OpenMed/multicare-articles huggingface dataset:
Massive hemothorax due to inferior phrenic artery injury after blunt trauma
Authors: Makoto Aoki, Kei Shibuya, Minoru Kaneko, Ayana Koizumi, Masato Murata, Jun Nakajima, Shuichi Hagiwara, Masahiko Kanbe, Yoshinori Koyama, Yoshito Tsushima, Kiyohiro Oshima
Journal: World J Emerg Surg (2015)
Keywords: blunt trauma, inferior phrenic artery, n-butyl cyanoacrylate, transcatheter arterial embolization
MeSH terms: Review

Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery caused by blunt trauma, which was complicated by massive hemothorax, and treated with transcatheter arterial embolization (TAE). An 81 year-old female hit by a car while walking at the traffic intersection was transferred to the emergency department, computed tomography scanning revealed active extravasations of the contrast medium within the retrocrural space and from branches of the internal iliac artery. The patient underwent repeated angiography, and active extravasation of contrast medium was observed between the retrocrural space and the right pleural space originating from the left inferior phrenic artery. The injured left inferior phrenic artery was successfully embolized with N-butyl cyanoacrylate, resulting in stabilization of the patient's clinical condition. Inferior phrenic artery injury should be recognized as a rare phenomenon and causative factor for hemothorax. TAE represents a safe and effective treatment for this complication and obviates the need for a thoracotomy.
Complete response to third-line treatment with trifluridine/tipiracil (TAS-102) in stage IV colon adenocarcinoma
Authors: Celia Lara-Morga, Magda Palka-Kotlowska, Sara Custodio-Cabello, Vilma Pacheco-Barcia, Luis Cabezón-Gutiérrez
Journal: Explor Target Antitumor Ther (2023)
Keywords: complete response, colorectal cancer, trifluridine/tipiracil (tas-102)
MeSH terms: Case Reports

A clinical case of a 61-year-old female diagnosed with stage IV right colon adenocarcinoma (unresectable liver and multiple lymph node metastases at the time of diagnosis), Kirsten rat sarcoma viral oncogene homolog (KRAS), neuroblastoma rat sarcoma viral oncogene homolog (NRAS) and v-raf murine sarcoma viral oncogene homolog B (BRAF) wild-type, proficient mismatch repair (pMMR), in whom a complete response to the third-line of systemic treatment with trifluridine/tipiracil (TAS-102) was obtained. The complete response has been maintained for more than 2 years after its suspension.
Case report: Coxiella burnetii endocarditis in the absence of evident exposure
Authors: Silvia Bozza, Alessandro Graziani, Monica Borghi, Daniele Marini, Michele Duranti, Barbara Camilloni
Journal: Front Med (Lausanne) (2023)
Keywords: coxiella burnetii, q fever, endocarditis, negative blood culture, serological diagnosis
MeSH terms: Case Reports

Q fever is a worldwide zoonotic disease caused by Coxiella burnetii. In humans, it can manifest clinically as an acute or chronic disease and endocarditis, the most frequent complication of chronic Q fever is associated with the greatest morbidity and mortality. We report a severe case of endocarditis in a 55-year-old man with a history of aortic valve replacement affected by monoclonal gammopathy of undetermined significance (MGUS), and living in a non-endemic area for C. burnetii. After two episodes of fever of unknown origin (FUO), occurring 2 years apart and characterized by negative blood cultures, a serological diagnosis of Q fever endocarditis was performed even though the patient did not refer to possible past exposure to C. burnetii. Since people with preexisting valvular heart disease, when infected with C. burnetii, have reported a 40% risk of Q fever endocarditis, clinicians should maintain a high index of suspicion for infective endocarditis in all patients with FUO even when the exposure to C. burnetii appears to be unlikely.
Endocarditis Complicated by Severe Aortic Insufficiency in a Patient with COVID-19: Diagnostic and Management Implications
Authors: David J Sanders, Joanne S Sutter, Antone Tatooles, Tisha M Suboc, Anupama K Rao
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

A 38-year-old man presented with cough, shortness of breath, and fatigue. He was diagnosed with Coronavirus Disease-2019 (COVID-19) as well as Enterococcus faecalis bacteremia. Imaging revealed a subaortic membrane with aortic valve endocarditis and severe aortic insufficiency. He had successful aortic valve replacement with a mechanical prosthesis and subaortic membrane resection. This case highlights some of the diagnostic and therapeutic challenges presented by COVID-19 pandemic.
Renal artery stenosis presenting as preeclampsia
Authors: Michael Brandon Omar, William Kogler, Satish Maharaj, Win Aung
Journal: Clin Hypertens (2020)
Keywords: preeclampsia, renal artery stenosis, renovascular hypertension, secondary hypertension
MeSH terms: Case Reports

