OpenMed/multicare-articles huggingface dataset:
Treatment of a prolonged air leak with radiotherapy: a case report
Authors: Erdoğan Cetinkaya, M Akif Ozgül, Sule Gül, Ertan Cam, Yakup Büyükpolat
Journal: Case Rep Pulmonol (2012)

Pneumothorax is defined as air in the pleural space. Depending on the severity of the pneumothorax, treatment consists of oxygen therapy, simple aspiration, tube thoracostomy, and pleurodesis. Prolonged air leakage is observed in 25% of the patients who have undergone surgical procedures, such as thoracotomy, pleurectomy, and video-assisted thoracoscopy. The patient presented here is the third reported case successfully treated with radiotherapy. Ventilation scintigraphy was used to localise the air leak, and localised radiotherapy was performed at the targeted location. After radiotherapy, the air leak ceased and at the 3-month followup, the pneumothorax had not recurred. Radiotherapy can be a treatment modality for patients with prolonged air leak, who are not candidates for surgery.
Amniotic Fluid Embolism Treated with Veno-Arterial Extracorporeal Membrane Oxygenation
Authors: Robert Gitman, Bradlee Bachar, Byron Mendenhall
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Amniotic fluid embolism (AFE) is an extremely rare yet fatal obstetric emergency. AFE presents as sudden cardiovascular collapse after a breach of maternal-fetal membranes and is often complicated by severe coagulopathy. We present a case where an AFE was treated with veno-arterial extracorporeal membrane oxygenation (ECMO) to help overcome the acute cardiopulmonary insult. The use of echocardiography proved to be an invaluable tool to help guide treatment and optimal duration of ECMO in the face of severe coagulopathy.
Gastric Signet-Ring Cell Carcinoma That Presented as an Elevated Lesion due to Fibromuscular Obliteration in the Lamina Propria
Authors: Yoshitsugu Misumi, Shin Ichihara, Kouichi Nonaka, Hiromi Onizuka, Yoji Nagashima
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

The widespread use of Helicobacter pylori eradication therapy in recent years has reduced the H. pylori infection rate, indicating that gastric cancer cases diagnosed in the future may be H. pylori-naïve. The typical endoscopic presentation of signet-ring cell carcinoma, which accounts for the majority of H. pylori-naïve gastric cancer cases, is a discolored, flat, or depressed lesion; it is rarely presented as an elevated lesion. In this study, we treated a patient with elevated signet-ring cell carcinoma in an H. pylori-naïve stomach. Histopathological testing after endoscopic submucosal dissection showed proliferation of fibromuscular tissue in the tumor, which may have caused the formation of the elevated lesion.
Bilateral retinitis following typhoid fever
Authors: M Prabhushanker, Tasneem T Topiwalla, Geetha Ganesan, Sripal Appandaraj
Journal: Int J Retina Vitreous (2017)
Keywords: immune mediated, post typhoid fever, retinitis, typhoid retinopathy
MeSH terms: Case Reports

Background:
Post typhoid fever immune related reactions affecting the eye is a rare finding which can have various presentations in which typhoid retinopathy is not a well recognized sequelae.
Case presentation:
Here we present a case of 59 year old male who presented with right eye sudden painless loss of vision 4 weeks after typhoid fever which was diagnosed and treated successfully. His BCVA was 2/60 in right eye and 6/6 in left eye. Fundus examination showed retinitis along with macular serous detachment in right eye and retinitis in left eye. Significant improvement in BCVA in right eye was observed after treatment with oral steroid with resolving retinitis lesions. Diagnosis of post typhoid immune mediated retinitis was made with good resolution following treatment.
Conclusions:
Immune mediated retinitis is a rare sequelae to typhoid infection which can be successfully treated with systemic steroids with good resolution of the lesions.
Malignant granular cell tumor of the back: a case report and review of the literature
Authors: Laura Stone McGuire, Danny Yakoub, Mecker G Möller, Andrew Rosenberg, Alan Livingstone
Journal: Case Rep Med (2014)

