OpenMed/multicare-articles huggingface dataset:
An Unusual Case of CMV/EBV Ventriculoencephalitis with Evolution to Primary Central Nervous System Lymphoma in HIV-Positive Patient
Authors: Gisela Borges, Diana Neves, Inês Pintado Maury, Aida Pereira, Maria de Jesus Silva
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Epstein-Barr virus (EBV) is a well-known cause of different types of malignancies particularly Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkin's lymphomas, and non-Hodgkin's lymphomas including primary central nervous system lymphoma (PCNSL). A higher tendency of malignant transformation associated with EBV has been noticed in immunocompromised patients, such as human immunodeficiency virus (HIV) infected patients. The rapid and effective immune reconstitution is crucial to prevent PCNSL in HIV-positive patients. We present a clinical case of a young patient diagnosed with HIV infection and medicated with antiretroviral therapy (ART) with poor immunological recovery. After two weeks, he developed ventriculoencephalitis, observed in the cranial magnetic resonance imaging (MRI), caused by cytomegalovirus (CMV) and EBV, both with high serum viral load, rapidly evolving to PCNSL. With this unusual clinical case, the authors want to draw attention to the importance of rapid immunological reconstitution in preventing the progression of EBV infection to PCNSL, as well as encouraging the confirmation of the usefulness of early combination of chemotherapy and antiviral therapy, in order to reach a more effective treatment of this herpesvirus infection and associated malignancies.
A Case of Malaria Predisposing to Salmonella Bacteremia in a Returning Traveler from Nigeria
Authors: Robert Jakubowski, Lisa L Steed, Susan E Dorman, Camelia Marculescu
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

We describe a febrile adult returning to the U.S. from Nigeria. Malaria was diagnosed by rapid antigen testing, but recognition of invasive nontyphoidal Salmonella disease was delayed. While the moniker, "typhomalaria," once used to describe an illness with features of malaria and typhoid fever, has fallen out of favor, it may nevertheless be a helpful reminder to clinicians that both infectious diseases can arise in the same patient. Blood cultures should be obtained routinely in febrile returning travelers from malaria-endemic regions, including those in whom the diagnosis of malaria has already been established.
Meckel's diverticulum causing intestinal obstruction in the newborn
Authors: Mohamed Amine Oukhouya, Saad Andaloussi, Hicham Abdellaoui, Mohammed Tazi, Abdelhalim Mahmoudi, Aziz Elmadi, Khalid Khattala, Youssef Bouabdallah
Journal: Pan Afr Med J (2018)
Keywords: intestinal obstruction, meckel´s diverticulum, neonate
MeSH terms: Intestinal Obstruction / diagnosis, Meckel Diverticulum / diagnosis, Vomiting / etiology, Case Reports, Humans, Infant, Newborn, Intestinal Obstruction / etiology, Intestinal Obstruction / surgery, Laparotomy / methods, Male, Meckel Diverticulum / complications, Meckel Diverticulum / surgery

The causes of neonatal bowel obstruction are variable and dominated by malformations and the Meckel diverticulum must remain exceptional. We report a case of neonatal bowel obstruction in a six day old male neonate admitted on account of inability to pass stool, abdominal distension and bilious vomiting. The radiologic additional examinations are non-specific. Exploratory laparotomy found obstruction at the site of a Meckel's diverticulum.
Laparoendoscopic Single-Site (LESS) Retroperitoneal Radical Nephrectomy in a Patient with Renal Cell Carcinoma Receiving Hemodialysis
Authors: Takeo Nomura, Fuminori Sato, Mika Takahashi, Yasuhiro Sumino, Hiromitsu Mimata
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We present here the patient undergoing laparoendoscopic single-site (LESS) retroperitoneal radical nephrectomy while receiving hemodialysis. An 81-year-old man under hemodialysis for 6 years was incidentally discovered to have two left renal masses with acquired cystic disease of the kidney (ACDK). A 4-cm flank incision for GelPort was made. Three trocars were inserted into the retroperitoneum through GelPort. After division of the renal vessels and ureter, the kidney was placed into the extraction bag and was retrieved through flank incision without any extra skin incision. There were no intraoperative and postoperative complications. This procedure offers an effective, minimally invasive therapeutic alternative to the standard laparoscopic technique in high-risk end-stage renal disease patients.
Malignant Ischemic Stroke in a Young Female: A Rare Primary Manifestation of Takayasu Arteritis
Authors: Bhupendra Shah, Roshan Chhetri
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Takayasu arteritis is a rare chronic progressive granulomatous necrotizing large vessel panvasculitis mainly involving aorta and its main branches. It commonly affects the female in second to third decades. Common clinical features of Takayasu arteritis are hypertension, claudication, dizziness, headache, or fever. Takayasu arteritis is diagnosed with clinical history of claudication, absent pulse, discordant blood pressure, bruit over aorta, and typical angiographic findings. Stroke as a primary manifestation of Takayasu arteritis is rarely reported in the medical literatures. We are reporting a 16-year-old female who had malignant ischemic stroke as a first manifestation of Takayasu arteritis.
Spontaneous rupture of the patellar tendon and the contralateral quadriceps tendon, associated with lupus erythematosus: analysis of the literature
Authors: Efthimios J Karadimas, Dimitrios Kotzamitelos, Despoina D Kakagia, Athanasios Hatziyiannakis
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