Background:
Renal artery stenosis is a notorious cause of secondary hypertension which classically presents as chronic refractory hypertension, recurrent flash pulmonary edema or renal insufficiency after initiation of an angiotensin converting enzyme inhibitor. Rarely, there have been reported cases of pregnant patients presenting with new onset or superimposed preeclampsia secondary to renovascular hypertension. In this subset of patients, renovascular hypertension carries significantly higher risks including obstetric, fetal and medical emergencies and death. Prompt treatment is required. However, the teratogenic risks of radiological investigations and antihypertensive medications limit diagnostic and management options thus posing quite a dilemma.
Case presentation:
A 38-year-old female, at 33 weeks of gestation, was hospitalized for preeclampsia with severe features. A viable neonate had been expeditiously delivered yet the patient's post-partum blood pressures remained severely elevated despite multi-class anti-hypertensive therapy. Renal artery dopplers revealed greater than 60% stenosis of the proximal left renal artery and at least 60% stenosis of the right renal artery. Renal angiography showed 50% stenosis of the left proximal renal artery for which balloon angioplasty and stenting was performed. The right renal artery demonstrated less than 50% stenosis with an insignificant hemodynamic gradient, thus was not stented. Following revascularization, the patient's blood pressure improved within 48 h, on dual oral antihypertensive therapy.
Conclusions:
Preeclampsia that is refractory to multi-drug antihypertensive therapy should raise suspicion for renal artery stenosis. Suspected patients can be screened safely with Doppler ultrasonography which can be then followed by angiography. Even if renal artery stenosis does not seem severe, early renal revascularization may be considered in patients with severe preeclampsia who do not respond to antihypertensive management.
Significant Lead Migration of a Subcutaneous Implantable Cardioverter-Defibrillator in a Pediatric Patient
Authors: Nayan T Srivastava, Adam C Kean
Journal: J Innov Card Rhythm Manag (2017)
Keywords: lead migration, pediatric, subcutaneous intracardiac defibrillator
MeSH terms: Case Reports

Since its introduction, the subcutaneous implantable cardioverter-defibrillator (S-ICD) has provided the benefit of reduced mortality from ventricular tachyarrythmias without the associated short- and long-term morbidity of transvenous or epicardial implantable cardioverter-defibrillator (ICD) leads. As its name implies, the S-ICD system is implanted in its entirety, including device and lead, just under the skin beginning along the anterior axillary line, with its lead tunneled to the left parasternum and then from the xiphoid to the manubrium-sternal junction. Dislocation of the lead due to migration of the parasternal lead has been described in a minority of patients. Here, we describe an unusual case of a significant lead migration in a pediatric patient.
Uterine artery pseudoaneurysm requiring embolization in pregnancy: a case report and review of the literature
Authors: Lilian Ugwumadu, Kevin Hayes, Anna-Maria Belli, Susan Heenan, Ian Loftus
Journal: CVIR Endovasc (2018)
Keywords: embolization, pseudoaneurysm, uterine artery pseudoaneurysm

Background:
Uterine Artery Pseudoaneurysm is a rare cause of pelvic pain and haemorrhage in pregnancy. It should be considered in the differential diagnosis of pregnant women presenting with abdominal pain and is readily diagnosed by colour Doppler ultrasound. If left untreated, they may bleed into the peritoneum causing severe pain and haemorrhagic shock and may progress to maternal and fetal death.
Case presentation:
We describe a case of a woman presenting with severe right iliac fossa pain at 26 weeks gestation attributed to a right uterine artery pseudoaneurysm diagnosed on duplex ultrasound which was successfully treated by uterine artery embolization at 28 weeks gestation without complication to the fetus.
Conclusion:
Uterine artery embolization appears to be a safe and effective method to treat pseudoaneurysm during pregnancy without compromising uteroplacental perfusion.
Treatment of Recurrent Hepatitis C Genotype-4 Post-Liver Transplantation with Sofosbuvir plus Simeprevir
Authors: Mustafa Ascha, Mona Ascha, N N Zein, N Alkhouri, B Eghtesad, K Abu-Elmagd, T Diago, I A Hanouneh
Journal: Int J Organ Transplant Med (2015)
Keywords: genotype, hepacivirus, interferon, liver transplantation
MeSH terms: Case Reports

