OpenMed/multicare-articles huggingface dataset:
In situ thrombosis of small pulmonary arteries in pulmonary hypertension developing after chemotherapy for malignancy
Authors: Kay Maeda, Yoshikatsu Saiki, Shigeo Yamaki
Journal: Pulm Med (2015)
MeSH terms: Drug-Related Side Effects and Adverse Reactions / pathology, Hypertension, Pulmonary / pathology, Pulmonary Artery / pathology, Thrombosis / pathology, Case Reports, Child, Child, Preschool, Female, Humans, Hypertension, Pulmonary / chemically induced, Male, Middle Aged, Neoplasms / drug therapy, Thrombosis / chemically induced

A few reports have provided histopathological insight into pulmonary hypertension developing after antitumor chemotherapy. In general, plexogenic pulmonary arteriopathy is a commonly observed finding in patients with severe pulmonary hypertension. We herein report a novel pathological finding that may characterize the histopathological change occurring in patients with pulmonary hypertension after chemotherapy for malignancy. Lung biopsy or autopsy was performed in 7 patients with pulmonary hypertension that developed during or after chemotherapy between 2006 and 2013 to examine the pulmonary vascular changes or to determine the cause of death. Pathological findings included in situ thrombosis in the small pulmonary arteries in 4 of 7 patients. In 2 of 4 patients, pulmonary hypertension was controlled by anticoagulants and antithrombotic agents. One patient who had organized thrombi attained spontaneous remission with oxygen therapy. The other patient died of sudden cardiopulmonary arrest during chemotherapy. Autopsy showed complete occlusion of the peripheral small pulmonary arteries and veins by thrombi. These results demonstrate that in situ thrombosis in the small pulmonary arteries could cause pulmonary hypertension after chemotherapy.
Aortic Root Abscess with Aorta to Right Atrium Fistula due to Vancomycin-Intermediate Staphylococcus aureus (VISA)
Authors: Stephen J Hankinson, Elliot A Sultanik, Gautam V Ramani
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

We present a case of root abscess with aorta to right atrium fistula due to vancomycin-intermediate Staphylococcus aureus (VISA) after limb amputation and cardiac surgery. Patient underwent redo aortic valve replacement, patch repair of aorta to right atrial fistula, and tricuspid valve repair with a ring. Fistula formation is a rare complication of prosthetic valve endocarditis (PVE). This is the first case to discuss aortocavitary fistula (ACF) formation due to VISA. Transesophageal echocardiogram (TEE) is the preferred imaging modality to diagnose ACF.
A case report of multi-step management of extracranial carotid artery aneurysm and carotid-cavernous fistula combination in patients
Authors: Chingiz Nurimanov, Yerbol Makhambetov, Assylbek Kaliyev, Serik Akshulakov
Journal: Front Neurol (2023)
Keywords: aneurysm, case report, endovascular embolization, fistula, stenting
MeSH terms: Case Reports

Extracranial carotid artery aneurysms (ECAA) and carotid-cavernous fistulas (CCF) are rare arterial pathologies with severe complications and increased risk of mortality. The optimal treatment approach for this combined condition is a topic of debate among neurosurgeons and neuroradiologists, and a standardized treatment protocol has yet to be established. The aim of this case report was to demonstrate the management of a rare combination of ECAA and CCF in patients. The treatment strategy included a two-step procedure of endovascular embolization of CCF followed by dual antiplatelet therapy and endovascular stenting of an aneurysm. Control angiograms showed the exclusion of an aneurysm from the blood circulation and CCF symptoms were resolved.
COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan?
Authors: Bruno Lima Moreira, Pablo Rydz Pinheiro Santana, Gláucia Zanetti, Edson Marchiori
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Betacoronavirus, Pulmonary Embolism / diagnostic imaging, Pulmonary Embolism / virology, Case Reports, Acute Disease, Computed Tomography Angiography, Humans, Male, Middle Aged, Pulmonary Embolism / drug therapy, Rivaroxaban / therapeutic use, SARS-CoV-2, Rivaroxaban

The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary angiography that can objectively identify filling defects in pulmonary arterial branches.
A Case of Congenital Hypotonia and Developmental Delay in an Individual with a De Novo Variant Outside of the Canonical HX-Motif of ATN1
Authors: Elizaveta Makarova, Nicole R Legro, Ermal Aliu
Journal: Case Rep Genet (2023)
MeSH terms: Case Reports

