OpenMed/multicare-articles huggingface dataset:
Case Report: Metagenomic Next-Generation Sequencing for Diagnosis of Human Encephalitis and Endophthalmitis Caused by Pseudorabies Virus
Authors: Weiqian Yan, Zhiping Hu, Yingchi Zhang, Xiaomei Wu, Hainan Zhang
Journal: Front Med (Lausanne) (2022)
Keywords: suid herpesvirus 1, encephalitis, endophthalmitis, next-generation sequencing, pseudorabies virus
MeSH terms: Case Reports

Purpose:
The objective of our study was to report a case of encephalitis and endophthalmitis caused by pseudorabies virus (PRV), identified using metagenomic next-generation sequencing (mNGS).
Case presentation:
A 54-year-old worker, from a swine slaughterhouse, developed signs of severe encephalitis, including fever, disturbance of consciousness, hypopnea, and status epilepticus, after finger injury at work. The PRV sequences were successfully identified from the blood, cerebrospinal fluid (CSF), and aqueous humor of the patient through mNGS, which was further verified using a Sanger sequencing.
Conclusion:
Our case emphasizes the importance of mNGS in early diagnoses of infectious diseases, and gives a clue that PRV can spread across species and infect human. It is necessary to carry out a skin protection and education about disease prevention for people who have close contact with swine.
Prolonged hypercalcemia following resection of dysgerminoma: a case report
Authors: Abigail Wald, Sumana Narasimhan, Lucybeth Nieves-Arriba, Steven Waggoner
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

Background. Hypercalcemia is a rare but potentially dangerous complication of pediatric cancer. Of the dysgerminoma cases reported to date, associated hypercalcemia is corrected within 2-7 days of tumor resection. Case. A 13-year-old female with an ovarian dysgerminoma was found to be hypercalcemic on presentation. Following dysgerminoma resection, moderate hypercaclemia persisted for 7 days and calcium remained mildly elevated for an additional 7 days. PTHrP was undetectable. Immunolocalization studies indicated that 1alpha-hydroxylase was expressed in dysgerminoma tissue but 1,25(OH)(2)D(3) was not elevated. Conclusion. Persistently elevated calcium levels following tumor resection suggests that this case involves a previously undescribed mechanism. Elucidation of this mechanism may offer new insights into tumor biology and opportunities for therapeutic correction of hypercalcemia in this patient population.
The prevalence of anti-factor VIII and anti-factor IX antibodies among patients with hemophilia in Rabat, Morocco: a single center experience
Authors: Meryem Bouyadmar, Mohamed El Khorassani, Maria El Kababri, Amina Kili, Laila Hessissen
Journal: Pan Afr Med J (2022)
Keywords: hemophilia, anti-factor ix inhibitors, anti-factor viii inhibitors
MeSH terms: Hemophilia A / complications, Hemophilia A / therapy, Case Reports, Antibodies, Child, Factor VIII, Factor VIIa, Humans, Morocco, Antibodies, Factor VIII, Factor VIIa

The emergence of anti-factor VIII and anti-factor IX antibodies in hemophilia A or B is the most serious complication of hemophilia. We aim to expose through a series of patient's data, collected between 02/2009 and 02/2016 in the pediatric service of university hospital of Rabat, Morocco, the epidemiological and clinical characteristics of these patients, and to highlight the therapeutic difficulties encountered during their treatment. Out of 120 hemophiliac patients, we included 22 hemophiliac patients (18.33%, p<0.004) who developed an antibody, 21 patients with hemophilia A. Among the patients, 54.5% (n=12) exhibited moderate hemophilia, while 45.5% (n=10) had major hemophilia. The average age at diagnosis is estimated to 12±6.6 years. The circumstances of diagnosis were dominated by therapeutic inefficiency (63.64% (n=14)), then came dental extraction (9.09% (n=2)), preoperative assessment 22.73% (n=5) and hemophiliac arthropathy in a single case. The titration of antibodies in a 12-person sample ranged from 0.6 UB to 84 UB, of which (41.67% (n=5)) were low responders. The therapeutic treatment was based on fresh frozen plasma (54.55% (n=7)), recombinant activated factor VII (18.2% (n=4)), recombinant activated factor VII and PFC (18.2% (n=4)), and induction of immune tolerance. The occurrence of an inhibitory antibody represents the major residual complication of replacement therapy.
Profound muscle weakness and pain after one dose of actonel
Authors: Irina Badayan, Merit E Cudkowicz
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