Hepatitis C virus (HCV) infection remains a leading indication for orthotopic liver transplantation (OLT) worldwide. Recurrence of HCV following OLT is universal. There is scarcity of data on the post-OLT treatment of HCV genotype-4-the predominant genotype in North Africa and the Middle East. Herein, we present three patients who have experienced HCV genotype-4 recurrence post-OLT. All three patients were interferon-naive and were treated with simeprivir (SIM) and sofosbuvir (SOF) combination therapy for 12-24 weeks. The data from this case series show that SIM+SOF are well-tolerated and effective for achieving viral clearance in HCV genotype-4 post-OLT patients. Given the limited nature of a case series, further research must be pursued regarding post-OLT HCV genotype-4 responses to direct-acting anti-viral therapy.
Cutaneous ulcer as leading symptom of systemic cytomegalovirus infection
Authors: Richard F Guo, Frew H Gebreab, Emily Hsiang-Ho Tang, Zhe Piao, Steve S Lee, Mario L Perez
Journal: Case Rep Infect Dis (2015)

Cytomegalovirus (CMV) infection rarely manifests with skin ulcerations. We describe a case report of a 64-year-old woman with chronic immunosuppression for treatment of mixed connective tissue disease, presenting with new onset leg ulcerations after a recent change in immunosuppressive regimen. She subsequently developed fulminant hepatitis, encephalopathy, and pancytopenia and was found to have severe systemic CMV viremia. Skin ulcer biopsy was positive by immunohistochemical staining for CMV infected endothelial cells. Both systemic disease and skin ulcer rapidly improved after stopping immunosuppression and administering intravenous ganciclovir. New onset skin ulcers in an immunosuppressed individual, especially with recent changes in immunosuppressive regimen, should raise the suspicion of reactivation of CMV.
Euglycemic Diabetic Ketoacidosis in the ICU: 3 Case Reports and Review of Literature
Authors: Pablo Lucero, Sebastián Chapela
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus, both type I and type II, as well as other types with diabetes such gestacional diabetes mellitus. It is characterized by blood glucose levels greater than 250 mg/dL and metabolic acidosis (pH < 7.3 and serum bicarbonate < 15 mEq/dL) with an increased anion gap and the presence of ketone bodies in the blood or urine. Within this pathology, there is a subgroup of pathologies which are characterized by being present with no signs of hyperglycemia, posing a diagnostic challenge due to the absence of the main sign of the pathology and the diversity of their pathophysiology. In this article, we will present 3 clinical cases with 3 different forms of clinical presentation: a case of DKA in pregnancy, a case of DKA associated with the use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and a third case related to sepsis, together with a narrative review of the literature on the topic.
Neoadjuvant Tyrosine Kinase Downstaging of T2 Renal Cell Carcinoma in Solitary Kidney Before Robotic Partial Nephrectomy
Authors: Mary K Powers, Oliver Sartor, Benjamin R Lee
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

We highlight the use of a tyrosine kinase inhibitor, pazopanib, for neoadjuvant downstaging a 7.4 cm right biopsy-proven clear cell renal-cell carcinoma in a solitary kidney before surgical intervention of robotic partial nephrectomy with retrograde cooling to induce cold ischemia in a 79-year-old male.
Tolvaptan Response in a Hyponatremic Newborn with Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Authors: Cengiz Zeybek, Ali Dinç Bozat, Erhan Calisici, Ahmet Bolat, Belma Saygili Karagol
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

The use of tolvaptan to treat both euvolemic and hypervolemic hyponatremia has rapidly increased in recent years. However, data on its effects on children, especially newborns and infants, are limited. Here, we present a newborn who developed syndrome of inappropriate secretion of antidiuretic hormone following an intracranial hematoma drainage operation who was unresponsive to conventional treatments. The infant was successfully treated with tolvaptan, a competitive inhibitor of the vasopressin V2 receptor.
Mondor's disease as a complication in breast surgery in a male patient. The first ever reported case in literature
Authors: Mario Faenza, Tommaso Pelella, Andrea Maria Antonetti, Sara Izzo, Roberto Grella, Giuseppe Andrea Ferraro
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: gynecomastia, body contouring, complication, thrombophlebitis
MeSH terms: Case Reports

