OpenMed/multicare-articles huggingface dataset:
A case report on pheochromocytoma mimicking as fulminant myocarditis-a diagnostic challenge
Authors: Yanwei Cheng, Ning Ding, Longan Wang, Lijie Qin
Journal: Front Cardiovasc Med (2024)
Keywords: domperidone, alpha-blockade therapy, catecholamine-induced cardiomyopathy, fulminant myocarditis, pheochromocytoma
MeSH terms: Case Reports

We present an exceptional case of a 53-year-old female, initially misdiagnosed with fulminant myocarditis, but later correctly diagnosed with pheochromocytoma. The presentation of the patient included a spectrum of symptoms such as headache, chest discomfort, palpitations, and dyspnea, following the intake of Domperidone. Two weeks prior to admission, the patient had experienced episodes of diarrhea and a low-grade fever. Unresolved symptoms and an unmanageable surge in blood pressure despite comprehensive fulminant myocarditis treatment prompted further investigation. The discovery of an adrenal mass via a CT scan and subsequent biochemical tests led to the confirmation of pheochromocytoma. Implementation of alpha-blockade therapy and a successful laparoscopic adrenalectomy resulted in significant clinical improvement. This case underscores the diagnostic intricacies of pheochromocytoma and highlights the need for vigilance when faced with severe, unresponsive cardiovascular symptoms.
IgG4-Related Pericarditis Diagnosed by Accumulated Pericardial Effusion
Authors: Hirohito Sugawara, Tomokazu Takahashi, Yukishige Kimura, Azumi Matsui, Tamaki Matsumoto, Kimio Nishisato, Mitsuhiro Nishimura
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

IgG4-related pericarditis has rarely been reported. Here, we report a case of IgG4-related disease that presented with pericardial effusion. A 67-year-old female who presented with palpitations and chest pain was admitted because of a large amount of pericardial effusion that required drainage. The patient underwent pericardial drainage, and the symptoms were gradually alleviated. IgG4 levels were elevated in the serum and pericardial effusions. A biopsy specimen of 18F-FDG accumulated in the submandibular gland showed lymphocyte infiltration with IgG4-positive cells. The patient was diagnosed with IgG4-related pericarditis. Glucocorticoids resolved serological and imaging abnormalities. Prompt treatment improves the disease status.
Clinical characteristics and prognostic factors of male breast cancer in China
Authors: Han Lei, Baojie Hua, Yingying Mao, Wei Cui, Caiping Mao, Shaoxue Yang, Jiayu Li
Journal: Front Oncol (2024)
Keywords: disease-free survival, male breast cancer, nomogram, overall survival, prognosis

Purpose:
This study aimed to explore the clinical characteristics of male breast cancer (MBC) patients and the factors influencing their prognosis.
Methods:
We conducted a retrospective case series analysis of 117 MBC cases who were treated at Zhejiang Cancer Hospital from 2009 to 2022. Cox proportional hazard model was used to identify prognostic factors of MBC. Nomogram was constructed based on these factors, which was further evaluated by C-index and calibration curves.
Results:
A total of 115 MBC cases were finally included in our analyses, with median diagnosis age of 59 years. Of these cases, 80.0% were estrogen receptor (ER) positive, 79.2% were progesterone receptor (PR) positive, 48.7% were human epidermal growth factor receptor 2 (HER2) negative, and 42.6% had Ki67 levels higher than 15%. 108 (93.9%) cases underwent radical mastectomy, while only 3 (2.6%) received breast-conserving surgery. The Logrank test suggested that lymphocyte-to-monocyte ratio (LMR) was negatively associated with both overall survival (OS) and disease-free survival (DFS) of MBC, while platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were only positively associated with OS (all P-values < 0.05). Multivariate regression analysis showed that age (HR 1.08, 95% CI 1.03-1.13) was significant prognostic factors for OS. Meanwhile, age (HR 1.06, 95% CI 1.02-1.10), histological differentiation grade (poorly differentiated/undifferentiated vs. well-differentiated: HR 2.55, 95% CI 1.05-6.17), and TNM stage (IV vs. I: HR 31.59, 95% CI 6.01-165.93) were also significant prognostic factors for DFS. Nomograms were developed for DFS, with C-indexes of 0.782, indicating good predictive performance.
Conclusion:
Increased age, bigger tumor size, higher TNM stage, and lower histological differentiation grade were associated with poor MBC prognosis, and LMR, PLR, and NLR might be potential predictors for MBC prognosis.
Davydov Vaginoplasty in Mayer-Rokitansky-Küster-Hauser Syndrome Patient Presenting With Urethral Dilatation
Authors: Jurgis Vitols, Lasma Lidaka
Journal: Case Rep Obstet Gynecol (2024)
Keywords: davydov vaginoplasty, mayer–rokitansky–küster–hauser syndrome, urethral dilatation, urethral intercourse
MeSH terms: Case Reports