The World Health Organization (WHO) defines osteopenia as a bone density between 1 and 2.5 standard deviation (SD) below the bone density of a normal young adult Iqbal 2000. Osteoporosis is defined as 2.5 SD or more below that reference point Iqbal 2000. Bisphosphonates are a group of medications used to treat osteoporosis, Padget's disease of bone, and osteopenia. We report a woman who developed profound muscle weakness and pain after one dose of Risedronate (Actonel).
Two Different Upper Tract Urological Malignancies on Either Side
Authors: W S L De Silva, S R De Almeida, G D B J Karunarathne, A A S Samarathunga, K M C S Gannoruwa, J A S B Jayasundara
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Introduction:
The genitourinary system is a recognized site for multiple primary malignant neoplasms even without syndromic anomalies. However, to the best of our knowledge, a case of upper tract urothelial carcinoma (UTUC) with contralateral renal cell carcinoma (RCC) is not reported in surgical literature so far. Case Presentation. A 52-year-old Sri Lankan male patient was found to have a right lower ureteric tumour and a left renal mass together upon investigating for painless visible hematuria. The right ureteric tumour measured 32 × 22 mm resulting in moderate hydronephrosis and cortical thinning of the right kidney, and the left renal mass measured 43 × 38 mm involving the lower pole. The biopsy of the right ureteric lesion revealed a high-grade transitional cell carcinoma with focal nested pattern and that of the left renal mass revealed a clear cell carcinoma. Right nephroureterectomy followed by a left partial nephrectomy was performed in six weeks' interval. The histology of both the resected specimens confirmed the biopsy findings. Discussion. A high-risk upper tract urothelial carcinoma such as the right ureteric tumour of this patient required a nephroureterectomy which makes the management of the contralateral renal cell carcinoma more complex. An adequate functional renal remnant was ensured after offering oncologically sound surgical treatment for both the malignancies of this patient.
Conclusion:
A UTUC when associated with a contralateral RCC poses challenges in patient management. The preservation of renal excretory function has to be considered as an important determinant in addition to oncologically sound surgical resection when managing complex cases of genitourinary malignancies involving both sides of the upper urinary tract.
Case Report: C-Reactive Protein Apheresis in a Patient With COVID-19 and Fulminant CRP Increase
Authors: Jens Ringel, Anja Ramlow, Christopher Bock, Ahmed Sheriff
Journal: Front Immunol (2021)
Keywords: c-reactive protein, covid-19, sars-cov-2, apheresis - therapeutic, pulmonary fibrosis (mesh)
MeSH terms: Blood Component Removal / methods, C-Reactive Protein / metabolism, COVID-19 / therapy, Respiratory Insufficiency / prevention & control, Case Reports, C-Reactive Protein / analysis, C-Reactive Protein / immunology, COVID-19 / blood, COVID-19 / complications, COVID-19 / immunology, Humans, Lung / diagnostic imaging, Lung / immunology, Male, Middle Aged, Respiratory Insufficiency / immunology, Respiratory Insufficiency / pathology, Respiratory Insufficiency / virology, SARS-CoV-2 / immunology, SARS-CoV-2 / isolation & purification, Treatment Outcome, C-Reactive Protein

Background:
Plasma levels of C-reactive protein (CRP), induced by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) triggering COVID-19, can rise surprisingly high. The increase of the CRP concentration as well as a certain threshold concentration of CRP are indicative of clinical deterioration to artificial ventilation. In COVID-19, virus-induced lung injury and the subsequent massive onset of inflammation often drives pulmonary fibrosis. Fibrosis of the lung usually proceeds as sequela to a severe course of COVID-19 and its consequences only show months later. CRP-mediated complement- and macrophage activation is suspected to be the main driver of pulmonary fibrosis and subsequent organ failure in COVID-19. Recently, CRP apheresis was introduced to selectively remove CRP from human blood plasma.
Case report:
A 53-year-old, SARS-CoV-2 positive, male patient with the risk factor diabetes type 2 was referred with dyspnea, fever and fulminant increase of CRP. The patient's lungs already showed a pattern enhancement as an early sign of incipient pneumonia. The oxygen saturation of the blood was ≤ 89%. CRP apheresis using the selective CRP adsorber (PentraSorb® CRP) was started immediately. CRP apheresis was performed via peripheral venous access on 4 successive days. CRP concentrations before CRP apheresis ranged from 47 to 133 mg/l. The removal of CRP was very effective with up to 79% depletion within one apheresis session and 1.2 to 2.14 plasma volumes were processed in each session. No apheresis-associated side effects were observed. It was at no point necessary to transfer the patient to the Intensive Care Unit or to intubate him due to respiratory failure. 10 days after the first positive SARS-CoV-2 test, CRP levels stayed below 20 mg/l and the patient no longer exhibited fever. Fourteen days after the first positive SARS-CoV-2 test, the lungs showed no sign of pneumonia on X-ray.
Conclusion:
This is the first report on CRP apheresis in an early COVID-19 patient with fulminant CRP increase. Despite a poor prognosis due to his diabetes and biomarker profile, the patient was not ventilated, and the onset of pneumonia was reverted.
Amiodarone hepatotoxicity with absent phospholipidosis and steatosis: a case report and review of amiodarone toxicity in various organs
Authors: Adela Cimic, Joseph Sirintrapun
Journal: Case Rep Pathol (2013)