Bilateral rupture of the patellar tendon is a rare injury. A case of a 67-year-old man with systemic lupus erythematosus under corticosteroid treatment for the last 10 years, who sustained spontaneous rupture of the patellar tendon and the contralateral quadriceps tendon, is herein presented. The patient was operated bilaterally, had an optimal outcome considering his age and the comorbidities, and was followed up for 24 months.
A patient with corneal epithelial disorder that developed after administration of a latanoprost generic, but not a brand-name drug, eye drop
Authors: Yukihisa Takada, Yuka Okada, Norihito Fujita, Shizuya Saika
Journal: Case Rep Ophthalmol Med (2012)

Background. We report a patient who developed corneal epithelial disorder repeatedly after changing the prescription from Xalatan eye drops (Pfizer Inc.) to Latanoprost eye drops (Kaken Pharmaceutical Co., Ltd.), both containing 0.005% latanoprost. Case Report. An 88-year-old male with glaucoma had been treated with Timoptol eye drops and Xalatan eye drops for a few years. While he stayed in a health care facility for the elderly, Xalatan eye drops was changed to Latanoprost eye drops usage, and eye pain developed on the day of this change. On the next day, he visited our department, and corneal epithelial disorder was observed. The drops were discontinued, and the corneal epithelial disorder healed after 2 days. Twenty days after the first consultation, Xalatan eye drops and Latanoprost eye drops were resumed by a physician of internal medicine in the health care facility, but eye pain developed again. After discontinuation of the two drugs, Xalatan eye drops usage was resumed the next day, but no corneal epithelial disorder was observed thereafter. Conclusions. This clinical history strongly suggested the association between a generic drug, Latanoprost eye drops, and the development of corneal epithelial disorder.
The Double-Edged Sword of Immunosuppressive Therapy in Kidney Transplantation: A Rare Case Report of Pulmonary Mucormycosis Post-Transplant and Literature Review
Authors: Hengcheng Zhang, Ke Wang, Hao Chen, Li Sun, Zijie Wang, Shuang Fei, Ruoyun Tan, Min Gu
Journal: Front Med (Lausanne) (2020)
Keywords: case report, immunosuppressant, infection, kidney transplantation, mucor, mucormycosis, pulmonary
MeSH terms: Case Reports

Immunosuppressive therapy is improving the graft survival of kidney transplant recipients and increasing the potential risk of infection. Pulmonary mucormycosis is a rare post-operative infection complication characterized with rapid deterioration and high mortality. In this case, a 33-year-old patient underwent a kidney transplantation with regular immunosuppressive therapy. Soon, 38 days post-transplant, pulmonary patchy shadows can be seen in the radiological examination and rounded into a large cavity formation with splenic rupture 25 days later. The diagnosis of mucormycosis was confirmed by lung biopsy and spleen histopathology. This case is a reminder that early diagnosis is imperative, meanwhile, rational antifungal therapy, timely elimination of immunosuppressants, and alternatively, abandoning the graft should be prudently assessed in the treatment of mucormycosis.
Young migrant men managing risk and seeking protection in a small town in Southern Uganda
Authors: Edward Tumwesige, Allen Asiimwe, Rachel Kawuma, Sarah Bernays, Janet Seeley
Journal: J Migr Health (2023)
Keywords: intersecting risks, migrants, poverty, precarity, sexual health, youth

