OpenMed/multicare-articles huggingface dataset:
Nafamostat Mesylate for the Hypercoagulable State of SARS-CoV-2 With Renal Replacement Therapy: A Case Report
Authors: Koki Nakada, Daisuke Hirai, Koichi Seta, Kei Nishiyama
Journal: Cureus (2024)
Keywords: continuous renal replacement therapy (crrt), covid-19, critical emergency medicine, heparin, hypercoagulation, intensive care unit, nafamostat, non-fractioned heparin, renal replacement therapy (rrt), thrombosis
MeSH terms: Case Reports

Being a dialysis patient is one of the risks for severe coronavirus disease 2019 (COVID-19) cases. In addition, there have been many reports of coagulation abnormalities in severe COVID-19 cases; these also make dialysis management more difficult. In this study, we report a case of severe COVID-19 in a hemodialysis patient who had coagulation in the dialysis circuit with unfractionated heparin (UFH), which could be managed without intracircuit obstruction when nafamostat mesylate (NM) was used in combination with unfractionated heparin.
Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report
Authors: Igor Santos Neto 4th, Tiago Ribeiro, Miguel Guimaraes, Margarida Rodrigues, Fatima Gandarez, Maria Cunha
Journal: Cureus (2024)
Keywords: magnetic resonance imaging, neuroradiology, spinal cord injury, spinal cord injury without neuroimaging abnormality (sciwna), true sciwora
MeSH terms: Case Reports

Spinal cord injury without radiographic abnormality is a condition primarily observed in the pediatric population. However, its occurrence in adults remains underreported. This case report aims to describe a rare instance of adult spinal cord injury without neuroimaging abnormality (SCIWNA) following a road accident in a 52-year-old woman, emphasizing the clinical nuances and management challenges associated with this condition. The patient presented with tetraplegia (American Spinal Injury Association Impairment Scale D) with a neurological injury level at C4, exhibiting subtle improvements during inpatient care. Comprehensive examinations revealed conflicting clinical and imaging findings, leading to the diagnosis of SCIWNA. A tailored rehabilitation program involving a multidisciplinary team resulted in notable improvements in neuromotor function, gait, and activities of daily living. The mechanisms behind SCIWNA in adults remain debated, possibly involving pre-existing spinal pathologies exacerbated by trauma. Neurological deficits can range from minor sensory issues to severe tetraplegia with unpredictable times of onset. Diagnostic challenges persist due to normal imaging results despite clinical symptoms. Treatment guidelines lack consensus, encompassing conservative approaches, steroid administration, and surgical interventions in select cases. This rare case of SCIWNA underscores the diagnostic complexity when clinical spinal cord injury contrasts with normal neuroimaging. This report highlights the significance of clinical assessment and the evolving landscape in diagnosing SCIWNA in adults. In addition, the absence of a standardized management protocol emphasizes the need for individualized strategies tailored to patient-specific needs, warranting further research and consensus-building among healthcare professionals.
Long-term response to sequential anti-HER2 therapies including trastuzumab-deruxtecan in a patient with HER2-positive metastatic breast cancer with leptomeningeal metastases: a case report and review of the literature
Authors: Axel de Bernardi, Thomas Bachelot, Louis Larrouquère
Journal: Front Oncol (2024)
Keywords: her2, breast cancer, leptomeningeal metastasis, trastuzumab-deruxtecan, tucatinib
MeSH terms: Review

The incidence of leptomeningeal metastases (LM) is increasing among breast cancer patients, but their prognosis remains dismal. Many therapeutic options are now available to treat HER2-positive (HER2+) metastatic breast cancer (MBC) involving the central nervous system (CNS). This case report illustrates a long-lasting response of more than 2 years in a patient with HER2+ MBC with LM after sequential administration of systemic and intrathecal (IT) anti-HER2 therapies and highlights that an appropriate treatment of HER2+ LM can result in durable survival.
Anomalous origin of the left circumflex coronary artery: is surgery required? A case report
Authors: William Murray, Ros Lavery, Jim O'Brien
Journal: Eur Heart J Case Rep (2023)
Keywords: alcxapa ventricular tachycardia, anomalous left circumflex, case report, main pulmonary artery
MeSH terms: Case Reports