Introduction: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a female congenital disorder characterized by an underdeveloped or absent vagina and uterus. The first-line treatment to create a neovagina is patient-performed vaginal dilatation. We report here the rare case of an MRKH patient who presented with urethral dilatation and was successfully treated with Davydov vaginoplasty. Case Report: Seventeen-year-old patient with known single kidney was consulted by a gynaecologist, and a diagnosis of MRKH syndrome was established. As the patient had urethral dilatation-resulting from repetitive intraurethral intercourse-neovaginal creation by means of self-performed vaginal dilatation was precluded. Rather, the Davydov vaginoplasty was successfully performed; there were no postoperative complications, and the patient was fully continent postsurgery. Conclusion: MRKH patients and healthcare providers should be educated on the damaging consequences of intraurethral intercourse. More cases need to be reported to establish the best treatment options for a normal sexual life.
Loss of Recurrent Laryngeal Papillomatosis following Postsurgical Treatment with dsRNA Interferon Inducer
Authors: Alina Sultanova, Liba Sokolovska, Maksims Cistjakovs, Andrejs Lifsics
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

Laryngeal papillomatosis (LP) is the most common benign laryngeal tumor in children, but it can affect both children and adults. Although benign, this condition still remains hard to treat and negatively affects patient quality of life as it can spread to the adjacent respiratory tract, recurs, and requires repeated medical intervention. As the surgical removal of papillomas with the preservation of normal mucosa is the only standard of care, there is still no standard for adjuvant therapy. In this case report, we describe the course of recurrent laryngeal papillomatosis in a Caucasian male from 2009 to 2016 and the positive response to dsRNA-based antiviral drug treatment in the complete resolvement of the condition.
Clavicle Fracture Site Surgical Contouring: A Case Report
Authors: Annachiara Cavaliere, Vincenzo Cepparulo, Giuseppe Pezone, Fabrizio Schonauer
Journal: Arch Plast Surg (2024)
Keywords: case report, clavicle contour, clavicle fracture, step deformity

Clavicle fractures are frequent injuries accounting for approximately 4% of all fractures in adults with about 35% occurring in the shoulder region among which midshaft fractures are the most common (>66%). Nonsurgical management is the treatment of choice for most clavicle fractures; however, poor functional and aesthetic outcomes may result from nonunion, symptomatic malunion, and aesthetic impairment which are the most common complications. A young woman was referred to our clinic for a "Step Deformity" resulting after primary, nonsurgical treatment of a midshaft clavicle fracture. Residual deformity was corrected with a novel simple and little invasive approach. Midshaft clavicle fractures typically only require conservative nonsurgical treatment, nevertheless suboptimal outcomes may occur. Selective osteotomies and fixation are deemed too invasive when only cosmetic impairment of the clavicle contour is present without any functional or sensitive damage and most patients are discouraged from undergoing surgery. Thus far, no specific focus on this topic, nor exploration of possible correction can be found in the published literature. These residual deformities may be very noticeable sometimes and cause psychological distress and social life impairment. Despite no related functional impairment, this deformity should still be addressed, to improve patients' quality of life.
Long-term Treatment With Metyrapone in a Man With Ectopic Cushing Syndrome
Authors: Tin Wai Wong
Journal: JCEM Case Rep (2022)
Keywords: ectopic cushing syndrome, metyrapone, thymic neuroendocrine tumor
MeSH terms: Case Reports