We present the first description of amiodarone toxicity in the liver without phospholipidosis or steatosis. In doing so, we will review the various effects of amiodarone toxicity in various organs. The patient is a young adult who had cardiac reconstruction as a child for transposition of the great vessels. A needle biopsy was taken due to elevated liver enzymes. Her ALT was 188 U/L (5-50) and AST 162 U/L (5-50). Alkaline phosphatase, total bilirubin, protein, and albumin were within normal limits. A serologic panel for viral hepatitis was negative. Antinuclear antibodies were positive at 260; however, anti-smooth muscle antibody and anti-mitochondrial antibody were negative. A protein electrophoresis showed a slightly elevated beta globulin 2 level of 0.5. Quantitative immunoglobulin levels were within normal limits except for a slightly elevated IgA 409 mg/dL (60-350). Liver ultrasound was unremarkable. The clinical differential was broad and included hepatic congestion along with autoimmune hepatitis. Sections showed only ballooned hepatocytes with Mallory-Denk bodies and perisinusoidal fibrosis. Arrival to the diagnosis was possible only after careful review of the patient's medications. After discontinuation of amiodarone, the patient's liver enzymes returned to normal levels.
Case Report: Myelodysplastic syndrome- associated myeloid sarcoma: an unusual clinical presentation of a rare disease
Authors: Emoke Horvath, Smaranda Demian, Elod Nagy
Journal: F1000Res (2016)
Keywords: immunophenotype, myelodysplastic syndrome, myeloid blasts, myeloid sarcoma

Myeloid sarcoma results from the extramedullary homing and proliferation of immature myeloid precursors. We present the timeline, events and diagnostic pitfalls related to a 66 year-old male patient's case, admitted to the Hematology Clinic for pancytopenia, fever, weight loss and fatigue. The severe cytopenia and the few blasts observed in his blood smear indicated a bone marrow biopsy. The bone marrow showed hypercellularity and multilineage dysplasia with the presence of 15% myeloblasts. After the biopsy, he promptly developed paraplegia and nuclear magnetic resonance revealed an epidural tumour which was then resected.In the epidural tumour mass blast-like, round cells were observed with a complex immunophenotype, characterized by myeloperoxidase, CD117, CD15, CD99, leucocyte common antigen positivity and a high Ki-67 proliferation index. Considering the main differential diagnostic issues, the final diagnosis was stated as myelodysplastic syndrome-associated myeloid sarcoma. The prognosis was unfavourable, the bone marrow was quickly invaded by proliferating blast cells, and despite chemotherapy attempts, the patient died.
Non-anatomical surgical solutions for difficult non-unions: case series
Authors: Galal Zaki Said, Osama Ahmed Farouk, Hatem Galal Said, Mohamed Mostafa Mohamed El-Sharkawi
Journal: Trauma Mon (2013)
Keywords: forearm, fracture, hip fractures, non-anatomical, non-unions
MeSH terms: Case Reports

