OpenMed/multicare-articles huggingface dataset:
Posterior Arthroscopic Treatment of a Massive Effusion in the Flexor Hallucis Longus Tendon Sheath Associated with Stenosing Tenosynovitis and Os Trigonum
Authors: Ichiro Tonogai, Koichi Sairyo
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

We report a rare case of massive accumulation of fluid in the flexor hallucis longus tendon sheath with stenosing tenosynovitis and os trigonum. A 34-year-old woman presented to our hospital with pain and swelling in the posteromedial aspect of the left ankle joint after an ankle sprain approximately 8 months earlier. There was tenderness at the posteromedial aspect of the ankle, and the pain worsened on dorsiflexion of the left great toe. Magnetic resonance imaging revealed massive accumulation of fluid around the flexor hallucis longus tendon. We removed the os trigonum, performed tenosynovectomy around the flexor hallucis longus, and released the flexor hallucis longus tendon via posterior arthroscopy using standard posterolateral and posteromedial portals. At 1 week postoperatively, the patient was asymptomatic and able to resume her daily activities. There has been no recurrence of the massive accumulation of fluid around the flexor hallucis longus tendon as of 1 year after the surgery. To our knowledge, this is a rare case report of extreme massive effusion in the flexor hallucis longus tendon sheath with stenosing tenosynovitis and os trigonum treated successfully by removal of the os trigonum, tenosynovectomy around the flexor hallucis longus, and release of the flexor hallucis longus tendon via posterior ankle arthroscopy.
Successful Treatment of an Infant with Left Ventricular Noncompaction Presenting with Fatal Ventricular Arrhythmia Treated with Cardiac Resynchronization Therapy and an Implantable Cardioverter Defibrillator
Authors: Masato Kimura, Kengo Kawano, Hisao Yaoita, Shigeo Kure
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

We herein report the successful treatment of a 4-year-old girl with left ventricular noncompaction (LVNC) who presented with incessant ventricular fibrillation at 5 months of age. An implantable cardioverter defibrillator (ICD) was implanted, and dual chamber (DDD) pacing was initiated at 7 months of age. At her 10-month follow-up, her left ventricular ejection fraction (LVEF) had decreased from 45% to 20% with mechanical dyssynchrony. After upgrading to cardiac resynchronization therapy (CRT), the LVEF improved to 50%. The usefulness of CRT in pediatric LVNC has not been fully elucidated. However, our case suggests that CRT therapy may be an effective option for LVNC-induced cardiac dysfunction.
Remission from Chronic Anorexia Nervosa With Ketogenic Diet and Ketamine: Case Report
Authors: Barbara Scolnick, Beth Zupec-Kania, Lori Calabrese, Chiye Aoki, Thomas Hildebrandt
Journal: Front Psychiatry (2020)
Keywords: activity-based-anorexia animal model, anorexia nervosa, brain-derived-neurotrophic factor (bdnf), ketamine, ketogenic diet
MeSH terms: Case Reports

Background:
Chronic anorexia nervosa is a tragic disease with no known effective pharmacological or behavioral treatment. We report the case of a 29 year-old woman who struggled with severe and enduring anorexia nervosa for 15 years, and experienced a complete recovery following a novel treatment of adopting a ketogenic diet followed by ketamine infusions. Her remission has persisted for over 6 months.
Case presentation:
At age 14.5, the patient embarked on an effort to "eat healthy." She quickly lost control of the dieting, developed associated compulsions and obsessions about food, body dissatisfaction, emotional lability, and lost nearly 13.6 kilograms (30 pounds). She was hospitalized for 6 weeks, and while she regained some weight, she did not attain full weight restoration. For 15 years, she continued to eat in a restrictive manner, exercise compulsively, and have intermittent periods of alcohol dependence. Nevertheless, she always hoped to get well, and at age 29, she began a novel treatment for anorexia nervosa.
Conclusions:
This is the first report of a ketogenic diet used specifically for the treatment of anorexia nervosa, followed by a short series of titrated IV ketamine infusions leading to complete remission of severe and enduring anorexia nervosa, with weight restoration, and sustained cessation of cognitive and behavioral symptoms, for 6 months. Although these treatments were used sequentially the relationship between these modalities, and possible synergy, is unclear, and deserves further study. Complete and sustained remission of chronic anorexia nervosa is quite rare, and the novel use of a ketogenic diet and IV ketamine treatment in this potentially lethal condition suggests avenues for further research, and hope for patients and their families.
Rapidly destructive inflammatory arthritis of the hip
Authors: Jenny Shu, Ian Ross, Bret Wehrli, Richard W McCalden, Lillian Barra
Journal: Case Rep Rheumatol (2014)