Malignant granular cell tumors are rare, intensely aggressive entities. This paper presents a case of a large rapidly recurrent malignant granular cell tumor with regional and distal metastases on the back of a 54-year-old Cuban man. The primary tumor recurred within six months of the original wide local excision and with satellite lesions apparent at twelve months, and the mass was diagnosed using the histological criteria established by Fanburg-Smith et al. for malignant granular cell tumors. By fifteen months, right axillary lymphadenopathy, multiple satellite lesions, pulmonary nodules, and distant metastasis in the right thigh were present. At sixteen months, wide local excision of recurrent mass and local satellite masses along with right axillary dissection and placement of Integra with subsequent split-thickness skin graft were performed by surgical oncology and plastic surgery teams. The surgical specimen measured 32.0 × 13.5 × 5.5 cm, containing multiple homogeneous masses with the largest mass 22.0 × 9.0 × 4.6 cm. Following surgery, patient was started on Pazopanib 800 mg/day based on phase III randomized trial data in the treatment of soft tissue sarcomas showing this as a potential novel therapy for malignant granular cell tumors.
Granulomatosis with Polyangiitis with Myocarditis and Ventricular Tachycardia
Authors: Ramy Magdy Hanna, Eduardo Lopez, James Wilson
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a pulmonary-renal syndrome affecting small and medium sized blood vessels. The disease has a prevalence in studies ranging from 3 to 15.7 cases per 100,000, with a noted increasing incidence and prevalence in more recent studies. Pulmonary manifestations include hemorrhage, lung cavitary lesions, and pulmonary fibrosis. Within the kidney, GPA is known to cause rapidly progressive pauci-immune crescentic glomerulonephritis. Rare and severe cardiovascular manifestations include pericarditis, arrhythmias, myocarditis, and aortic valve disease. Our patient is a 43-year-old female with typical pulmonary and renal lesions from GPA and also acute myocarditis, multiple episodes of ventricular tachycardia, and a severe reactive thrombocytosis.
Infra-Low Frequency Neurofeedback rapidly ameliorates schizophrenia symptoms: A case report of the first session
Authors: Joannis N Nestoros, Nionia G Vallianatou
Journal: Front Hum Neurosci (2022)
Keywords: infra-low frequency regime, neurofeedback, antipsychotic treatment, rapid improvement, schizophrenia
MeSH terms: Case Reports

A 38-year-old army officer started therapy in 2020 with a four-year history of auditory hallucinations and delusions of reference, persecution and grandeur, symptoms that were resistant to traditional antipsychotic medications. He follows an integrative psychotherapy program that aims to reduce his anxiety, continues his antipsychotic medications, and has Infra-Low Frequency Neurofeedback. After his initial assessment he had a 40 min session of Infra-Low Frequency Neurofeedback before any other kind of intervention. Before and immediately after the session he completed the SCL-90 scale and the Visual Analog Scale covering 20 aspects of his psychological and physical state as well as his schizophrenic symptoms. This first Neurofeedback session had dramatic effects on his psychotic symptoms, levels of anxiety and psychosomatic condition, before his first psychotherapy session and/or any changes in his antipsychotic medication. The above results have great importance due to the severity and chronicity of schizophrenia. Informed consent was obtained from the participant for the publication of this case report (including all data and images).
Cerebral Large Vessel Occlusion Caused by Fat Embolism-A Case Series and Review of the Literature
Authors: Suyi Ooi, Subahari Raviskanthan, Bruce C V Campbell, Elspeth J Hutton, Peter J Mitchell, Geoffrey C Cloud
Journal: Front Neurol (2021)
Keywords: endovascular clot retrieval, fat embolism, ischaemic stroke, large vessel occlusion (lvo), surgical complication
MeSH terms: Case Reports

The diagnosis of fat embolism syndrome typically involves neurological, respiratory and dermatological manifestations of microvascular occlusion 24-72 h after a precipitating event. However, fat embolism causing cerebral large vessel occlusion strokes and their sequelae have rarely been reported in the literature. This case series reports three patients with fat emboli post operatively causing cerebral large vessel occlusions, as well as a review of the literature to identify differences in clinical presentations and outcomes in stroke secondary to fat emboli causing large vessel occlusions compared to those with fat embolism syndrome.
A Historic Case of Cardiac Surgery in Pregnancy
Authors: Said Benlamkaddem, Adnane Berdai, Smael Labib, Mustapha Harandou
Journal: Case Rep Obstet Gynecol (2016)

