OpenMed/multicare-articles huggingface dataset:
Intraoperative Use of CBCT for Identification and Localization of Calcified Canals: A Clinical Technique
Authors: Spyros Floratos, Maria-Elpida Miltiadous
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Localization of calcified canals has always been a challenge in the field of endodontics. The following report of three cases describes a technique for the identification and negotiation of obliterated canals by use of cone beam computed tomography (CBCT) intraoperatively. Canal orifices could not be found clinically in all three cases. Gutta-percha points were placed and compacted at the position where the canal orifices were estimated to be. Intraoperative CBCT was taken, and the distance between the gutta-percha points and the canal orifices was calculated at all planes of space in the first two cases. In the third case, only one canal orifice could be identified due to obliteration of the other canals.
Renal Abscess Caused by Crizotinib: A Rare Case Report
Authors: Zhaojun Wan, Kai Wang, Xiangfu Yin, Xiangting Guo, Guoli Cheng, Jihong Pan
Journal: Front Oncol (2022)
Keywords: nsclc, ros1, crizotinib, renal abscess, renal cysts
MeSH terms: Case Reports

Crizotinib is a tyrosine kinase inhibitor that has been found to be effective in the treatment of c-ros oncogene 1-positive non-small cell lung cancer. Although this targeted agent for treating cancer has shown superiority to standard chemotherapy in some ways, this drug has adverse effects, such as the development of renal abscesses. Some associated renal damage may disappear with crizotinib withdrawal. Hence, we present the case of a 58-year-old man with non-small cell lung cancer on crizotinib therapy who developed bilateral renal abnormal space-occupying lesions, successively which were difficult to identify using various imaging methods; even PET-CT highly suspected the right renal masses as malignant. Finally, the right renal lesions were confirmed as renal abscesses by postoperative pathology. The left renal lesion was considered as renal cysts through the lesion disappearing after crizotinib withdrawal. There have been very few reports in this respect, especially proved by various methods and confirmed by postoperative pathology. It is important to recognize this drug-related complication in order to avoid incorrect diagnosis and inadequate therapy. It is necessary to monitor renal changes after taking crizotinib.
COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation
Authors: Mary E Burgoyne, Emad A Elsamadicy, Liviu Cojocaru, Andrea Desai
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for coronavirus disease 2019 (COVID-19), continues to have a devastating impact on healthcare systems worldwide, and many questions remain unanswered. The effect of COVID-19 on the pregnant population is widely debated, and the unique risks in pregnancy have not yet been elucidated. What has been established, however, is the recommendation for healthcare workers to use personal protective equipment (PPE) for both contact and airborne precautions to prevent transmission of the pathogen-adding another barrier to care for vulnerable populations. We report a case of a young woman from Haiti during her first pregnancy, who was admitted to the antepartum service at 22 weeks of gestation with preterm premature rupture of membranes (PPROM) and remained admitted in isolation, though asymptomatic, for over six weeks due to persistent positive SARS-CoV-2 testing. Our case highlights the unique barriers to care that COVID-19 poses to antepartum patients, particularly in the setting of pregnant women with persistent positive testing.
Megaloappendix: a case report
Authors: Abdel Hady A Samaha, Ayman S Tawfik, Tariq O Abbas, Ashraf Abdelhamid
Journal: Case Rep Surg (2011)
MeSH terms: Case Reports

The vermiform appendix is an organ that can have variable sizes, locations as well as functional potentials. We describe here the longest and largest appendix removed measuring about 55 cm in length.
Severe Pneumonia Caused by Infection With Tropheryma whipplei Complicated With Acinetobacter baumannii Infection: A Case Report Involving a Young Woman
Authors: Sheng Wang, Demeng Xia, Jianghong Wu, Dandan Jia, Lei Li, Shuogui Xu
Journal: Front Public Health (2021)
Keywords: acinetobacter baumannii, tropheryma whipplei, bronchoalveolar lavage, metagenomics next-generation sequencing, severe pneumonia
MeSH terms: Acinetobacter Infections / diagnosis, Acinetobacter baumannii, Pneumonia, Whipple Disease / complications, Case Reports, Adult, Female, Humans, Male, Middle Aged, Tropheryma / genetics