This is a unique case of ectopic adrenocorticotropic hormone (ACTH)-secreting mediastinal neuroendocrine tumor, presumably thymic in origin, with suspected lung metastasis in a 61-year-old man who was successfully managed with long-term metyrapone alone. He presented with severe hypokalemia and hypertension, complicated with psychosis and vertebral collapse. He survived through a complicated course of pulseless ventricular tachycardia arrest and a severe Cushing storm due to drug nonadherence. For 3 years since diagnosis, he remained stable on metyrapone, and was able to achieve biochemical eucortisolism, with normalization of ACTH and cortisol levels. In addition, his tumor was reduced in size and the suspicious lung metastasis regressed.
Respiratory physiotherapy as a tool to allow and optimize lung donation
Authors: Ricardo Miguel Rodrigues-Gomes, Lucas Lage Cendón, Rosa Martínez Rolán, Miguel Gelabert-González
Journal: Respir Med Case Rep (2023)
Keywords: chest physiotherapy, intensive care, lung donation, respiratory physiotherapy
MeSH terms: Case Reports

Lung donation is complex and sometimes the secretion retention makes it impossible. We report a case of a patient that was screened as potential lung donor with PaO2/FiO2 ratio below range. As in viable patients, the respiratory physiotherapist applied a ventilator-based group of techniques with removal of huge amount of secretions and consequent increase in the PaO2/FiO2 ratio that allowed the inclusion of the patient as potentially lung donor. The protocol was applied until the extraction day, with successful extraction and transplantation. We believe that respiratory physiotherapy could have a potential role in increasing lung viability.
Treatment of a Patient with Acute Promyelocytic Leukemia with Multiple Isolated Relapses in the Central Nervous System: A Case Report and Mini-Review of the Literature
Authors: Qixin Sun, Wenyi Chen, Ahui Wang, Zili Yang, Guiping Chen, Zhigang Zhu
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

The efficacy of therapeutics for acute promyelocytic leukemia (APL) has exhibited an increase in recent years. Only a few patients experience relapse, including extramedullary relapse, and in patients with extramedullary relapse, the central nervous system (CNS) is the most common site. To date, there is no expert consensus or clinical guidelines available for CNS relapse, at least to the best of our knowledge. The optimal therapeutic strategy and management options for these patients remain unclear. The present study reports the treatment of a patient with APL with multiple isolated relapses in the CNS. In addition, through a mini-review of the literature, the present study provides a summary of various reports of this disease and discusses possible treatment options for these patients.
Multidisciplinary tumor board for head and neck cancer from the perspective of medical oncologists-optimizing its effectiveness
Authors: Tomoya Yokota, Takashi Mukaigawa, Yoshichika Yasunaga, Hirofumi Ogawa, Tsuyoshi Onoe, Takashi Yurikusa, Aiko Yamashita
Journal: Front Oncol (2023)
Keywords: evidence-based medicine, head and neck oncology, medical oncologists, multidisciplinary intervention, multidisciplinary tumor board, personalized medicine
MeSH terms: Review

Head and neck cancer (HNC) treatment is becoming increasingly multidisciplinary, and patient characteristics vary. Therefore, a multidisciplinary tumor board (MTB) is essential in clinical practice. This review provides insights into the benefits and tips for improving head and neck MTB from the perspective of medical oncologists. The MTB is a platform to discuss the optimal application of the standard of care to each case, reach a consensus, and establish a recommendation to support patients' decision-making. A productive and educational MTB also provides an opportunity to share information on ongoing clinical trials with physicians. Case presentations should be systematic to discuss all new and challenging cases before, during, and after the treatment. Human resource development, particularly of head and neck medical oncologists, is crucial. The type of multidisciplinary network between medical staff and the extent of patient intervention differs among MTB teams. Subsequently, a virtual MTB can establish a medical network between institutions that will contribute to the equalization and centralization of head and neck oncologic care.
Case Report: Soft tissue infection with Burkholderia thailandensis capsular variant: case report from the Lao PDR
Authors: Souphaphone Vannachone, Manophab Luangraj, David Dance, Narisara Chantratita, Natnaree Saiprom, Rathanin Seng, Sarunporn Tandhavanant, Sayaphet Rattanavong, Andrew Simpson, Tamalee Roberts
Journal: Wellcome Open Res (2024)
Keywords: b thailandensis capsular variant, burkholderia thailandensis, lao pdr
MeSH terms: Case Reports

Background:

Burkholderia thailandensis is an environmental bacteria closely related to Burkholderia pseudomallei that rarely causes infection in humans. Some environmental isolates have shown to express a capsular polysaccharide known as B. thailandensis capsular variant (BTCV), but human infection has not previously been reported. Although B. thailandednisis has been identified in environmental samples in Laos before, there have not been any human cases reported.
Case:
A 44-year-old man presented to a district hospital in Laos with a short history of fever and pain in his left foot. Physical examination identified a deep soft-tissue abscess in his left foot and an elevated white blood count. A deep pus sample was taken and melioidosis was suspected from preliminary laboratory tests. The patient was initially started on cloxacillin, ceftriaxone and metronidazole, and was then changed to ceftazidime treatment following local melioidosis treatment guidelines.
Laboratory methods:
A deep pus sample was sent to Mahosot Hospital microbiology laboratory where a mixed infection was identified including Burkholderia sp. Conventional identification tests and API 20NE were inconclusive, and the B. pseudomallei-specific latex agglutination was positive. The isolate then underwent a Burkholderia species specific PCR which identified the isolate as B. thailandensis. The isolate was sent for sequencing on the Illumina NovaSeq 6000 system and multi-locus sequence typing analysis identified the isolate had the same sequence type (ST696) as B. thailandensis E555, a strain which expresses a B. pseudomallei-like capsular polysaccharide.
Conclusion:
This is the first report of human infection with B. thailandensis in Laos, and the first report of any human infection with the B. thailandensis capsular variant. Due to the potential for laboratory tests to incorrectly identify this bacteria, staff in endemic areas for B. thailandensis and B. pseudomallei should be aware and ensure that appropriate confirmatory methods are used to differentiate between the species.
Nasal Glial Hamartoma: A New Type of Sinonasal Hamartomas
Authors: Nian Patel, Mehmet Server, Ahmed Bayoumi, Abdelrahman Ezzat Ibrahim
Journal: Cureus (2024)
Keywords: glial hamartoma, inverted papilloma, nasal chondromesenchymal hamartoma, nasal tumours, olfactory epithelial hamartoma, respiratory epithelial adenomatoid hamartoma, seromucinous hamartoma, sinonasal hamartoma
MeSH terms: Case Reports

Hamartomas are rare, tumour-forming, benign lesions that have been reported throughout the body that can resemble other malignant entities. Hamartoma subtypes can be distinguished based on their histological features. Sinonasal hamartomas may have presenting symptoms and radiological features that mimic other nasal neoplastic lesions. Therefore, it is essential to diagnose it accurately, as the treatment approaches can range from radical surgeries in malignant cases to a simple excision in hamartoma. In this paper, we report a novel case of sinonasal hamartoma, which demonstrates an unprecedented histological feature of glial tissue with astrocyte-like cells. Furthermore, we present the unconventional presenting symptoms and radiological features seen in this case that mimic the behaviours of nasal inverted papilloma (IP) lesions, thereby highlighting the need for careful investigation of such patients in order to distinguish both glial hamartoma and IP lesions. Concluding that identification of glial hamartoma as a new subtype of sinonasal hamartoma is crucial, as mistaking it for other lesions may subject patients to overly aggressive treatment and potential unnecessary harm.
Irreducible Posterior Shoulder Dislocation With Concomitant Fracture of Both the Greater and Lesser Tuberosity: An Extremely Rare Shoulder Injury
Authors: Giannis Kotsalis, Aristidis Georgountzos, Ioannis Kechagias, Maria Ladogianni
Journal: Cureus (2024)
Keywords: fracture, greater tuberosity, lesser tuberosity, posterior dislocation, reduction, shoulder
MeSH terms: Case Reports