Rapidly destructive coxarthrosis (RDC) is a rare syndrome that involves aggressive hip joint destruction within 6-12 months of symptom onset with no single diagnostic laboratory, pathological, or radiographic finding. We report an original case of RDC as an initial presentation of seronegative rheumatoid arthritis (RA) in a 57-year-old Caucasian woman presenting with 6 months of progressive right groin pain and no preceding trauma or chronic steroid use. Over 5 months, she was unable to ambulate and plain films showed complete resorption of the right femoral head and erosion of the acetabulum. There were inflammatory features seen on computed tomography (CT) and magnetic resonance imaging (MRI). She required a right total hip arthroplasty, but arthritis in other joints showed improvement with triple disease modifying antirheumatic drugs (DMARD) therapy and almost complete remission with the addition of adalimumab. We contrast our case of RDC as an initial presentation of RA to 8 RDC case reports of patients with established RA. Furthermore, this case highlights the importance of obtaining serial imaging to evaluate a patient with persistent hip symptoms and rapid functional deterioration.
Mixed Epithelial and Stromal Tumor of the Kidney with Extension into Inferior Vena Cava: Case Report and Discussion of Adult Biphasic Cystic Renal Lesions and the Significance of Vascular Involvement
Authors: Maria M Picken, Davide Bova, Michael R Pins, Marcus L Quek
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Mixed epithelial and stromal tumor (MEST) is a biphasic adult renal lesion composed of solid and cystic areas containing spindle cell stroma and epithelium that lines the tubules and cystic spaces. While most MEST lesions are benign, rare cases with malignant morphology and biology have been reported. We present a case of mixed epithelial and stromal tumor of the kidney (MEST) with extension into the inferior vena cava in a young adult male. We discuss the differential diagnosis of MEST in the context of other biphasic cystic renal lesions and the significance of vascular involvement in the setting of an otherwise benign tumor morphology.
Postpartum Pelvic Instability: A Case Report
Authors: David Sosnoski
Journal: Cureus (2023)
Keywords: pelvic diastasis, pelvic instability, pelvis, pelvis surgery, postpartum, pregnancy
MeSH terms: Case Reports

Pubic symphysis diastasis following childbirth is a rare orthopedic condition that can be debilitating in the postpartum period. There have been treatment options documented, ranging from conservative to surgical; however, no standard of care has been established. We present a 44-year-old female patient who underwent open reduction and internal fixation for continued instability from postpartum pubic symphysis diastasis with a good overall outcome. We demonstrate good outcomes in a patient treated with surgical fixation of postpartum pelvic diastasis. We hope to deliver insight to future orthopedic surgeons with the challenges in treating this condition.
Dengue fever as a potential cause of sickle cell intrahepatic cholestasis: A report of two cases
Authors: Leonardo Rodrigues de Oliveira, Ana Laura Castro Costa, Paula Veloso Almeida, Luzia Beatriz Ribeiro Zago, Vanessa Afonso da Silva, Sheila Soares-Silva
Journal: Rev Soc Bras Med Trop (2021)
MeSH terms: Anemia, Sickle Cell / complications, Cholestasis, Intrahepatic / etiology, Dengue / complications, Case Reports, Hospitalization, Humans, Pain