Background:
Deviations from usual coronary artery anatomy are well documented. The left circumflex artery (LCx) arising from the pulmonary artery is an example of one such deviation which is rarely seen. We present the case of a 26-year-old male with this coronary artery distribution presenting with an episode of ventricular flutter with late gadolinium enhancement and pluri-morphological ventricular arrhythmias.
Case summary:
A 26-year-old male with a history of cardiac surgery presented to his local hospital with an episode of symptomatic broad-complex tachycardia (BCT). It failed to revert to sinus rhythm following intravenous beta-blockers and amiodarone and required external cardioversion. Subsequently, the patient developed a aspiration pneumonia requiring ICU admission, after which he was transferred to our institute for ongoing cardiac management. Cardiac computed tomography CTA and coronary angiography revealed that the LCx was found to originate from the pulmonary artery. He underwent insertion of a subcutaneous pacemaker and was subsequently discharged. Despite the potential for steal syndrome of viable coronary territories. Multidisciplinary team discussion determined him to be fit for conservative management and not for surgical correction of his anomalous coronary artery anatomy.
Discussion:
Aberrant coronary artery anatomy can lead to diverse outcomes for patients in terms of both morbidity and mortality. The need for surgery in these situations varies on a case-by-case basis and little research exists to guide decision-making for healthcare professionals. As such there is a need for further study both to guide treatment and to ensure high-quality outcomes for patients with this condition.
Treatment of Mucous Retention Cyst in Association with Sinus Lift and Implant Placement: A Case Report with 1-Year Follow-Up
Authors: Antoine Berberi, Georges Aad, Sara Kebbe, Rebecca El Hachem, Nabih Nader
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Sinus lift augmentation techniques, lateral or crestal approaches, have been well documented, with bone substitute graft, or without bone material, with immediate or delayed implant placement as a treatment option for the atrophic maxilla in the posterior area. However, the sinus lift procedures performed in the presence of cysts, mucoceles, mucous retention cysts (MRCs), and antral pseudo-cysts could mainly decrease the sinus cavity volume and could increase the possibility of ostium obstruction and might lead to infection followed by failure of the grafting procedure. A radiological assessment should be made with computerized tomography (CT) or cone-beam CT to evaluate the remaining bone volume and to detect any pathology in the sinus. Different techniques were described in the literature for sinus lifting and bone grafting in patients with cysts. For some authors, cysts should be treated before sinus grafting and six months later, the procedure could be performed. For others, sinus lifting can be performed without lesion removal. At this time, controversy exists regarding the decision on whether lesions must be removed/aspirated or not before sinus grafting. In this study, we report a case where an MRC was aspirated and instantaneously, the sinus membrane was lifted and grafted, and implants were installed with 1-year follow-up after loading. Identifying lesions in the maxillary sinus is essential before planning any type of sinus augmentation and implant placement.
A Report of Two Rare Cases of Buschke-Löwenstein Tumor
Authors: Tariq Bouhout, Abdelbassir Ramdani, Ayoub Kharkhach, Badr Serji
Journal: Cureus (2024)
Keywords: bushke-löwenstein tumor, condyloma acuminata, giant condyloma acuminatum, human papillomavirus, local excision
MeSH terms: Case Reports

The Buschke-Löwenstein tumor is a rare clinical entity. Its severity is related to the local invasion and the risk of recurrence and malignant transformation. It is caused by a viral infection due to the human papillomavirus. The transmission is primarily sexual and often affects the penile region. The perineal location is relatively rare. We report two rare cases of neglected Buschke-Löwenstein tumor due to the late diagnosis treated with large surgical resection. This study aimed to emphasize the contribution of clinical examination in the early diagnosis and the management of our patients.
A case report of transcatheter aortic valve replacement in a patient with Sjögren's syndrome and aortic stenosis
Authors: Zhenyu Yang, Wei Fang, Qiuhe Wang, Yan Li
Journal: Eur Heart J Case Rep (2023)
Keywords: sjögren's syndrome, aortic stenosis, case report, thrombocytopaenia, transcatheter aortic valve replacement
MeSH terms: Case Reports