Whipple's disease is a very rare systemic infectious disease, and very few cases have been reported. However, it can be fatal if not diagnosed and treated appropriately. The major clinical manifestations of this disease are usually digestive and nervous system symptoms. The majority of patients are male and between 40 and 50 years old. Although respiratory symptoms of this disease have rarely been reported, they pose a serious threat to the lives of the patients, especially when they progress to severe pneumonia. During admission to the hospital, Acinetobacter baumannii infection makes treatment more difficult. While most patients are middle-aged men, more attention should be given to the diagnosis and treatment of affected young women. To our knowledge, the case presented in the study is the first case of Tropheryma whipplei infection that resulted in severe pneumonia and was complicated by A. baumannii infection during treatment. We hope that our study can serve as a reference for the diagnosis and treatment of related cases in the future.
Posttraumatic Bacillus cereus Endophthalmitis: Clinical Characteristics and Antibiotic Susceptibilities
Authors: Feng Mei, Jiaqi Lin, Manli Liu, Yao Yang, Xiaofeng Lin, Fang Duan
Journal: J Ophthalmol (2021)

Purpose:
To report the clinical characteristics, antibiotic susceptibilities, and visual outcomes of patients with posttraumatic endophthalmitis caused by Bacillus cereus.
Methods:
In this retrospective, noncomparative case series, the medical records of eyes with culture-proven Bacillus cereus endophthalmitis treated from January 2016 to December 2019 at a referral center were reviewed. Clinical features, antibiotic susceptibilities, and visual outcomes were assessed.
Results:
A total of 19 eyes of 19 patients were identified. Three patients progressed to orbital cellulitis. Vitrectomy was performed in 13 eyes, and 11 required silicone oil tamponade. Finally, seven eyes underwent silicone oil removal surgery during follow-up. Only two patients retained a visual acuity better than FC. Four patients underwent evisceration, and three patients had NLP. The cultured Bacillus cereus was sensitive to levofloxacin, ofloxacin, tobramycin, and neomycin at 100%.
Conclusions:
The visual outcomes of posttraumatic Bacillus cereus endophthalmitis were generally poor regardless of the prophylactic and therapeutic measures administered. Vitrectomy combined with silicone oil tamponade could help to save the eyeball. Bacillus cereus has a good susceptibility to ofloxacin, levofloxacin, tobramycin, and neomycin; therefore, fluoroquinolones and aminoglycosides can be used to treat Bacillus cereus infection.
Prothrombin Gene Mutation as a Teaching Tool: An Autobiographical Case Report
Authors: Tucker Morris, Elizabeth R Lorbeer, Richard R Roach
Journal: Cureus (2023)
Keywords: blood clot, cholecystectomy, portal vein thrombosis, prothrombin g20210a factor ii mutation, pulmonary embolization
MeSH terms: Case Reports

The prothrombin G20210A factor II mutation carrier status has been reported to cause complications during pregnancy. This report presents the case of a patient diagnosed with heterozygous prothrombin G20210A factor II mutation at 29 years of age during preconception genetic screening. The patient had two uncomplicated pregnancies. The patient underwent laparoscopic cholecystectomy with a complicated postoperative course. The complications included deep vein thrombophlebitis (DVT), portal vein thrombosis (PVT), and pulmonary embolization (PE). The treatment options and contraceptive choices are also discussed in this report. Our report discusses the subsequent risks inherent in a heterozygote following the administration of oral contraceptives, prolonged immobilization related to lower extremity trauma, and extended motor vehicle excursion.
Atorvastatin Plus Low-Dose Dexamethasone May Be Effective for Leukemia-Related Chronic Subdural Hematoma but Not for Leukemia Encephalopathy: A Report of Three Cases
Authors: Jiangyuan Yuan, Ying Li, Xuanhui Liu, Meng Nie, Weiwei Jiang, Yibing Fan, Tangtang Xiang, Hanhua Wang, Wei Quan, Chuang Gao, Jinghao Huang, Shuo An, Yongxin Ru, Qiufan Zhou, Jianning Zhang, Rongcai Jiang
Journal: Front Oncol (2021)
Keywords: atorvastatin, chronic subdural hematoma, dexamethasone, leukemia, leukemia encephalopathy
MeSH terms: Case Reports