Sickle cell intrahepatic cholestasis is a potentially fatal syndrome characterized by jaundice, painful hepatomegaly, and organ dysfunction. Two cases of sickle cell intrahepatic cholestasis associated with dengue fever were described. Endothelial damage/dysfunction is a mechanism involved in severe hepatobiliary complications related to sickle cell diseases. However, the reasons for the lack of increase in the admission of patients with sickle cell disease having severe acute hepatobiliary complications triggered by endothelial damage/dysfunction due to dengue fever remain unknown. This study describes the first association between sickle cell intrahepatic cholestasis and dengue fever.
Cervical hibernoma in a two year old boy
Authors: Khalid Khattala, Aziz Elmadi, Hanane Bouamama, Mohamed Rami, Youssef Bouabdallah
Journal: Pan Afr Med J (2013)
Keywords: cervical, children, hibernoma, surgery
MeSH terms: Head and Neck Neoplasms / diagnosis, Lipoma / diagnosis, Case Reports, Adipose Tissue, Brown, Child, Preschool, Diagnosis, Differential, Head and Neck Neoplasms / pathology, Head and Neck Neoplasms / surgery, Humans, Lipoma / pathology, Lipoma / surgery, Male

Hibernomas are uncommon benign soft tissue tumours mimicking brown fat. They are mostly seen in the fourth and fifth decades of life. Only few cases in the cervical area have been reported. Because of its rarity in pediatrics and difficult diagnosis, we report a tow year-old patient with a cervical tumor. Ultrasound and computed tomography exams showed an infiltrative, with hypervascular and lipomatous features. After tumor excision, histopathological exam confirmed the diagnosis of hibernoma or brown fat tumor. This presentation describes the characteristics of this type of tumor, rare in children.
Head to Toe Psychiatry: The Lady Who Limped in front of a Psychiatrist
Authors: Emmanuel Stip, Hind Mohammed Ahmed, Syed Fahad Javaid, Leena Amiri
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Physical examination is a core component of any assessment done by a physician. Despite that, a physical examination is not always a top priority in many patients with psychiatric illnesses. We present the case of a woman with a prior diagnosis of a delusional disorder with overinvested religious beliefs. The patient had been stable on treatment for many years and only recently presented with a physical complaint, and manifestation assumed to be due to the nature of her psychiatric illness and, hence, overlooked by many physicians before being examined by her last psychiatrist. This resulted in a significant mobility problem for the patient. The patient showed partial insight, linking her pain to a "message from God." Despite the delusional context, the psychiatrist was allowed to examine her feet and discovered significant neglect and poor foot hygiene. This case emphasizes the importance of conducting thorough physical examinations in psychiatric settings. Moreover, it presents an example of situations preventing psychiatric patients from being examined despite displaying obvious physical signs.
A Case of Small Bowel Obstruction and Enterocutaneous Fistulation Resulting from a Mesenteric Haematoma following Blunt Abdominal Trauma
Authors: Matthew North, Nicholas Aveyard, Oyeniyi Diya, Jeremy Berger, Maitham Al-Whouhayb
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

A 23-year-old male with a history of previous abdominal surgery was involved in a road traffic accident. He was discharged after initial assessment but represented several days with small bowel obstruction secondary to a mesenteric haematoma. He underwent resection and recovered well but represented later on the day of discharge with a leaking surgical wound consistent with an enterocutaneous fistula. This was managed conservatively and closed spontaneously after ten days. This case serves to highlight that adhesions from previous surgery can tether the small bowel causing mesenteric injury following blunt-force trauma. It also demonstrates that postoperative ileus can result in an enterocutaneous fistula that has the appearance of an anastomotic breakdown but which resolves more rapidly.
An Unusual Cause of Fetal Stroke: Secondary HSV Infection
Authors: Tara Banaszek Daming, Sherri Jackson
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Herpes simplex virus (HSV) is a recognized cause of neonatal infection, with hematologic vertical spread usually only during a primary infection. This is an unusual case with hematologic spread of an HSV 2 infection resulting in a fetal stroke, not associated with a primary outbreak during pregnancy. A 25-year-old multigravida at 26 weeks was diagnosed with a large fetal stroke. Previous ultrasounds showed normal anatomy. She had preterm labor and delivery, with unsuccessful neonatal resuscitation. Vesicular lesions were noted on the infant. Both the lesions and the cerebral spinal fluid were positive for HSV 2. She had documented HSV infection prior to pregnancy, indicating that this was due to a hematologic secondary infection, as there was no rupture of membranes or evidence of other modes of transmission. This case shows that, while unusual, HSV hematologic vertical transmission can occur in both primary and secondary infection during pregnancy. Infection screening is worthwhile in unexplained fetal strokes.
The Influence of Perforated Prosthetic Liners on Residual Limb Wound Healing: a Case Report
Authors: M McGrath, J McCarthy, A Gallego, A Kercher, S Zahedi, D Moser
Journal: Can Prosthet Orthot J (2019)
Keywords: lower limb prosthetics, perforated liner, residual limb, sweating, vacuum, wound healing
MeSH terms: Case Reports