Mondor's disease (MD) is an uncommon clinical condition characterized by thrombophlebitis of the superficial veins of the anterolateral thoracoabdominal wall. In this paper we present the first ever reported case of Mondor's disease in male patient after surgical correction of gynecomastia with liposuction assisted skin sparing adenectomy.
Vena Cava Superior Syndrome Related to Right Heart Invasion of an Unresectable Hepatocellular Carcinoma
Authors: Geert Maleux, Werner Budts, Vincent Vandecaveye
Journal: Can J Gastroenterol Hepatol (2016)
MeSH terms: Carcinoma, Hepatocellular / complications, Liver Neoplasms / complications, Superior Vena Cava Syndrome / etiology, Case Reports, Aged, Carcinoma, Hepatocellular / pathology, Echocardiography, Heart Atria / pathology, Heart Ventricles / pathology, Humans, Liver Neoplasms / pathology, Male, Neoplasm Invasiveness, Superior Vena Cava Syndrome / pathology, Tomography, X-Ray Computed

A rare case of hepatocellular tumor extension in the right heart was reported. The patient presented with clinical signs of a vena cava superior syndrome. Computed tomography and transthoracic echocardiography demonstrated a large tumoral mass lesion extending from the left liver lobe into the inferior vena cava right atrium and right ventricle. The patient was treated with best supportive care.
An intriguing case of lichen simplex chronicus in an elderly sub-Saharan African with longstanding scabies and sensory neuropathy
Authors: Ekongefeyin Sintieh Nchinda Ngek, Ridley Mbwoge Nsioge, Michael Budzi Ngenge, Benjamin Momo Kadia
Journal: Pan Afr Med J (2019)
Keywords: lichen simplex chronicus, neuropathy, scabies
MeSH terms: Neurodermatitis / diagnosis, Peripheral Nervous System Diseases / diagnosis, Scabies / diagnosis, Case Reports, Africa South of the Sahara, Aged, Female, Humans, Neurodermatitis / etiology, Peripheral Nervous System Diseases / complications, Scabies / complications

Lichen Simplex Chronicus (LSC) is chronic dermatitis caused by repetitive scratching or rubbing of the skin. It presents as hyperpigmentation and thickening of the skin with variable scaling. Because LSC is a secondary lesion with a wide variety of causes, optimal management is contingent on identifying and managing its exact aetiology. We report an intriguing case of LSC in an elderly patient with longstanding scabies and sensory neuropathy.
Compound Heterozygosity for Novel Truncating Variants in the LMOD3 Gene as the Cause of Polyhydramnios in Two Successive Fetuses
Authors: Ye Wang, Caixia Zhu, Liu Du, Qiaoer Li, Mei-Fang Lin, Claude Férec, David N Cooper, Jian-Min Chen, Yi Zhou
Journal: Front Genet (2019)
Keywords: lmod3, nemaline myopathy, polyhydramnios, prenatal diagnosis, truncating variant, whole exome sequencing
MeSH terms: Case Reports

Polyhydramnios is sometimes associated with genetic defects. However, establishing an accurate diagnosis and pinpointing the precise genetic cause of polyhydramnios in any given case represents a major challenge because it is known to occur in association with over 200 different conditions. Whole exome sequencing (WES) is now a routine part of the clinical workup, particularly with diseases characterized by atypical manifestations and significant genetic heterogeneity. Here we describe the identification, by means of WES, of novel compound heterozygous truncating variants in the LMOD3 gene [i.e., c.1412delA (p.Lys471Serfs*18) and c.1283dupC (p.Gly429Trpfs*35)] in a Chinese family with two successive fetuses affected with polyhydramnios, thereby potentiating the prenatal diagnosis of nemaline myopathy (NM) in the proband. LMOD3 encodes leiomodin-3, which is localized to the pointed ends of thin filaments and acts as a catalyst of actin nucleation in skeletal and cardiac muscle. This is the first study to describe the prenatal and postnatal manifestations of LMOD3-related NM in the Chinese population. Of all the currently reported NM-causing LMOD3 nonsense and frameshifting variants, c.1412delA generates the shortest truncation at the C-terminal end of the protein, underscoring the critical role of the WH2 domain in LMOD3 structure and function. Survey of the prenatal phenotypes of all known LMOD3-related severe NM cases served to identify fetal edema as a novel presenting feature that may provide an early clue to facilitate prenatal diagnosis of the disease.
Hereditary neuropathy with liability to pressure palsy presenting with hand drop in a young child
Authors: Inês Sobreira, Cátia Sousa, Ana Raposo, M Rita Soares, Ana Soudo, Ana Isabel Dias
Journal: Case Rep Pediatr (2012)