We are not aware of any reports regarding conservative treatment for leukemia-related chronic subdural hematoma (CSDH). We report our experience with 3 men who were admitted with subdural masses and abnormal leukocyte counts. In two patients, leukemia and CSDH were confirmed on the basis of medical records, mild head trauma, and neuroimaging features. Both patients experienced reduced CSDH and neurological symptoms after receiving atorvastatin (20 mg/day) plus low-dose dexamethasone. However, this combined conservative treatment was ineffective in the third patient, who was diagnosed as having leukemia and showed an increased hematoma volume after two weeks of therapy. Magnetic resonance imaging findings suggested dural metastasis, which prompted a switch from statin-based conservative treatment to chemotherapy. Complete remission of the leukemia and resolution of the subdural mass were observed after chemotherapy, which supported a diagnosis of leukemia encephalopathy. The 5-month follow-ups did not reveal CSDH relapse in all 3 cases. Thus, atorvastatin-based conservative treatment may be effective for leukemia-related CSDH but not for leukemia encephalopathy.
Lymphepithelial carcinoma - a rare tumor of the larynx. Case Report
Authors: Piotr Nogal, Michalina Staśkiewicz, Joanna Jackowska, Małgorzata Wierzbicka
Journal: Front Surg (2022)
Keywords: schmincke's tumor, head and neck surgery, laryngeal malignancy, laser microsurgery, lymphoepithelial carcinoma (lec), rare tumor location
MeSH terms: Case Reports

Lymphoepithelioma was described in 1921 separately by Regaud and Schmincke as nests of non-keratinizing squamous cells embedded in a lymphoid stroma (Regaud) and isolated transitional cells scattered in lymphoid tissue resembling sarcoma (Schmincke). Lymphoepithelial tumors are the most common lesions of the nasopharynx, although they have also been reported in other localizations, such as the nasal cavity, maxillary sinus, the base of the tongue, parapharyngeal area, tonsils and thymus. Lymphoepithelioma of the larynx is extremely rare. We present a case of a 55-year-old patient treated due to this type of lesion to share our experience in the management of this type of malignancy and contribute to the field of rare laryngeal tumors diagnosis and treatment.
Ultrasound diagnosis of fetal neck masses: a case series
Authors: Shakina Rauff, Tan Eng Kien
Journal: Case Rep Obstet Gynecol (2013)

Fetal neck masses are rare and may not be apparent during the second trimester fetal anomaly screening scan. It is essential to distinguish the different pathologies as it influences prenatal counseling, antenatal, and postnatal management. Furthermore, some causes may be amenable to in utero treatment. Others have a poor prognosis due to their association with congenital syndromes and aneuploidies. Differentiating the various neck masses and reaching an accurate diagnosis are a challenge. This requires a systematic approach, time and patience, together with an experienced sonographer. Ancillary investigations like karyotyping and magnetic resonance imaging may be used as well. It is important to attain an accurate diagnosis and to follow up the fetus with serial scans as this affects antenatal counselling and prognosis as well as the mode of delivery. Here, we present four cases of fetal neck masses that were seen at our antenatal diagnostic centre and highlight the distinguishing ultrasound features of each. This will enable one to approach the ultrasound diagnosis of fetal neck masses in a methodical and logical manner.
Cognitive behavioral therapy in the treatment of social phobia
Authors: Richa Priyamvada, Sapna Kumari, Jai Prakash, Suprakash Chaudhury
Journal: Ind Psychiatry J (2009)
Keywords: cognitive behavior therapy, psychotherapy, social phobia
MeSH terms: Case Reports