Young migrants in resource-constrained settings face multiple challenges when they move away from home for work and try to make their way in a new place. In Uganda, with a growing youthful population increasing numbers of young people are leaving home to look for opportunities in urban areas, often facing a precarious existence as they try to make money. Using data from in-depth interviews we investigate the lived experience of precarity of 20 young men who had recently migrated to a small town in south-west Uganda. We adopt a case study approach to look in-depth at the experience of three of the young men, showing how they engage in a continual evaluation of risk in their day to day lives, as they face multiple challenges related to their insecure employment and poor access to health services. We found that the risks that the young men are willing to take to maximise their limited opportunities changed over time. Our findings provide valuable insights into the gendered risks faced by young male migrants and illustrate the ways in which young migrants, many of whom may only have travelled a relatively short distance from home, face risks and challenges to their health and wellbeing, and need to be recognised as a population in need of attention and support.
An Unusual Terrible Triad Variant Associated with an Essex-Lopresti Injury
Authors: Luis M Salazar, Abdullah Ghali, Jose M Gutierrez-Naranjo, Thomas L Hand, Anil K Dutta
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Essex-Lopresti injuries and terrible triad injuries of the elbow are rare injuries that typically result from high-energy trauma such as falling from a height or a motor vehicle collision. However, the combination of an Essex-Lopresti injury and terrible triad injury is unique and poses a significant challenge for treatment as these injuries are independently associated with poor functional outcomes if they are not acutely diagnosed. We describe a case of a 19-year-old who presented with an unusual variant of a terrible triad injury associated with an Essex-Lopresti injury. The patient had a distal radioulnar joint (DRUJ) and elbow dislocation, a radial head and coronoid process fracture, and a distal radius fracture. Almost a reverse Essex-Lopresti, this injury was successfully managed with open reduction and repair of the distal radius, radial head, and damaged ligaments in the elbow, along with an internal joint stabilizer (IJS).
An unusual presentation of an inflammatory fibroid polyp of the ileum: A case report
Authors: Jun Sang Bae, Ji Soo Song, Seung-Mo Hong, Woo Sung Moon
Journal: Oncol Lett (2015)
Keywords: ileum, polyp

Inflammatory fibroid polyps (IFP) are rare, benign lesions of the gastrointestinal tract. Recent molecular studies of IFPs identified platelet-derived growth factor receptor α (PDGFRA)-activating mutations, suggesting possible neoplastic qualities to IFPs. IFPs originate from the submucosa and often extend into the overlying mucosa. Although certain IFPs infiltrate the muscularis propria focally, disruption of the muscularis propria and penetration into the subserosa is extremely rare. The current study presents an unusual case of an ileal IFP. A 48-year-old female visited the Department of Surgery, Chonbuk National University Hospital (Jeonju, Republic of Korea) due to abdominal pain. Radiological study demonstrated an ileocecal-type intussusception due to a luminal polypoid mass of the ileum. The excised tumor consisted of haphazardly arranged epithelioid and spindled cells in a fibromyxoid stroma, with an abundant vascular network, accompanied by an inflammatory reaction predominantly composed of eosinophilic infiltrates. The infiltrating tumor cells disrupted the muscularis mucosa above the tumor cells and the muscularis propria below the tumor cells, and extended into the subserosa. Immunohistochemically, the tumor cells were positive for vimentin and cluster of differentiation 34, while they were negative for keratin, PDGFRA, smooth muscle actin, desmin, S-100 protein, DOG-1 and c-kit. Sequencing analysis of c-kit exons 9, 11, 13 and 17, and PDGFRA exons 12 and 18 indicated a wild-type status. The patient has remained well for 12 months after surgery without further treatment, with no recurrence of the tumor. Although spread of IFP under the muscularis propria is rare, identification of similar cases and further study will enhance our understanding of the nature of this tumor.
Acute Abdomen Revealing an Unusual Case of Intra-Abdominal Testicular Torsion
Authors: Maazou Halidou, Amadou Roua, Ibrahim Amadou Magagi, Harissou Adamou, Ousseini Adakal, Mohamed Rouga, Soumana Amadou, Rachid Sani
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Introduction. Intra-abdominal testicular torsion is a rare event. We report hereby our experience of the management of a spermatic cord twist on intra-abdominal testis discovered during an acute surgical abdomen. Case Presentation. This was a 42-year-old patient admitted to the emergency department for abdominal pain that had been evolving for a week. The physical examination showed tenderness and guarding in the left iliac fossa with an empty ipsilateral hemiscrotum. Complementary examinations led to the discovery of an intra-abdominal left-lateral mass. The laparotomy found a whitish mass with areas of infarction, which was resected. Anatomopathological examination of the operative specimen identified it as a testis with atrophy of germ cells and necrotic areas without evidence of malignancy. Conclusion. Intra-abdominal testicular torsion should be considered in case of patients with an acute surgical abdomen with vacuity of one of the bursae.
Scleritis Caused by In Vitro Linezolid-Resistant Nocardia asteroides
Authors: Andres Gonzalez, Kaihan Fakhar, David Gubernick, Sonal Tuli
Journal: Case Rep Ophthalmol Med (2014)