Hereditary neuropathy with liability to pressure palsy (HNPP) results from the deletion of the PMP22 gene in chromosome 17p11.2. Clinically, it presents with painless pressure palsies, typically in the 2nd and 3rd decades of life, being a rare entity in childhood. We present the case study of a six-year-old male child who presented with left hand drop that he kept for over four weeks. Electrophysiological studies suggested HNPP and genetic studies confirmed it. With this paper, we pretend to create awareness to this entity as a diagnosis to be considered in a child with painless monoparesis and to emphasize the importance of electrophysiological studies in the diagnosis.
Diagnosis and therapy of functional tremor a systematic review illustrated by a case report
Authors: Michael Bartl, Rebekka Kewitsch, Mark Hallett, Martin Tegenthoff, Walter Paulus
Journal: Neurol Res Pract (2020)
MeSH terms: Review

Background:
Diagnosis of functional movement disorders and specifically functional tremor (FT) (representing 50% of them) remains demanding. Additionally, due to heterogeneity of the disorders, structured concepts and guidelines for diagnosis and therapy are difficult to establish. Ascertaining the state of knowledge to derive instructions for operating procedures is the aim of this review.
Main text:
Based on a standardized systematic literature research using the term "psychogenic tremor" in the MEDLINE database dating back ten years, 76 studies were evaluated. Conventional features of FT are variability of frequency and amplitude. Further, response to distraction by motor and cognitive tasks is a key diagnostic feature in differentiation between organic and functional origin. A variety of electrophysiological tests have been evaluated including surface electromyography and accelerometry to establish laboratory-supported criteria for diagnosing tremor. Also, finger tapping tests have been used to identify FT, showing positive potential as supplementary evidence.Imaging studies in general are mostly underpowered and imaging cannot be used on an individual basis. Therapeutic studies in FT often have a diagnostic component. Cognitive behavioral therapy should be the preferred psychological treatment independent of additional psychiatric symptoms. Other psychotherapeutic methods show lack of evidence concerning FT. Relaxation techniques and physiotherapy are an important additional feature, especially in children and adolescents. In regard to drug therapy, randomized and blinded trials are not available. A significant decrease in rating scales could be detected after active, not sham repetitive transcranial magnetic stimulation with a long-lasting effect. Also root magnetic stimulation seems to be effective. The clinical feature of tremor entrainment in FT can be used in combination with biofeedback as so-called tremor retrainment, using self-modulation of frequency and severity, to bring the movements under volitional control.
Conclusion:
Diagnosis and treatment of FT is challenging and should include a combination of intensive clinical examination and targeted addition of standardized testing, especially electrophysiological methods. Often therapeutic effects have a diagnostic component. A multimodal strategy, considering psychological factors as a potential origin as well as maintaining effects seems to be most effective.
Cytomegalovirus pneumonia presenting as pulmonary nodules
Authors: Janet Basinger, Meghan E Kapp
Journal: Autops Case Rep (2021)
Keywords: autopsy, cytomegalovirus, multiple pulmonary nodules, pneumonia, transplant recipients
MeSH terms: Case Reports

Cytomegalovirus (CMV) pneumonia is a well-known cause of morbidity and mortality in patients with a history of allogenic hematopoietic stem cell transplant. Radiographically, CMV pneumonia most commonly presents as bilateral ground glass opacities; however, the presentation is non-specific and can be variable, including presenting as areas of air-space consolidation or pulmonary nodules. We report a case of a 70-year-old man who presented with rapidly progressive bilateral pulmonary nodules approximately two months after receiving a bone marrow transplant. No infectious etiology was identified for the pulmonary nodules, and a bronchoscopy was unable to be performed due to a rapid decline in the patient's overall condition and respiratory status. The patient died shortly after the decision was made to transition to palliative care and a limited autopsy was performed to explore the pulmonary findings. Corresponding to premortem imaging were the postmortem gross findings of numerous bilateral pulmonary nodules and a large mass-like area of consolidation in the right upper lobe. Microscopic examination of the nodules demonstrated a necrotizing pneumonia with few foci of viral cytopathologic change consistent with CMV, which was confirmed by immunohistochemistry. While CMV is a common infectious agent in the immunocompromised population, CMV pneumonia continues to be a challenging entity due to difficulty in diagnosis and treatment. Rapidly enlarging pulmonary nodules in an immunosuppressed patient is highly suggestive of an infectious process and careful histologic examination for viral cytopathologic change is essential.