We present a case of a 4-year-old female with a de novo heterozygous variant in the ATN1 gene. The whole exome sequencing was performed on the patient and her parents, and a likely pathogenic, de novo variant was identified in exon 5 of the ATN1 gene. There are two well-documented conditions associated with the ATN1 gene: congenital hypotonia, epilepsy, developmental delay, and digital anomalies (CHEDDA) syndrome and dentatorubral-pallidoluysian atrophy (DRPLA). Unlike DRPLA which is caused by an expanded trinucleotide repeat, CHEDDA syndrome is caused by variants in the histidine-rich (HX) motif at exon 7 of ATN1 similar to the de novo variant found in exon 5 of the presented individual. CHEDDA syndrome is a neurodevelopmental disorder previously documented in over 17 unrelated individuals. Compared to other documented CHEDDA syndrome cases, this individual shares similarities in respect to hypotonia, hearing impairment, impaired gross and fine motor ability, gastrointestinal abnormalities, hyperextensible joints, and frontal bossing. However, the individual presented here has only a moderate developmental delay and has acquired more developmental milestones such as higher-level language skills and more developed fine motor skills, than previously described individuals. The authors of this paper believe the patient's milder phenotype may be due to the variant's location outside of the canonic HX motif.
Comparing the epidemiology of community- and hospital-associated Clostridium difficile infections in Northern Ireland, 2012-2016: a population data linkage and case-case study
Authors: A Maisa, G Ross, N Q Verlander, D Fairley, D T Bradley, L Patterson
Journal: Epidemiol Infect (2019)
Keywords: clostridium difficile, community-associated infections, hospital-associated, ribotype, risk factors
MeSH terms: Clostridium Infections / epidemiology, Community-Acquired Infections / epidemiology, Cross Infection / epidemiology, Comparative Study, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Incidence, Male, Middle Aged, Northern Ireland / epidemiology, Risk Factors, Young Adult

The burden of community-associated Clostridium difficile infection (CA-CDI) has increased. We aimed to describe the epidemiology of CA-CDI to inform future interventions. We used population-based linked surveillance data from 2012 to 2016 to describe socio-demographic factors, ribotype and mortality for all CA (n = 1303) and hospital-associated (HA, n = 1356) CDI. For 483 community-onset (CO) CA-CDI and 287 COHA-CDI cases, a questionnaire on risk factors was completed and we conducted a case-case study using logistic regression models for univariate and multivariable analysis. CA-CDI cases had lower odds of being male (adjusted odds ratio (AOR) 0.71, 95% confidence interval (CI) 0.58-0.87; P &lt; 0.001), and higher odds of living in rural rather than urban settlement (AOR 1.5, 95% CI 1.1-2.1; P = 0.05) compared with HA-CDI cases. The distribution of ribotypes was similar in both groups with RT078 being most prevalent. CDI-specific death was lower in CA-CDI than HA-CDI (7% vs. 11%, P &lt; 0.001). COCA-CDI had lower odds of having had an outpatient appointment in the previous 4 weeks compared with COHA-CDI (AOR 0.61; 95% CI 0.41-0.9, P = 0.01) and lower odds of being in a care home or hospice when compared with their own home, than COHA-CDI (AOR 0.66; 95% CI 0.45-0.98 and AOR 0.35; 95% CI 0.13-0.92, P = 0.02). Exposure to gastric acid suppressants (50% in COCA-CDI and 55% in COHA-CDI) and antimicrobial therapy (18% in COCA-CDI and 20% in COHA-CDI) prior to CDI was similar. Our analysis of community-onset cases suggests that other risk factors for COHA-CDI may be equally important for COCA-CDI. Opportunities to safely reduce antibiotic and gastric acid suppressants use should be investigated in all healthcare settings.
Metal-Working Fluids Exposure and a Rare Frontoethmoid Lesion
Authors: Shayan Shahidi, Abdul Nassimizadeh, Ann Sandison, Shahzada Ahmed
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