Cognitive behavior therapy is probably the most well-known and the most practiced form of modern psychotherapy and has been integrated into highly structured package for the treatment of patients suffering from social phobia. The present case study is an attempt to provide therapeutic intervention program to a 27-year-old, unmarried Christian man suffering from social phobia. The patient was treated by using cognitive behavioral techniques. After 17 sessions of therapeutic intervention program, significant improvement was found. He was under follow-up for a period of 6 months and recovered to the premorbid level of functioning.
Severe Hypocalcemia and Dramatic Increase in Parathyroid Hormone after Denosumab in a Dialysis Patient: A Case Report and Review of the Literature
Authors: Ravinder D Bhanot, Jasleen Kaur, Zeenat Bhat
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Chronic kidney disease-mineral and bone disorder (CKD-MBD) is frequently present in advanced stages of chronic kidney disease (CKD) patients with high risk of fracture and elevated socioeconomic burden. Denosumab, an injectable human monoclonal antibody with affinity for nuclear factor-kappa ligand (RANKL), is an effective treatment for osteoporosis in postmenopausal women and men. Unlike the bisphosphonates, the pharmacokinetics and pharmacodynamics of denosumab are not influenced by the renal function and are being increasingly used for patients having CKD-MBD with low bone mineral density (BMD) to reduce the risk of fragility fractures. Hypocalcemia is a known side effect of this drug along with compensatory increase in parathyroid hormone (PTH). However, limited information is available in the literature regarding this potentially life-threatening side effect with denosumab in end-stage renal disease (ESRD) patients on dialysis. We present a patient with ESRD on peritoneal dialysis who developed severe symptomatic hypocalcemia and dramatic increase in PTH following denosumab therapy. She was conservatively managed with calcium supplementation and appropriate adjustment in calcium dialysate. We have also reviewed the literature on the use of denosumab in dialysis patients and looked at additional factors that may precipitate severe hypocalcemia in these patients. We believe that denosumab should be used with caution in dialysis patients since it may lead to profound hypocalcemia. Clinicians should ensure special attention in recognizing patients at risk of developing this serious adverse effect, so that prompt treatment and preventive strategies can be implemented.
Splenic abscess due to fungal infection after kidney transplantation; a case report
Authors: Tahereh Malakoutian, Maliheh Yarmohamadi, Ronak Mohammadi, Mojgan Asgari, Reyhaneh Mahmoodian
Journal: J Renal Inj Prev (2016)
Keywords: candidiasis, immunosuppressive therapy, renal transplantation, splenectomy
MeSH terms: Case Reports

Splenic abscess is one of the rare and potentially life-threatening complications after kidney transplantation. Splenic abscess generally occurs in patients who have immunodeficiency state. It becomes more important with the increased use of immunosuppressed drugs and organ transplantation. The clinical presentation of splenic abscess is insidious, often with constitutional symptoms. Left upper quadrant tenderness is an uncommon sign. Therefore, its diagnosis is difficult and requires a high degree of clinical suspicion. We report a case under renal transplantation with recurrent fungal infection in different organs with two episodes of fungemia who died after splenectomy.
Systemic Embolization from an Unusual Intracardiac Mass in the Left Ventricular Outflow Tract
Authors: Kelechukwu U Okoro, Timothy R Larsen, John C Lystash
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Endocarditis can affect any endocardial surface; in the vast majority of cases, the cardiac valves are involved. It is exceedingly rare to develop infective endocarditis on the endocardium of the left ventricular outflow tract due to the high velocity of blood that traverses this area. Herein, we present a rare case of left ventricular outflow tract endocarditis that likely occurred secondary to damage to the aortic valve leaflets (from healed prior aortic valve endocarditis) causing a high velocity aortic valve regurgitant jet that impinged upon the interventricular septum which damaged the endocardium and resulted in a fibrotic "jet lesion." This fibrous jet lesion served as a nidus for bacterial proliferation and vegetation formation. The high shear stress (due to high blood flow velocity through the left ventricular outflow tract) likely promoted the multiple embolic events observed in this case. Our patient was successfully treated with aortic valve replacement, vegetation resection, and antibiotics.
Three Cases of Right Heart Thrombus: Using POCUS for the Diagnosis of Thromboembolism in COVID-19
Authors: Sergio Velasco Malagón, Juliana Moreno Ladino, Hector Andres Ruiz
Journal: POCUS J (2022)
Keywords: pocus, pulmonary embolism, sars-cov-2
MeSH terms: Case Reports