Posterior shoulder dislocation is a relatively rare injury representing only 5% of all shoulder dislocations. It is usually the result of a high-energy trauma or an epileptic seizure. Diagnosis is challenging with half of these injuries missed in the emergency room (ER). Often the dislocation is accompanied by a lesser tuberosity fracture as a result of the impact between the posterior glenoid and the proximal humerus. Additionally, fractures of the greater tuberosity or even the metaphysis are extremely rare, and their treatment remains challenging. We present a rare case of posterior locked shoulder dislocation with a concomitant lesser and greater tuberosity fracture in a young patient. A 29-year-old male was brought to the ER following a motor vehicle accident. The patient reported significant pain and inability to move his left shoulder. The arm was locked in an internal rotation and was neurovascularly intact. Simple radiographs revealed a locked posterior dislocation with fractures of both the lesser and greater tuberosity. The CT scan confirmed the fracture pattern and excluded metaphyseal fracture. Surgical treatment was decided. Under general anesthesia and a classic thoracodeltoid approach, both tuberosities were recognized and the dislocation was gently reduced. Fixation of the tuberosities with an anatomic plate and Ethibond No. 5 sutures was performed. He was discharged the next day with a 30-degree abduction sling cast. He was instructed to perform passive shoulder and scapula exercises once a day. After one month, the sling was removed and active elevation and rotation exercises were started. Plane X-rays were performed at one, six, and twelve months. The reduction remained stable and the patient recovered full range of motion with a slight loss of external rotation (10 degrees) compared to the contralateral limb. He returned to his previous activities without any complications. Posterior shoulder dislocations with additional fractures of the tuberosities are rare and severe injuries requiring open surgery as the humeral head may remain locked prohibiting closed reduction. Even after the reduction, the stable fixation of the tuberosities is crucial for shoulder stability and postoperative clinical and functional results.
Glycodeoxycholic acid as alternative treatment in 3β-hydroxy-Δ5-C27-steroid-oxidoreductase: a case report
Authors: S Majait, F M Vaz, E Marleen Kemper, A H Bootsma, A K Groen, M Nieuwdorp, Maarten R Soeters
Journal: Front Pediatr (2024)
Keywords: 3β-hsd, fxr ligand, bile acid defect, glycine-conjugated deoxycholic acid, postprandial
MeSH terms: Case Reports

Background:
3β-hydroxy-Δ5-C27-steroid-oxidoreductase (3β-HSD) deficiency is a bile acid synthesis disorder that leads to the absence of normal primary bile acids and the accumulation of abnormal bile acids. This results in cholestatic jaundice, fat-soluble vitamin deficiency, acholic or fatty stools and failure to thrive. Bile acid supplementation is used to treat 3β-HSD-deficiency and its symptoms.
Methods:
This report details the case of a 28-year-old woman diagnosed with 3β-HSD-deficiency, who was treated with glycine-conjugated deoxycholic acid (gDCA).
Results:
gDCA treatment successfully restored normal bile acid levels, improved body weight by reducing fat malabsorption, and was well-tolerated with no observed liver problems or side effects.
Conclusions:
As a potent FXR ligand, gDCA might exert its action through FXR activation leading to bile acid synthesis regulation.
Methicillin-resistant Staphylococcus aureus-associated empyema necessitans in a child: A case report and a literature review
Authors: Ghada Habachi, Sondes Sahli, Sabrine Ben Ammar, Bochra Aziza, Riadh Jouini
Journal: Qatar Med J (2024)
Keywords: children, mrsa, empyema necessitans
MeSH terms: Case Reports

Introduction:
Empyema is a known complication of severe pleuropneumonia. In rare cases, if poorly treated, it could result in dissemination and fistulization and transformation into empyema necessitans. The manifestation may appear as a superficial abscess. However, as management highly differs, the recognition of potentially severe phenomenon is required.
Case presentation:
We describe a case of empyema necessitans on a 4-year-old girl secondary to methicillin-resistant Staphylococcus aureus. It represents the sixth pediatric case reported in the literature. It was managed by open drainage and prolonged antibiotherapy. The outcome was favorable as guidelines were extracted from similar reported cases.
Conclusion:
Empyema necessitans remains a rare complication with significant morbidity. Prompt diagnosis and adapted management have relied on limited literature. As such, further reports are necessary to establish proper guidelines.
Case report: Thoracic vertebral abscess caused by Salmonella via diagnosed next-generation sequencing
Authors: Xiao-Guang Cao, Jun-Xi Ni, Chong-Jian Huang
Journal: Front Med (Lausanne) (2024)
Keywords: ngs, salmonella typhi, diagnosis, infection, thoracic vertebra
MeSH terms: Case Reports

The genus Salmonella consists of Gram-negative bacteria with various serotypes. It commonly causes bacterial infections that affect the intestines. Infection can occur in humans and animals through the ingestion of contaminated food or water, or through contact with infected animals or environments. Complications commonly include intestinal hemorrhage and perforation, though vertebral osteomyelitis is rarely observed. Therefore, in patients with spinal cord abscesses, The genus Salmonella is typically not considered a likely pathogen, especially in the absence of typical symptoms. In this case, the limited information provided by traditional cultivation methods, particularly under the influence of antibiotics. However, next-generation sequencing (NGS) unexpectedly detected Salmonella, which assisted in formulating the final treatment plan. This underscores the role and clinical value of NGS in pathogen identification.