Background:
The co-existence of Sjögren's syndrome and aortic stenosis (AS) is infrequent, and there lack cases of transcatheter aortic valve replacement (TAVR) for these patients with detailed management decision-making.
Case summary:
We report a case of a female patient who had AS and Sjögren's syndrome with leukopaenia and thrombocytopaenia. To overcome co-existing hyper-coagulation and high thrombogenesis risk, difficult lifetime valve management, and high infection risk, we performed TAVR with 3D printing and formulated antithrombotic and antibiotic schemes.
Conclusion:
This case provided a successful experience of TAVR in patients with Sjögren's syndrome. Long-term follow-up will be conducted, and optimization of the therapeutic regimen requires further exploration.
New Onset of Symptomatic Peptic Ulcer Disease Postpartum Secondary to Nonsteroidal Anti-Inflammatory Drug Use
Authors: Maggie Tallmadge, Margaret MacBeth, Anna Palatnik
Journal: Case Rep Obstet Gynecol (2024)
Keywords: nsaid, cesarean section, peptic ulcer, postoperative pain, postpartum care
MeSH terms: Case Reports

The use of nonsteroidal anti-inflammatory drug (NSAID) medications is a risk factor for peptic ulcer disease (PUD). PUD in the postpartum period is rare, despite the common use of NSAIDs. A G1P0 presented 6 days postcesarean section with fatigue, lightheadedness, melenic stools, and a hemoglobin of 5.4 g/dL after using NSAIDs and acetaminophen for postoperative pain control. An esophagogastroduodenoscopy (EGD) was performed for a suspected upper gastrointestinal bleed and found one gastric and one duodenal ulcer. Though typically used for a short course in the postpartum period, NSAIDs remain a predisposing risk factor for PUD postpartum, and patients and providers must be aware of this risk.
Combined use of veno-venous extracorporeal membrane oxygenation and asynchronous independent lung ventilation after thoracic surgery for lung abscess
Authors: Ryuhei Yoneda, Takeo Matsuyoshi, Tatsuro Yogi, Yuichi Sato, Jun Hamaguchi, Keiki Shimizu
Journal: Clin Case Rep (2023)
Keywords: extracorporeal membrane oxygenation, lung abscess, pneumothorax, pulmonary atelectasis, respiratory insufficiency
MeSH terms: Case Reports

We used independent lung ventilation (ILV) during veno-venous extracorporeal membrane oxygenation (V-V ECMO) after lung abscess surgery in a patient with severe hypoxia and air leak. ILV can be effective in V-V ECMO as unilateral lung air leak.
A Japanese Boy With Spotted Fever and Overlapping Symptoms of Kawasaki Disease: A Case Report
Authors: Kosuke Sasaki, Kenji Yamada, Chihiro Matama, Daisuke Koike, Tomohiro Hirade, Junji Mashino, Fumihide Kato, Takeshi Taketani
Journal: Cureus (2024)
Keywords: azithromycin, japanese spotted fever, kawasaki disease, rickettsia japonica, tosufloxacin
MeSH terms: Case Reports

Japanese spotted fever (JSF) is a tick-transmitted infection caused by Rickettsia japonica (R. japonica), which is indigenous to Japan. Patients with JSF typically present with fever and spotted erythema on the palms and/or soles, and most of them have site(s) of tick bites. The prognosis is good, but some cases have a fatal course. Kawasaki disease (KD) is a systemic vasculitis with an unknown cause that is characterized by symptoms such as fever, conjunctival injection, oral findings, amorphous rash, rigid edema, and nonsuppurative cervical lymphadenopathy. Although the symptoms of JSF are partially similar to those of KD, case reports of JSF overlapping KD have never been internationally published. Herein, we report a boy with JSF and KD symptoms. A five-year-old boy presented with fever and rash after he had been on a mountain inhabited by R. japonica. On the fifth day, erythema was spotted mainly on his bilateral palms, bilateral cervical lymphadenopathy, rigid edema of his lower feet, and mild conjunctival injection appeared. Intravenous immunoglobulin (IVIG) therapy was performed because these symptoms satisfied five out of the six diagnostic criteria for KD. However, on the sixth day, the fever persisted, and then we readministered IVIG in addition to tosufloxacin and azithromycin since we found a tick-bite eschar, which suggested a complication of JSF. His symptoms resolved soon after this treatment. Coronary artery lesions were never observed. This case indicates that the R. japonica infection overlaps clinically with KD. Tosufloxacin and azithromycin should be considered to avoid the use of minocycline in younger patients with JSF.
ECMO management for severe pulmonary embolism with concurrent cerebral hemorrhage: a case report
Authors: Lutao Xie, Pin Lan, Mingjun Liu, Kechun Zhou
Journal: Front Cardiovasc Med (2024)
Keywords: ecmo, anticoagulation, balloon pulmonary angioplasty, cerebral hemorrhage, pulmonary embolism
MeSH terms: Case Reports