This case report describes a unique nasal mass that was difficult to diagnose clinically and histologically. The patient was a middle-aged man employed as a metalworker, and he presented with a unilateral nasal obstruction and a mass arising from the right middle meatus. After a series of investigations, he underwent right-sided sphenoethmoidectomy with excision of a nasal lesion. The surgical specimen presented a major diagnostic challenge for the pathologists and clinicians involved. A series of discussions amongst two different head and neck expert teams combined with detailed clinicopathological correlation resulted in a diagnosis of a granulomatous lesion or pseudotumour related to the ingestion of water-soluble cutting oils, or "Suds oil," as they are more commonly called. Although occupational exposures to certain inhalants, such as wood dust and formaldehyde, are well-known risk factors for sinonasal lesions, here we present a rare association between a sinonasal lesion and another inhalant, Suds oil, that has not been previously reported in the literature.
Duodenal Diverticular Perforation after Small Bowel Obstruction: A Case Report
Authors: Khuram Khan, Saqib Saeed, Haytham Maria, Mohammed Sbeih, Farhana Iqbal, Alexius Ramcharan, Brian Donaldson
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Duodenal diverticulum is a rare disease that can be easily missed. The incidence of duodenal diverticulum diagnosed by upper GI study is approximately 5%. Autopsy results show that 22% of the population have duodenum diverticulum. Most patients with duodenal diverticulum are asymptomatic. However, complications like inflammation, perforation with retroperitoneal abscess, sepsis, pancreatitis, bile duct obstruction, and bleeding can occur. Approximately 162 cases of perforated duodenal diverticulum have been reported in the literature.
Case presentation:
We present a rare case of an 82-year-old female with perforation of a duodenal diverticulum caused by small bowel obstruction; in addition to this, there was a synchronous colonic tumor.
Conclusion:
Diagnosis and management of this rare disorder are controversial. Nonoperative management is advocated in some cases. Some of the cases require early aggressive surgical intervention. The mortality rate remains approximately 45% in all these patients.
Case report: An illusive cortical venous infarction mimicking glioma hemorrhage
Authors: Dayun Feng, Le Zou, Huaizhou Qin, Qing Cai
Journal: Front Neurosci (2022)
Keywords: computerized tomography, cortical vein infraction, cortical vein thrombosis, glioma hemorrhage, magnetic resonance venography
MeSH terms: Case Reports

Cortical vein thrombosis (CVT) is a rare subtype of cerebral venous thrombosis. Because CVT is rare and its clinical and imaging findings are atypical, the misdiagnosis of CVT may be extremely high. We report a case of cortical venous infarction (CVI) secondary to CVT. Due to the atypical symptoms, we were perplexed about confirming the diagnosis between CVI and glioma hemorrhage. Eventually, CVT was confirmed by pathology combined with imaging.
Association of an empty sella and grave´s disease in a patient with acromegaly: a case report
Authors: Imen Halloul, Asma Ben Abdelkerim, Ghada Saad, Ahlem Slim, Yosra Hasni, Wafa Ben Othman, Maha Kacem, Molka Chaieb, Amel Maaroufi, Koussay Ach
Journal: Pan Afr Med J (2021)
Keywords: acromegaly, case report, empty sella, grave´s disease, hyperthyroidism
MeSH terms: Acromegaly / diagnosis, Empty Sella Syndrome / diagnostic imaging, Graves Disease / diagnostic imaging, Growth Hormone-Secreting Pituitary Adenoma / diagnostic imaging, Case Reports, Antithyroid Agents / administration & dosage, Diabetes Mellitus / physiopathology, Female, Growth Hormone-Secreting Pituitary Adenoma / surgery, Humans, Hyperthyroidism / diagnosis, Hyperthyroidism / drug therapy, Insulin-Like Growth Factor I / metabolism, Magnetic Resonance Imaging, Middle Aged, Thyrotropin / metabolism, Antithyroid Agents, IGF1 protein, human, Insulin-Like Growth Factor I, Thyrotropin

Acromegaly is, in most cases, caused by growth hormone secreting pituitary adenomas. Those patients often develop different pathologies of the thyroid gland, however, the occurrence of Grave´s disease is quite a rare situation. We report a case of a 64-year-old female patient who presented with signs of hyperthyroidism and imbalance of her diabetes mellitus. On physical examination, she had facial features of acromegaly. Biochemical testing confirmed the suspicion of acromegaly and Grave´s disease, with an elevated insulin-like growth factor-1 and a suppressed thyroid stimulation hormone (TSH) with positive TSH-receptor antibodies. A pituitary Magnetic Resonance Imaging (MRI) was performed, revealing a macro-adenoma and an empty sella. The patient successfully underwent a transsphenoidal surgery and obtained a remission of her hyperthyroidism under anti-thyroid drugs.
A Case of an Advanced Chain of Survival in Penetrating Cardiac Injury
Authors: Mads Jønsson Andersen, Frank V De Paoli, Rikke Mærkedahl, Søren Vad Jepsen, Karoline Skov Dalgaard, Thomas Falstie, Gustav Gerstrøm
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