Purpose. To describe a case of postoperative scleritis caused by a novel strain of Nocardia resistant to linezolid and trimethoprim-sulfamethoxazole (TMP-SMX). Methods. Case report of a patient with microbiologically proven scleritis due to Nocardia asteroides. Results. The patient presented with pain, redness, and nodules on the sclera three months following pterygium excision with mitomycin C and amniotic membrane placement. As no response was noted with empiric treatment for bacterial scleritis, debridement was performed. The cytopathology report showed gram positive filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made and therapy was initiated based on a literature review on treatments for Nocardia infections. Cultures returned growing Nocardia asteroides. Antibiotic sensitivity testing revealed resistance to linezolid and TMP-SMX which are the traditional drugs of choice for Nocardia. The patient was treated with amikacin and imipenem as well as extensive debridement with pedicle grafts. The patient's scleritis resolved with a good visual outcome. Conclusions. Cultures should be obtained in all cases of necrotizing scleritis in patients with a recent history of conjunctival surgery to rule out unusual organisms such as Nocardia. Although literature states that resistance to linezolid and TMP-SMX is rare in Nocardia, sensitivity testing can be useful in unresponsive cases.
Marginalization and Precariat: The Challenge of Intensifying Life Construction Intervention
Authors: Annamaria Di Fabio, Letizia Palazzeschi
Journal: Front Psychol (2016)
Keywords: career counseling innovative outcomes (ccio), life adaptability qualitative assessment (laqua), case study, decent work, life construction intervention, marginalization, precariat

This article discusses the case study of a graduate student who, at the time of the study, was doing an internship, considered in the literature as a new form of precariat (temporary or insecure employment). The student participated in a life construction intervention during which he completed two new qualitative instruments: the Life Adaptability Qualitative Assessment (LAQuA) and the Career Counseling Innovative Outcomes (CCIO) before and after the life construction intervention. The results are discussed in the article. The life construction intervention helped the participant understand himself better, develop his life and career paths, and construct his identity. The study confirmed the value of enhancing life construction interventions using a preventive approach, particularly for precarious people (people in temporary or unstable jobs), with early interventions starting with young internees in organizations.
Cerebral air embolism from angioinvasive cavitary aspergillosis
Authors: Chen Lin, George A Barrio, Lynne M Hurwitz, Peter G Kranz
Journal: Case Rep Neurol Med (2014)

Background. Nontraumatic cerebral air embolism cases are rare. We report a case of an air embolism resulting in cerebral infarction related to angioinvasive cavitary aspergillosis. To our knowledge, there have been no previous reports associating these two conditions together. Case Presentation. A 32-year-old female was admitted for treatment of acute lymphoblastic leukemia (ALL). Her hospital course was complicated by pulmonary aspergillosis. On hospital day 55, she acutely developed severe global aphasia with right hemiplegia. A CT and CT-angiogram of her head and neck were obtained demonstrating intravascular air emboli within the left middle cerebral artery (MCA) branches. She was emergently taken for hyperbaric oxygen therapy (HBOT). Evaluation for origin of the air embolus revealed an air focus along the left lower pulmonary vein. Over the course of 48 hours, her symptoms significantly improved. Conclusion. This unique case details an immunocompromised patient with pulmonary aspergillosis cavitary lesions that invaded into a pulmonary vein and caused a cerebral air embolism. With cerebral air embolisms, the acute treatment option differs from the typical ischemic stroke pathway and the provider should consider emergent HBOT. This case highlights the importance of considering atypical causes of acute ischemic stroke.
Extraneural Metastases From a High-Grade Glioma (HGG) With an H3F3A G34R Mutation
Authors: Amit Jethanandani, Maria K Gule-Monroe, Melissa Chen, Jason M Johnson
Journal: Front Oncol (2019)
Keywords: cns, mri, glioma, metastasis, spine
MeSH terms: Case Reports