Background:
Acute pulmonary embolism (APE) is a common and potentially fatal cardiovascular disease that can lead to sudden cardiac arrest in severe cases. When conventional cardiopulmonary resuscitation measures fail to achieve the return of spontaneous circulation (ROSC) in patients with APE, venoarterial extracorporeal membrane oxygenation (ECMO) becomes a viable therapeutic option. As an advanced life support treatment, ECMO ensures the perfusion of critical organs, providing sufficient time for interventions necessary for ROSC.
Case introduction:
We report the case of a patient who experienced cardiac arrest due to pulmonary embolism. During the treatment, the patient received two sessions of external cardiopulmonary resuscitation (ECPR) as supportive care and experienced cerebral hemorrhage. Ultimately, the patient improved and was discharged following support from extracorporeal membrane oxygenation (ECMO), careful anticoagulation strategies, and intervention with balloon pulmonary angioplasty.
Conclusion:
ECMO can serve as an important life support technology for patients with severe APE. Through a cautious anticoagulation therapy, not only was the ECMO support successfully maintained but also was further deterioration of cerebral hemorrhage effectively prevented. For patients with concurrent main pulmonary artery embolism and bleeding, balloon pulmonary angioplasty may be an option.
Herpes simplex viral encephalitis with acute memory impairment and low cellular cerebrospinal fluid: A case report with systematic review literature
Authors: Mostafa Mahmoud Meshref, Abdullah Ashraf Hamad, Amira Mohammed Taha, Yahia Nabil, Ahmed Hassan, Ahmed Samir Farw, Mohamed Elmasry, Abdulqadir J Nashwan
Journal: IDCases (2024)
Keywords: case report, cerebrospinal fluid, herpes simplex virus, memory affection, polymerase chain reaction
MeSH terms: Case Reports

Herpes simplex encephalitis (HSVE) is a potentially fatal infectious central nervous system (CNS) disorder. Thus, early detection is critical in determining the case's fate. Clinical history and examination, brain computed tomography, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and lumbar puncture have been used to establish a diagnosis. This report describes a case of HSVE with hypocellular cerebrospinal fluid (CSF) and an uncommon form of memory impairment. However, MRI results were consistent with HSVE, and CSF PCR tested positive for HSV-1 DNA that responded to treatment. We routinely advise patients to begin antiviral therapy as soon as possible to avoid complications.
Acute Disseminated Encephalomyelitis Presenting with Neuropsychiatric Symptoms
Authors: Mrinal Shrestha, Anish Joshi, Ajit Pandey, Aashutosh Chaudhary, Aman Raj Shrestha, Naman Koju, Sujan Timilsina, Ashlesha Chaudhary
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Background:
Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated pathology involving inflammatory demyelination of the central nervous system. Case Presentation. In this case report, we present the case of a nine-year-old female who exhibited altered mental status and focal neurological deficit, subsequently diagnosed as ADEM based on clinical presentation and magnetic resonance imaging (MRI) findings. The patient was managed symptomatically along with glucocorticoids.
Conclusion:
ADEM must be suspected when a patient, especially a child, presents with prodromal symptoms followed by multifocal neurological symptoms. Diagnosis can be established with an MRI brain scan. Most patients respond to high-dose intravenous glucocorticoids.
Recurrent laryngeal papillomatosis with pulmonary involvement: case report
Authors: Enrique Zumaeta-Saavedra, Christian Chiara-Chilet, Julio Maquera-Afaray, Medalit Luna-Vilchez
Journal: Rev Peru Med Exp Salud Publica (2023)
MeSH terms: Laryngeal Neoplasms / complications, Laryngeal Neoplasms / diagnosis, Laryngeal Neoplasms / therapy, Papilloma / diagnosis, Papillomavirus Infections / complications, Respiratory Tract Infections / complications, Case Reports, Adolescent, Adult, Child, Preschool, Humans, Male, Laryngeal papillomatosis