Background. Heart disease is the leading cause of nonobstetric mortality in pregnant women. Because of high risk, medical management represents the first line of treatment. However, when medical treatment fails, cardiac surgery becomes necessary. Case Presentation. A 27-year-old female who underwent successfully cardiac surgery three times within 3 years. At the first time, she had an aortic valve replacement at 25 weeks of gestation after an infectious endocarditis complicated with an ischemic stroke. At 39 weeks of gestation, she had delivered, vaginally, a healthy baby boy weighing 2800 g. In the second time, pregnant again at 30 weeks of gestation, she had a mitral valve replacement with an aortic prosthesis reinforcement after a paraprosthetic regurgitation and a mitral vegetation. A fetal death in utero had occurred; the extraction of the fetus by cesarean section with a tubal ligation was performed after stabilization of the mother. In the third time, she underwent successfully a mitral prosthesis replacement with Bentall's procedure after a mitral prosthesis disinsertion with an abscess of aortic annulus due to new episode of infectious endocarditis. Conclusion. Our patient has assembled almost all poor prognosis factors, which makes her a real historic case, probably never described in the literature.
Pleural Effusion Caused by Mycolicibacterium mageritense in an Immunocompetent Host: A Case Report
Authors: Takayuki Niitsu, Tomoki Kuge, Kiyoharu Fukushima, Yuki Matsumoto, Yuko Abe, Masashi Okamoto, Kako Haduki, Haruko Saito, Tadayoshi Nitta, Akira Kawano, Takanori Matsuki, Daisuke Motooka, Kazuyuki Tsujino, Keisuke Miki, Shota Nakamura, Hiroshi Kida, Atsushi Kumanogoh
Journal: Front Med (Lausanne) (2021)
Keywords: mycolicibacterium mageritense, immunocompetent, nontuberculous mycobacteria, pleural effusion, rapidly growing mycobacteria
MeSH terms: Case Reports

Mycolicibacterium mageritense (M. mageritense) is a rare species among rapidly growing mycobacteria, and M. mageritense pleurisy is very rare. Here, we report for the first time, an immunocompetent patient with pleurisy caused by M. mageritense. The patient had no history of immunodeficiency and no recurrence of lung cancer after surgery. However, 8 months after surgery, he developed a new lung shadow and pleurisy. Although whole-genome analysis of the colony cultured from the patient's pleural fluid revealed M. mageritense, we could not identify it in time, resulting in a poor outcome. M. mageritense pleurisy in this case might have occurred via a bulla rupture of the lung lesion because computed tomography of the patient's chest showed pneumothorax and a lung lesion in contact with thoracic cavity. This case emphasized that nontuberculous mycobacterial pleurisy should be considered in the differential diagnoses of pleural effusion even in immunocompetent patients. Advancement of comprehensive and rapid analyses of genomic data from clinical specimens will lead to better treatment strategies.
Pericardial tamponade and coexisting pulmonary embolism as first manifestation of non-advanced lung adenocarcinoma
Authors: Salwa Akhbour, Brahim Amine Khennine, Latifa Oukerraj, Jamila Zarzur, Mohamed cherti
Journal: Pan Afr Med J (2014)
Keywords: pericardial tamponade, lung adenocarcinoma, pulmonary embolism
MeSH terms: Adenocarcinoma / diagnosis, Cardiac Tamponade / etiology, Lung Neoplasms / diagnosis, Pulmonary Embolism / etiology, Case Reports, Adenocarcinoma / complications, Adenocarcinoma / pathology, Adenocarcinoma of Lung, Echocardiography, Female, Humans, Hypertension, Pulmonary / etiology, Lung Neoplasms / complications, Lung Neoplasms / pathology, Middle Aged, Pericardial Effusion / etiology

Pericardial effusion and pulmonary embolism are relatively common complications of malignancy and are uncommon as its initial manifestation. This report describes a case of a patient, who presented with this association, due to an underlying pulmonary adenocarcinoma. When a major pericardial effusion is associated with pulmonary hypertension, some echocardiographic signs may redress the diagnosis. This case emphasizes a challenge diagnostic which may be guided by high right ventricular pressure and on the other hand the importance of keeping both these conditions in mind when dealing with context of malignancy.
Epithelial Ovarian Carcinoma Associated with Metastases to Central Nervous System: Two Case Reports
Authors: Yasuyuki Kawagoe, Tetsuo Nakayama, Satoshi Matuzawa, Kazuko Fukushima, Junji Onishi, Yuichiro Sato, Kimihiro Nagai, Hiroshi Sameshima
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