Case description:
Good residual limb skin health is vital to successful prosthetic prescription. Unnatural loading profiles and excessive sweating can lead to skin and soft tissue problems. Perforated liners allow the transport of moisture away from the skin and allow negative pressure (a condition that has been shown to aid wound healing) to act directly on the residuum surface.
Aim:
Assess the effects of perforated prosthetic liner use, particularly with respect to wound healing.
Method:
Three patient histories were retrospectively reviewed following prescription of perforated prosthetic liners due to excessive sweating or prolonged residual limb health concerns. Photographic records from patient files were used to document changes in residual limb condition. Patients also provided subjective feedback regarding their experiences.
Findings:
Two cases described active amputees with persistent blistering irritated during exercise. Another case described a patient of low mobility level with a history of residual limb skin infections. All saw their conditions heal and reported a reduction in problematic sweating. Two patients reported cancelling surgical interventions after substantial improvements with the perforated liner.
Discussion:
These findings provide evidence that the use of perforated prosthetic liners allow improvements in residual limb health, while still permitting prosthetic use.
Challenging clinical cases in HCV infection
Authors: Alessio Strazzulla, Giovanni Matera, Selma Valerie Mammone, Vittoria Vaccaro, Vincenzo Pisani, Chiara Costa, Francesco Manti, Patrizia Doldo, Lucio Cosco, Francesco Quintieri, Francesco Cesario, Maria Carla Liberto, Aida Giancotti, Carlo Torti, Alfredo Focà
Journal: BMC Infect Dis (2014)
MeSH terms: Carcinoma, Hepatocellular / virology, Hepacivirus / physiology, Hepatitis C / virology, Liver Neoplasms / virology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Biopsy, Carcinoma, Hepatocellular / diagnosis, Hepacivirus / genetics, Hepacivirus / isolation & purification, Hepatitis C / diagnosis, Humans, Liver Neoplasms / diagnosis, Male

We present clinical cases, which underline some difficulties in diagnosis and treatment of hepatitis C virus (HCV) infection. Case report #1 shows a patient who avoided clinical follow-up for HCV until the development of hepatocellular carcinoma. In this patient, non-invasive procedures did not allow to make a differential diagnosis between hydatidosis and hepatocellular carcinoma but diagnosis was only made with liver biopsy.
Postpartum Treatment of a Herniation of the Anterior Uterine Wall due to Remains of Placenta Increta
Authors: Anis Haddad, Olfa Zoukar, Houda Mhabrich, Awatef Hajjeji, Raja Faleh
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

In recent years, the incidence of placenta accreta and associated complications has increased significantly. The authors report the case of a pregnant woman in the 5th month of pregnancy for premature rupture of the membranes. The placenta was inserted low. The evolution was marked spontaneous work followed by the expulsion of the fetus. The delivery of the placenta was haemorrhagic and incomplete. Ultrasonic testing showed a placental fragment integrated in the thickness of the myometrium. Conservative treatment with methotrexate was published a few days later and MRI showed that the anterior uterine sac was filled with blood clots associated with pelvic effusion. A laparotomy was then performed to resect the pouch and the one-piece fragment. The follow-up was uneventful.
Intrathecal Trastuzumab Treatment of the Neoplastic Meningitis due to Breast Cancer: A Case Report and Review of the Literature
Authors: Cristina Dumitrescu, Dominique Lossignol
Journal: Case Rep Oncol Med (2013)