Recurrent respiratory papillomatosis is a neoplastic disease caused by the human papillomavirus and characterized by the growth of exophytic proliferative lesions affecting the mucosa of the respiratory tract. This condition has a bimodal age distribution; the juvenile form affects those under 20 years of age, is more aggressive and presents multiple papillomatous lesions and high frequency of recurrence, compared to the adult form. Pulmonary involvement is rare and challenging to treat. We present the case of a 13-year-old male with a history of laryngeal papillomatosis since the age of two years. The patient showed respiratory distress and multiple stenosing nodules in the larynx and trachea, as well as several pulmonary cysts identified on chest CT. The patient underwent excision of the papillomatous lesions and tracheostomy. Then, the patient received a single dose of intravenous bevacizumab 400 mg and respiratory therapies with favorable evolution, without recurrences during follow-up.
Catatonia as a Result of a Traumatic Brain Injury
Authors: Jessica Berthelot, Jacob Cambre, Madeline Erwin, Jennifer Phan
Journal: Case Rep Psychiatry (2024)
MeSH terms: Case Reports

Catatonia is a neuropsychiatric syndrome typically marked by disturbances in motor activity, speech, and behavior. It has historically been associated with psychiatric illness, but acute medical illness, neurocognitive disorders, and neurodevelopmental disorders can cause catatonia as well. Catatonia is likely underrecognized and underdiagnosed in the general medical hospital, despite high risks of morbidity and mortality and the availability of rapidly effective treatment. Here, we present a case of catatonia secondary to traumatic brain injury that responded to lorazepam after a delayed diagnosis. A young male patient who was incarcerated and assaulted was sent to the emergency department multiple times for unresponsive and unpredictable behavior, including not agreeing to be released home. After being admitted with the diagnosis of postconcussive syndrome, he was ultimately diagnosed with catatonia, and intravenous lorazepam resulted in a return to his baseline mental status. We discuss factors that led to the delay in diagnosis, including lack of training in recognition of catatonia, suspicion of feigned symptoms for secondary gain, and the implication of stigma in an African American young male arrested for a drug-related crime.
The global population stru cture of Lacticaseibacillus rhamnosus and its application to an investigation of a rare case of infective endocarditis
Authors: Phillip P Santoiemma, Susan E Cohn, Samuel W M Gatesy, Alan R Hauser, Saaket Agrawal, Maria E Theodorou, Kelly E R Bachta, Egon A Ozer
Journal: PLoS One (2024)
MeSH terms: Genome, Bacterial, Lacticaseibacillus rhamnosus / genetics, Lacticaseibacillus rhamnosus / isolation & purification, Phylogeny, Case Reports, Endocarditis / microbiology, Endocarditis, Bacterial / microbiology, Gram-Positive Bacterial Infections / diagnosis, Gram-Positive Bacterial Infections / microbiology, Humans, Male, Probiotics, Yogurt / microbiology

Background:
Lacticaseibacillus (formerly Lactobacillus) rhamnosus is widely used in probiotics or food supplements to promote microbiome health and may also be part of the normal microbiota of the human gastrointestinal tract. However, it rarely also causes invasive or severe infections in patients. It has been postulated that these infections may originate from probiotics or from endogenous commensal reservoirs. In this report, we examine the population structure of Lacticaseibacillus rhamnosus and investigate the utility of using bacterial genomics to identify the source of invasive Lacticaseibacillus infections.
Methods:
Core genome phylogenetic analysis was performed on 602 L. rhamnosus genome sequences from the National Center for Biotechnology public database. This information was then used along with newly generated sequences of L. rhamnosus isolates from yogurt to investigate a fatal case of L. rhamnosus endocarditis.
Results:
Phylogenetic analysis demonstrated substantial genetic overlap of L. rhamnosus isolates cultured from food, probiotics, infected patients, and colonized individuals. This was applied to a patient who had both consumed yogurt and developed L. rhamnosus endocarditis to attempt to identify the source of his infection. The sequence of the isolate from the patient's bloodstream differed at only one nucleotide position from one of the yogurt isolates. Both isolates belonged to a clade, identified here as clade YC, composed of mostly gastrointestinal isolates from healthy individuals, some of which also differed by only a single nucleotide change from the patient's isolate.
Conclusions:
As illustrated by this case, whole genome sequencing may be insufficient to reliably determine the source of invasive infections caused by L. rhamnosus.