We experienced two rare cases of metastases to the central nervous system (cerebral and leptomeningeal metastases) from primary epithelial ovarian carcinoma. The first case was a 55-year-old woman who developed carcinomatous meningitis while on chemotherapy for ovarian cancer stage IIIC. Cytological analysis confirmed carcinomatous cells of ovarian origin in the cerebrospinal fluid. Magnetic resonance imaging demonstrated abnormal hyperintensity in the cerebral sulci on fluid attenuated inversion recovery (FLAIR) sequence with enhanced gadolinium indicating leptomeningeal metastases. Her consciousness rapidly declined and she died 42 days after diagnosis. The second case was a 63-year-old woman who underwent surgery for ovarian cancer and who was diagnosed as stage IA. Thirty-eight months after surgery, she developed weakness of the left hand and headaches. A CT scan revealed metastases to the right cerebrum and she was treated with surgical resection followed by radiotherapy. Five months after resection, she developed ileus caused by multiple relapses in the pelvis. Despite chemotherapy, her performance status declined and she died nine months after the resection. Both cases were rare because the first case was isolated leptomeningeal metastases, and the second case was confirmed relapse site in the cerebrum due to neurological symptoms despite her early clinical stage.
Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports
Authors: Jae Yoon Kim, Sang Yoon Do, Young Hoon Moon, Chul Gab Lee, Yun Sung Kim, Byung Soon Choi, Eun-A Kim, Han Soo Song
Journal: Ann Occup Environ Med (2017)
Keywords: crystalline silica, jewelry, korea, occupational exposure, systemic sclerosis
MeSH terms: Case Reports

Background:
Occupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field.
Case presentation:
Case 1 is a 57-year-old man who had worked mainly in crystal processing for multiple jewelry-processing companies for 17 years, since the age of 15 years. He contracted tuberculosis at the age of 25 years and showed Raynaud's phenomenon of both the hands and feet at age 32 years. Digital cyanosis and sclerosis developed at approximately age 41 years. The patient was diagnosed with systemic sclerosis at age 48 years. Case 2 is a 52-year-old man who worked in crystal processing for various jewelry-processing companies for 7 years, since the age of 23 years. He first showed signs of cyanosis in the third and fourth digits of both hands at age 32 years, was diagnosed with Raynaud's syndrome at age 37 years, and was diagnosed with systemic sclerosis at age 38 years. Crystal processing is a detailed process that involves slabbing and trimming the selected amethyst and quartz crystals, which requires close proximity of the worker's face with the target area. In the 1980s and 1990s, the working hours were 12 h per day, and the working environment involved 15 workers crowded into a small, 70-m2 space with poor ventilation.
Conclusion:
Two workers who processed crystals with a maximum crystalline silica content of 56.66% developed systemic sclerosis. Considering the epidemiological and experimental evidence, exposure to crystalline silica dust was an important risk factor for systemic sclerosis. An active intervention is necessary to reduce exposure in similar exposure groups in the field of jewelry processing.
Tetralogy of Fallot and pheochromocytoma in a situs inversus totalis: An unusual association
Authors: Rubén Kevin Arnold Tapia-Orihuela, Jorge Huaringa-Marcelo, David Loja-Oropeza
Journal: J Cardiovasc Thorac Res (2016)
Keywords: congenital heart defects, hypoxia, pheochromocytoma, situs inversus, tetralogy of fallot
MeSH terms: Case Reports

Introduction: Situs inversus totalis is an uncommon anomaly which exist a complete transposition of organs and it's occasionally associated with congenital heart diseases, such as tetralogy of fallot. Pheochromocytoma is a rare neuroendocrine tumor with an annual incidence of 2-8 cases per million people and for years has been studied its relationship with the hypoxic pathway. Case Report: A 29 year old male with a history of tetralogy of fallot corrected at 10 years and situs inversus totalis. He was admitted to hospital with a progressive story of four months of constipation, palpitations, headache, dyspnea and sweating. Physical examination revealed a thinned man with peripheral cyanosis, clubbing and signs of decompensated congestive heart failure as hepatomegaly, legs edema, multifocal systodiastolic murmurs, abdominal distension and jugular venous distention. The echocardiogram shows severe right ventricular dysfunction and severe pulmonary hypertension. Furthermore, abdominal computed tomography shows right adrenal mass. Elevated metanephrines and catecholamines confirmed the diagnosis of pheochromocytoma. Surgical removal is decided and preoperative management begins with alpha-adrenergic blockade, however the patient had a hemodynamic decompensation with an unfavorable evolution. Discussion: In conclusion, there are few reports of cyanotic congenital heart disease with pheochromocytoma. Several studies show a significant association between both of them due to chronic hypoxia leads sustained hyperresponsiveness in adrenal medulla and it would cause the tumor. Special preoperative management of pheochromocytoma is recommended when there underlying heart disease and congestive heart failure. We present the first international report of tetralogy of fallot and pheochromocytoma in a patient with situs inversus totalis.
Spontaneous spinal epidural hematoma management: a case series and literature review
Authors: Kyle Raasck, Ahmed A Habis, Ahmed Aoude, Leonardo Simões, Fernando Barros, Rudy Reindl, Peter Jarzem
Journal: Spinal Cord Ser Cases (2017)
Keywords: neurological disorders, neurological manifestations, neurosurgery, outcomes research, prognosis