Distant metastatic disease from gliomas is extremely rare. We report the case of a 17-year-old female with an H3F3A G34R mutated infiltrative glioma who developed painful osseous metastases to her pelvis and spine within 3 months of clinical presentation. The presence of an H3F3A mutation in these patients may indicate further work-up to include intensive staging examination.
Microneedling combined with compound betamethasone in treatment of severe alopecia areata: A case report
Authors: Danning Pei, Lirong Chen, Yue Yao, Linxi Zeng, Guoqiang Zhang
Journal: Front Immunol (2022)
Keywords: alopecia areata, collapse of hair follicle immune privilege, compound betamethasone, dermoscopy, microneedling
MeSH terms: Alopecia Areata / drug therapy, Case Reports, Betamethasone / therapeutic use, Child, Preschool, Hair, Hair Follicle / pathology, Humans, Betamethasone, Diffuse alopecia

Alopecia areata (AA) is a common inflammatory, non-cicatricial hair loss. At present, it is considered that its pathogenesis is an autoimmune disease specific to hair follicle organs mediated by T cells under the combined action of genetic and environmental factors. Treatment is challenging for children with severe AA who are resistant or intolerant to conventional treatment.Here, we treated a 3-year-old child with severe AA with microneedling combined with compound betamethasone. After 6 months of treatment, the patient's condition was significantly improved, and most of the primary hair loss areas had hair regeneration.
Durable response of glioblastoma to adjuvant therapy consisting of temozolomide and a weekly dose of AMD3100 (plerixafor), a CXCR4 inhibitor, together with lapatinib, metformin and niacinamide
Authors: Adan Rios, Sigmund H Hsu, Angel Blanco, Jamie Buryanek, Arthur L Day, Mary F McGuire, Robert E Brown
Journal: Oncoscience (2016)
Keywords: biomedical analytics, glioblastoma, morphoproteomics, plerixafor, preventative and targeted therapy
MeSH terms: Case Reports

Glioblastoma multiforme (GBM) is a CNS (central nervous system) malignancy with a low cure rate. Median time to progression after standard treatment is 7 months and median overall survival is 15 months [1]. Post-treatment vasculogenesis promoted by recruitment of bone marrow derived cells (BMDCs, CD11b+ myelomonocytes) is one of main mechanisms of GBM resistance to initial chemoradiotherapy treatment [2]. Local secretion of SDF-1, cognate ligand of BMDCs CXCR4 receptors attracts BMDCs to the post-radiation tumor site.[3]. This SDF-1 hypoxia-dependent effect can be blocked by AMD3100 (plerixafor) [4]. We report a GBM case treated after chemo- radiotherapy with plerixafor and a combination of an mTOR, a Sirt1 and an EGFRvIII inhibitor. After one year temozolomide and the EGFRvIII inhibitor were stopped. Plerixafor, and the MTOR and Sirt-1 inhibitors were continued. He is in clinical and radiologic remission 30 months from the initiation of his adjuvant treatment. To our knowledge, this is the first report of a patient treated for over two years with a CXCR4 inhibitor (plerixafor), as part of his adjuvant treatment. We believe there is sufficient experimental evidence to consider AMD3100 (plerixafor) part of the adjuvant treatment of GBM.
Significance:
The adjuvant inhibition of GBM vasculogenesis(a process different from local angiogenesis) by specifically blocking the migration of BMDCs to the primary tumor site with inhibitors of the CXCR4/SDF-1 axis represents a potential novel therapeutic approach to GBM. There is significant pre-clinical evidence and validation for its use as demonstrated in a patient derived tumor xenograft model of GBM. Together with other specific anti-tumoral therapies, the active inhibition of vasculogenesis in the adjuvant treatment of GBM is deserving of further exploration.
Spinal cord involvement and contrast enhancement in posterior reversible encephalopathy syndrome
Authors: Himanshu Agarwal, Leve Joseph Devarajan Sebastian, Shailesh B Gaikwad, Ajay Garg, Nalini Kant Mishra
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Although posterior reversible encephalopathy syndrome (PRES) is a widely encountered clinicoradiological entity, spinal cord involvement on MRI is very rarely reported. We found only eight cases that have been reported so far. Reports of post-contrast meningeal or parenchymal enhancement in PRES are even rarer. Herein we report a case of PRES with extensive spinal cord signal abnormality with contrast enhancement. Familiarity with this rare imaging finding of PRES, in the appropriate clinical setting, will avoid unnecessary investigations and inappropriate treatment.