COVID-19 generates a series of challenges, one of them being thrombotic manifestations of the disease. The growing use of POCUS and its wide versatility have expanded its use outside of radiology rooms. The development of focused protocols has facilitated its use in emergency units, clinical wards, intensive care units, and operating rooms. We report three cases of patients with SARS-CoV-2 infection in whom the use of POCUS allowed the identification of the presence of intracavitary thrombus with acute right ventricular dysfunction. These cases illustrate the importance of ultrasound focused on critically ill patients in guiding the diagnosis and treatment amid the pandemic situation.
Anastomotic Biliary Stricture Development after Liver Transplantation in the Setting of Retained Prophylactic Intraductal Pediatric Feeding Tube: Case and Review
Authors: Patrick T Koo, Valentina Medici, James H Tabibian
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

The biliary anastomosis remains a common site of postoperative complications in liver transplantation (LT). Biliary complications have indeed been termed the "Achilles' heel" of LT, and while their prevention, diagnosis, and treatment have continued to evolve over the last two decades, various challenges and uncertainties persist. Here we present the case of a 33-year-old man who, 10 years after undergoing LT for idiopathic recurrent intrahepatic cholestasis, was noted to have developed pruritus and abnormalities in serum liver biochemistries during routine post-liver transplant follow-up. Abdominal ultrasound revealed a linear, 1.5 mm hyperechoic filling defect in the common bile duct; magnetic resonance cholangiopancreatography demonstrated a curvilinear filling defect at the level of the choledochocholedochostomy, corresponding to the ultrasound finding, as well as an anastomotic biliary stricture (ABS). On endoscopic retrograde cholangiography (ERC), a black tubular stricture with overlying sludge was encountered and extracted from the common bile duct, consistent with a retained 5 Fr pediatric feeding tube originally placed at the time of LT. The patient experienced symptomatic and biochemical relief and successfully underwent serial ERCs with balloon dilatation and maximal biliary stenting for ABS management. With this case, we emphasize the importance of ensuring spontaneous passage or removal of intraductal prostheses placed prophylactically at the time of LT in order to minimize the risk of chronic biliary inflammation and associated sequelae, including cholangitis and ABS formation. We also provide herein a brief review of the use of prophylactic internal transanastomotic prostheses, including biliary tubes and stents, during LT.
Severe Chest Pain due to N-Acetylcysteine-Induced Esophagitis
Authors: Weihong Wang, Yu Zhang, Yi Liu, Lei Xu, Dingmei Shi
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

We report an unusual case of severe chest pain caused by N-acetylcysteine-induced esophagitis. An 81-year-old Chinese man with a history of interstitial lung disease was admitted to our hospital with intermittent arrhythmia that began 5 days ago. The patient presented with complaints of cough, sputum, and shortness of breath. Cefminox injections and N-acetylcysteine tablets were prescribed to improve respiratory symptoms. The patient developed severe chest pain and odynophagia 4 hours after swallowing the N-acetylcysteine tablet while in the decubitus position. Upper gastrointestinal endoscopy revealed four discrete areas of ulcerations measuring approximately 1 cm at the midesophageal level. The distance between the foci and the incisors was approximately 24 cm. The patient continued the N-acetylcysteine orally, which was administered in powdered form with more water while in the upright position. Pantoprazole and hydrotalcite were also administered to the patient. The symptoms subsided, and a follow-up endoscopy after 20 days showed that the ulcers healed. This case highlights that seemingly safe drugs such as N-acetylcysteine can lead to severe chest pain if ingested inappropriately.