Objective:
Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord and leading to acute neurological deficits. Standard therapy is decompressive laminectomy, although spontaneous recoveries have been reported. Sub-optimal therapeutic principles contribute to SSEH's 5.7% mortality-which patient will benefit from surgery remains unclear. This study aims to investigate parameters that affect SSEH's progression, outlining a best-practice therapeutic approach.
Materials and methods:
Literature review yielded 65 cases from 12 studies. Furthermore, 6 cases were presented from our institution. All data were analyzed under American Spinal Injury Association (ASIA) score guidelines.
Results:
Fifty percent of SSEH patients do not fully recover. In all, 30% of patients who presented with an ASIA score of A did not improve with surgery, although every SSEH patient who presented at C or D improved. Spontaneous recovery is rare-only 23% of patients were treated conservatively. Seventy-three percent of those made a full recovery, as opposed to the 48% improvement in patients managed surgically. Thirty-three percent of patients managed conservatively had an initial score of A or B, all improving to a score of D or E without surgery. Regardless, conservative management tends toward low-risk presentations. Patients managed conservatively were three times as likely to have an initial score of D than their surgically managed counterparts.
Discussion:
The degree of pre-operative neural deficit is a major prognostic factor. Conservative management has proven effective, although feasible only if spontaneous recovery is manifested. Decompressive laminectomy should continue to remain readily available, given the inverse correlation between operative interval and recovery.
Acute zonal occult outer retinopathy with atypical findings
Authors: Dimitrios Karagiannis, Georgios A Kontadakis, Artemios S Kandarakis, Nikolaos Markomichelakis, Ilias Georgalas, Efstratios A Parikakis, Stamatina A Kabanarou
Journal: Case Rep Med (2014)

Background. To report a case of acute zonal occult outer retinopathy (AZOOR) with atypical electrophysiology findings. Case Presentation. A 23-year-old-female presented with visual acuity deterioration in her right eye accompanied by photopsia bilaterally. Corrected distance visual acuity at presentation was 20/50 in the right eye and 20/20 in the left eye. Fundus examination was unremarkable. Visual field (VF) testing revealed a large scotoma. Pattern and full-field electroretinograms (PERG and ERG) revealed macular involvement associated with generalized retinal dysfunction. Electrooculogram (EOG) light rise and the Arden ratio were within normal limits bilaterally. The patient was diagnosed with AZOOR due to clinical findings, visual field defect, and ERG findings. Conclusion. This is a case of AZOOR with characteristic VF defects and clinical symptoms presenting with atypical EOG findings.
Severe Thrombocytopenia Caused by Vancomycin in the Intensive Care Unit: A Case Report
Authors: Xiao-Xiao Li, Guan-Ru Wang, Chao Li, Na He, Peng Yao, Yin-Chu Cheng, Chu-Hui Wang, Qing-Gang Ge, Min Yi, Zong-Yu Wang, Lu-Wen Shi, Rong-Sheng Zhao
Journal: Front Med (Lausanne) (2022)
Keywords: adverse drug reaction, case report, critically illness, thrombocytopenia, vancomycin
MeSH terms: Case Reports

Thrombocytopenia can cause substantial morbidity and mortality in critically ill patients. There are multiple etiology factors and various mechanisms associated with thrombocytopenia, of which drug-induced thrombocytopenia (DITP) deserves attention. Herein, we describe a case of severe thrombocytopenia during intensive care unit (ICU) hospitalization that was likely to be associated with vancomycin. By revealing the process of identifying this case of DITP and reviewing relevant clinical studies, a risk alert of vancomycin-related severe hematotoxicity should be considered.