Non-union occurs when bone healing ceases and does not continue without some type of intervention. Classification of non-union is traditionally based on the amount of callus or bone healing at the fracture site. Successful treatment of non-union often depends on appropriate reduction and realignment of the fracture, bone grafting if necessary, and stabilization. This may not be possible in some neglected and complicated non-unions. Under these circumstances, modification of the standard techniques or a limited surgical interference, that might not be anatomical, may succeed in improving function. We present four cases of non-anatomical salvage solutions for difficult long bone non-unions with satisfactory functional outcome.
Large Bowel Obstruction Subsequent to Resected Lobular Breast Carcinoma: An Unconventional Etiology of Malignant Obstruction
Authors: Melissa Amberger, Nancy Presnick, Gerard Baltazar
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Breast cancer metastasis to the gastrointestinal tract is rare and mostly limited to case reports which recommend consideration of metastasis when breast cancer patients particularly those with invasive lobular carcinoma present with new gastrointestinal complaints.
Presentation of case:
We report a 50-year-old female who presented with gastrointestinal symptoms of nausea and vomiting determined to be the result of large bowel obstruction secondary to rectosigmoid metastasis and carcinomatosis of breast invasive lobular carcinoma. She was treated with diverting loop sigmoid colostomy for her large bowel obstruction.
Discussion:
Our case reflects the importance of gastrointestinal surveillance of patients with a history of breast cancer. Current National Comprehensive Cancer Network (NCCN) guidelines for stage I-II breast cancer suggest posttreatment lab and imaging evaluation for metastasis only if new symptoms present.
Conclusion:
We observed an unusually rapid disease progression, requiring evaluation of new gastrointestinal symptoms. Assessment for GI tract metastatic involvement should be done as early as progression to symptomatic disease can result in need for further invasive surgery in advanced stages of cancer.
Intestinal invasion and disseminated disease associated with Penicillium chrysogenum
Authors: Adrian L Barcus, Steven D Burdette, Thomas E Herchline
Journal: Ann Clin Microbiol Antimicrob (2005)
MeSH terms: Abdomen, Acute / microbiology, Intestinal Diseases / microbiology, Intestines / microbiology, Mycoses / microbiology, Penicillium chrysogenum / pathogenicity, Case Reports, Amphotericin B / therapeutic use, Antifungal Agents / therapeutic use, Female, Humans, Intestinal Diseases / drug therapy, Middle Aged, Mycoses / drug therapy, Penicillium chrysogenum / drug effects, Penicillium chrysogenum / isolation & purification, Treatment Outcome, Antifungal Agents, Amphotericin B

Background:
Penicillium sp., other than P. marneffei, is an unusual cause of invasive disease. These organisms are often identified in immunosuppressed patients, either due to human immunodeficiency virus or from immunosuppressant medications post-transplantation. They are a rarely identified cause of infection in immunocompetent hosts.
Case presentation:
A 51 year old African-American female presented with an acute abdomen and underwent an exploratory laparotomy which revealed an incarcerated peristomal hernia. Her postoperative course was complicated by severe sepsis syndrome with respiratory failure, hypotension, leukocytosis, and DIC. On postoperative day 9 she was found to have an anastamotic breakdown. Pathology from the second surgery showed transmural ischemic necrosis with angioinvasion of a fungal organism. Fungal blood cultures were positive for Penicillium chrysogenum and the patient completed a 6 week course of amphotericin B lipid complex, followed by an extended course oral intraconazole. She was discharged to a nursing home without evidence of recurrent infection.
Discussion:
Penicillium chrysogenum is a rare cause of infection in immunocompetent patients. Diagnosis can be difficult, but Penicillium sp. grows rapidly on routine fungal cultures. Prognosis remains very poor, but aggressive treatment is essential, including surgical debridement and the removal of foci of infection along with the use of amphotericin B. The clinical utility of newer antifungal agents remains to be determined.
Acute arterial occlusion of the lower limb as the main clinical manifestation in a patient with Covid-19 - Case Report
Authors: Víctor de Oliveira Costa, Guilherme Bicalho Civinelli de Almeida, Eveline Montessi Nicolini, Guilherme de Abreu Rodrigues, Bruna Malaquias Arguelles da Costa, Guilherme Heluey Carvalho, Álvaro Luiz Segregio Dos Reis, Davi Pinto Colen
Journal: Int J Surg Case Rep (2020)
Keywords: case report, coronavirus infections, ischemia, thrombosis
MeSH terms: Case Reports

