTrials.gov, #jRCT2053190081). The patches were produced under clinical-grade conditions and displayed cardiogenic phenotypes and safety in vivo (severe immunodeficient mice) without any genetic mutations in cancer-related genes. The patches were then implanted via thoracotomy into the left ventricle epicardium of the patient under immunosuppressive agents. Positron emission tomography and computed tomography confirmed the potential efficacy and did not detect tumorigenesis in either the heart or other organs. The clinical symptoms improved 6 months after surgery, without any major adverse events, suggesting that the patches were well-tolerated. Furthermore, changes in the wall motion in the transplanted site were recovered, suggesting a favorable prognosis and the potential tolerance to exercise. This study is the first report of a successful transplant of hiPSC-CMs for severe ischemic cardiomyopathy.
Rhinolith: delayed presentation after head trauma-a case report
Authors: Ali S Al Mastour, Wagih M Ghnnam, Abdu H Zubaidi
Journal: Case Rep Otolaryngol (2012)

Rhinoliths are uncommon clinical entities reported in clinical practice as unusual cause of unilateral nasal obstruction and foul smell nasal discharge. Rhinolith is calcified material found in the nasal cavity incidentally or due to patient complaint. It should be suspected when patient presents with nasal symptoms and found to have stony mass showed radiologically. We reported a 28-year-old Saudi male with left sided (LT) nasal obstruction and foul smell discharge for 5 years suspected as being due to foreign body presence since childhood due to head trauma following car accident in sandy area.
Successful Therapy for Myocarditis Concomitant With Complete Heart Block After Pembrolizumab Treatment for Head and Neck Squamous Cell Carcinoma: A Case Report With Literature Review
Authors: Lina Su, Chuanfen Liu, Wenjie Wu, Yuxia Cui, Manyan Wu, Hong Chen
Journal: Front Cardiovasc Med (2022)
Keywords: complete atrioventricular (av) block, global longitudinal peak strain, head and neck squamous cancer cells (hnscc), immune checkpoint inhibitors, myocarditis
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy over the past decade. Despite their beneficial effects on treating numerous types of tumors, cardiotoxicity resulting from ICIs is a rare side effect but a concerning one due to its high mortality rate. We herein describe a case of an 80-year-old woman with recurrent head and neck squamous cell cancer (HNSCC), who presented with myocarditis complicated by complete atrioventricular block (CAVB) after second infusion of pembrolizumab. After quickly ruling out myocardial infarction and viral myocarditis, the strong relationship between the onset time and pembrolizumab therapy suggested that ICI-induced myocarditis was the most possible diagnosis. Though CAVB frequently presents with fulminant myocarditis in the setting of ICI-related cardiotoxicity, the patients kept a stable hemodynamic status and had normal myocardial function with just a slightly low global longitudinal strain (GLS) at-16.4%, which implied myocardial injury but was highly related to good prognosis based on the existing literature. Besides, elderly patients are vulnerable to adverse outcomes of steroid therapy, notably opportunistic infections. To balance beneficial effects and adverse effects of immune suppression, she accepted high-dose steroids without pulse methylprednisolone. Excitingly, she had a dramatic clinical and laboratory improvement, and heart block quickly returned to normal sinus rhythm. Another interesting finding was that the patient's tumor remained stable during the half-year follow-up from the termination of immunotherapy. Besides, we here firstly review previously reported cases in terms of their clinical characteristics and prognosis of ICI-induced myocarditis with CAVB, in particular the reversibility of heart block. In conclusion, ICI-induced myocarditis can be life-threatening and it therefore warrants efforts to increase awareness, facilitate early detection, and initiate prompt intervention. Importantly, CAVB secondary to ICIs-induced myocarditis may not always present with fulminant myocarditis and more than 50% of these surviving patients might recover to normal sinus rhythm. For patients with ICI-induced myocarditis with contraindication for cardiac magnetic resonance (CMR), speckle-tracking echocardiography is a reliable and sensitive alternative to CMR for detecting myocardial injury, and GLS may be an important prognostic indicator.
Spontaneous perforation of pyometra
Authors: Begüm Yildizhan, Esra Uyar, Alper Sişmanoğlu, Gülfem Güllüoğlu, Zehra N Kavak
Journal: Infect Dis Obstet Gynecol (2006)
MeSH terms: Abdominal Pain / etiology, Rupture, Spontaneous / complications, Uterine Diseases / complications, Uterine Rupture, Case Reports, Review, Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Suppuration

Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01-0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy). Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.
Cystic Echinococcosis: A Rare Case of Brain Localization
Authors: Ali Baradan Bagheri, Mohammad Zibaei, Mehdi Tayebi Arasteh
Journal: Iran J Parasitol (2017)
Keywords: brain, echinococcosis, hydatid cyst, surgery
MeSH terms: Case Reports

Although Hydatid disease eradicated in many countries, it is still widespread in communities where agriculture is dominant. Cystic hydatidosis is significant public health problem in the regions with endemic echinococcosis. The hydatid cysts tend to form mostly in the liver or lung. Brain involvement is very rare. In the present report, we describe magnetic resonance imaging findings in an 18-yr-old male with cerebral echinococcosis, in Shahid Madani Hospital, Karaj, Iran in 2015. The patient, presented with headache, hemiparesis, impairment of speech, vomiting, and nausea. Computed tomography, magnetic resonance imaging, and surgical exploration proved a cyst in the superior portion of left temporal lobe. Pathological examination showed it to be a solitary primary cerebral hydatid cyst.