We report the case of a 65-year-old woman, diagnosed with a breast cancer human epidermal growth factor receptor (HER2) previously negative, who developed leptomeningeal carcinomatosis and was treated with intrathecal (IT) trastuzumab (TST). After five doses of IT trastuzumab, at escalading doses, once weekly, the patient's neurological status stabilised, and that result was maintained for two months. There is evidence in the literature that breast cancer receptor status may change over time, and when it occurs, it may modify the therapeutical approach. We reviewed the pertinent literature and concluded that IT trastuzumab might be a promising treatment for patients with HER2-positive breast cancer leptomeningeal carcinomatosis.
Gingival fibromatosis: clinical, molecular and therapeutic issues
Authors: Katarzyna Gawron, Katarzyna Łazarz-Bartyzel, Jan Potempa, Maria Chomyszyn-Gajewska
Journal: Orphanet J Rare Dis (2016)
MeSH terms: Fibromatosis, Gingival / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Review, Adolescent, Adult, Female, Fibromatosis, Gingival / epidemiology, Fibromatosis, Gingival / etiology, Fibromatosis, Gingival / genetics, Humans

Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient's history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the type of overgrowth and the extent of disease progression, thus, scaling of teeth is sufficient in mild cases, while in severe cases surgical intervention is required. Prognosis is precarious and the risk of recurrence exists.
Mexiletine Treatment for Neonatal LQT3 Syndrome: Case Report and Literature Review
Authors: Alena Bagkaki, Alexandros Tsoutsinos, Eleftheria Hatzidaki, Manolis Tzatzarakis, Fragiskos Parthenakis, Ioannis Germanakis
Journal: Front Pediatr (2021)
Keywords: lqt syndrome, lqt3, qt prolongation, scn5a mutation, case report, child, mexiletine, neonate
MeSH terms: Case Reports

Background: Early diagnosis of long QT type 3 (LQT3) syndrome during the neonatal period is of paramount clinical importance. LQT3 syndrome results in increased mortality and a mutation-specific response to treatment compared to other more common types of LQT syndrome. Mexiletine, a sodium channel blocker, demonstrates a mutation-specific QTc shortening effect in LQT3 syndrome patients. Case Presentation: A neonate manifested marked QTc prolongation after birth. An electrocardiogram (ECG) recording was performed due to positive family history of genetically confirmed LQT3 syndrome (SCN5A gene missense mutation Tyr1795Cys), and an association with sudden cardiac death was found in family members. The mexiletine QTc normalizing effect (QTc shortening from 537 to 443 ms), practical issues related to oral mexiletine treatment of our young patient, along with a literature review regarding identification and mexiletine treatment in infants with LQT3 syndrome are presented. Conclusions: Mexiletine could be considered in the treatment of high-risk LQT3 patients already in the neonatal period in addition to b-blocker therapy. Availability of standardized commercial mexiletine pediatric formulas, serum mexiletine level analyses, and future prospective studies are needed to evaluate the potential beneficial effect of early mexiletine treatment on the incidence of future acute cardiac events in these high-risk LQT syndrome patients.
Calcifying bowel inflammation: a case report
Authors: Jacques Klein, Philippe Morel, Christian Toso
Journal: Gastroenterol Res Pract (2010)
MeSH terms: Case Reports

We report about a previously healthy 72-year-old woman, presented with 6 days of left lower quadrant abdominal pain and constipation. There was no report of fever, melena, hematochezia or change in appetite. The physical exam demonstrated a distended abdomen with palpable left lower quadrant pain, without guarding. CT showed images compatible with a sigmoid diverticulitis and a calcification of the sigmoid colon. After antibiotic threatment, a colonoscopy was performed which revealed the presence of a shell in the sigmoid colon. Our case illustrates the need for a colonoscopy following an attack of diverticulitis to look for a cancer or rarely a foreign body.