Introdution:
COVID-19 infection may predispose to venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilization and disseminated intravascular coagulation; however, there are few reports of lower limb ischemia as the main manifestation of the disease.
Presentation of case:
Male patient, 69 years old, asthmatic, ex-smoker and bearer of systemic arterial hypertension, has been admitted to the emergency department with sudden onset of pain in the right lower limb (RLL), associated with cyanosis and reduced temperature of the limb. He has been tested for COVID-19 in the OR with positive result for IGG and IGM. Computed tomography angiography (AngioCT) was performed, showing signs of arterial embolization to both limbs, right internal iliac artery, and superior mesenteric artery. Faced with the threat of limb loss and the absence of signs and symptoms of visceral ischemia, the patient underwent full anticoagulation and RLL thromboembolectomy and tricompartmental fasciotomy. He was discharged after 7 days of hospitalization and demonstrated no other signs and symptoms of COVID-19, following outpatient follow-up.
Discussion:
COVID-19 is associated with high risk of thrombotic complications being related to the clinical severity of the patient, with few studies that show symptoms of sudden pain in the lower limb without other complaints.
Conclusion:
Individuals infected with COVID-19 are at risk for arterial thromboembolic events, and knowledge of such cases is essential in order to create specific protocols for prophylaxis of thrombotic events in these patients, in addition to increasing the suspicion of infection in individuals with acute arterial occlusion, mostly during pandemic times.
An atypical metastasis of follicular-type adenocarcinoma of the thyroid gland to thumb
Authors: Gazi Huri
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

Bone metastasis in the hand is rare. The etiology of metastatic hand cancers is different from other bones. Bronchogenic carcinoma is the most common primary tumor metastasis to hand. In this paper a rare case of thumb metastasis from "follicular-type carcinoma" of the thyroid is presented.
Acute Glomerulonephritis in a Child with Chlamydia pneumoniae Infection: A Case Report
Authors: Giovanna Vitaliti, Raffaele Falsaperla, Leandra Giunta, Giuseppina Spataro, Venerando Rapisarda, Mario Velardita, Giuseppe Nunnari, Piero Pavone
Journal: Case Rep Med (2013)

Background. Infectious diseases seem to be an important and independent risk factor for renal failure, but the underlying mechanism of renal involvement during some kinds of infectious diseases is still unclear, even if the literature data report immunomediated and/or autoimmune mechanisms to explain the pathogenic relationship between the two diseases. In paediatric patients, Chlamydia pneumoniae is a rare cause of renal complications and it may manifest in several ways, mainly involving the respiratory system, even if also renal and glomerulalr complications, have been described. Case Diagnosis/Treatment. Herein we report a case of a 3-year-old child who developed an acute glomerulonephritis that was chronologically, clinically, and biologically related to a previous Chlamydia pneumoniae infection. On our knowledge, in the literature it is the youngest patient with renal involvement during course of Chlamydia pneumoniae infection ever reported. Conclusions. The present case supports the hypothesis of a rather close causal relationship between this infective agent and renal and glomerular symptoms occurred in this child, during an acute episode of respiratory disease.
Report of a Novel SHOX Missense Variant in a Boy With Short Stature and His Mother With Leri-Weill Dyschondrosteosis
Authors: Laura Lucchetti, Paolo Prontera, Amedea Mencarelli, Ester Sallicandro, Annalisa Mencarelli, Marta Cofini, Alberto Leonardi, Gabriela Stangoni, Laura Penta, Susanna Esposito
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: leri–weill dyschondrosteosis, shox, novel missense mutation, pediatric endocrinology, short stature
MeSH terms: Case Reports

Heterozygous mutations in the SHOX gene or in the upstream and downstream enhancer elements are associated with 2-22% of cases of idiopathic short stature (OMIM #300582) and with 60% of cases of Leri-Weill dyschondrosteosis (OMIM #127300) with which female subjects are generally more severely affected. Approximately 80-90% of SHOX pathogenic variants are deletions or duplications, and the remaining 10-20% are point mutations that primarily give rise to missense variants. The clinical interpretation of novel variants, particularly missense variants, can be challenging and can remain of uncertain significance. Here, we describe a novel missense variant (c.1044 G>T, p.Arg118Met) in a Moroccan boy with a disproportionately short stature and without any radiological traits or bone deformities and in his mother, who had a disproportionately short stature and a Madelung deformity. This variant has not been reported to date in the updated SHOX allelic variant or Human Gene Mutation Databases nor is it listed as a polymorphism in the ExAC browser, dbSNP, or 1000G. This mutation was predicted to be deleterious by three different bioinformatics tools since it modifies an amino acid in a highly conserved DNA-binding domain of the SHOX protein. Based on this evidence, the patient was treated with recombinant human growth hormone.