The survival rate of penetrating cardiac trauma is dismal, with only a few patients reaching the hospital with any signs of life. Short transport time and close proximity to the trauma center are positive factors for survival. We report the successful case of a 21-year-old male with penetrating cardiac injury and tension-pneumothorax with long distance to a trauma facility. The patient was stabbed twice in the anterior left side of the thorax. The emergency services found the patient with suspicion of left tension-pneumothorax. Urgent left mini-thoracotomy was established resulting in spontaneous respiration and clinical improvement. Due to rapid clinical deterioration and clinical suspicion of pericardial tamponade, patient was transported to the local regional hospital only minutes away. Echocardiography confirmed tamponade, and urgent ultrasound-guided pericardiocentesis was performed. During the transport blood was intermittently drained from the pericardial sack until arrival at the trauma center where a penetrating injury to the left ventricle was repaired during urgent cardiac surgery. The patient was discharged 8 days after the incident. Conclusion. Well organized emergency medical transport systems increase the chance of survival in penetrating cardiac injuries. Urgent pericardiocentesis with continuous drainage can help stabilize a patient until arrival at trauma facility.
Case Report: Prolonged clinical benefit with sequential trastuzumab-containing treatments in a patient with advanced extramammary Paget disease of the groin
Authors: Emma Zattarin, Federico Nichetti, Francesca Ligorio, Laura Mazzeo, Riccardo Lobefaro, Giovanni Fucà, Giorgia Peverelli, Andrea Vingiani, Giulia V Bianchi, Giuseppe Capri, Filippo de Braud, Claudio Vernieri
Journal: Front Oncol (2022)
Keywords: her2 overexpression, antiandrogen therapy, extramammary paget disease (empd), prolonged benefit, rare cancer, trastuzumab
MeSH terms: Case Reports

Extramammary Paget disease (EMPD) is a rare form of cutaneous, intraepithelial adenocarcinoma, which typically presents itself as an erythematous plaque originating from apocrine-gland rich regions, such as the vulva, the perianal region, the scrotum, the penis, or the axilla. EMPD patients typically have a good prognosis, with expected 5-year survival of 60%-92%, but it is estimated that about one-third of EMPD patients will develop lymph node or distant metastases. Treatment approaches for EMPD include locoregional therapies such as broad surgical resection, radiotherapy, or topical imiquimod, when the disease is localized, and chemotherapy and biological agents for advanced EMPD. We report the case of a 58-year-old man diagnosed with locally advanced, symptomatic HER2-overexpressing, AR-positive EMPD, who achieved long-term tumor control with a sequence of several trastuzumab-based treatments (more than 30 months with second-line carboplatin plus paclitaxel plus trastuzumab followed by trastuzumab maintenance; 9 months for third-line vinorelbine plus trastuzumab). Even if it is reported that AR expression occurs concomitantly with HER2 overexpression in more than half of the cases of EMPD, to the best of our knowledge, this is the first case report describing androgen receptor blockade therapy in combination with an anti-HER2 agent. Our patient did not benefit from androgen receptor blockade in combination with trastuzumab, thus suggesting that AR expression may simply reflect an intrinsic characteristic of the EMPD cell of origin, rather than tumor dependence upon AR signaling. Given the reported sensibility to anti-HER2 therapy, also new antibody drug conjugates targeting HER2 are worth exploring in the management of advanced EMPD.
Benign lymphoid hyperplasia of the tongue base causing upper airway obstruction
Authors: Noah B Sands, Marc Tewfik
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

Severe benign lymphoid hyperplasia (LH) is unusual in the head and neck region, but the diagnosis of LH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and pathologically. While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking.
Multifocal Multisystem Langerhans Cell Histiocytosis Involving Pituitary Masquerading as Crohn's Disease: A Case Report and Review of the Literature
Authors: Mohd Ashraf Ganie, Bhanu Malhotra, Manpreet Saini, Arshiya Dutta, Atul Sharma, Kim Vaiphie, Pinaki Dutta
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Background/Objective. We present a case of Langerhans cell histiocytosis (LCH) with gastrointestinal involvement masquerading as inflammatory bowel disease (IBD) in a patient who initially had features of central diabetes insipidus (CDI). Case Report. A 19-year-old male presented at 14 years of age with central diabetes insipidus. He subsequently developed panhypopituitarism and sellar-suprasellar mass, the biopsy of which was inconclusive. Secondary causes for hypophysitis were ruled out. Five years later, he developed perianal pus discharging sinuses, positive ASCA, and sacroiliitis. Rectal ulcer biopsy showed nonspecific inflammation and necrosis. Hence, he was managed as inflammatory bowel disease (IBD). Due to nonresponsiveness of symptoms, doubt about diagnosis was invoked and rectal ulcer biopsy was repeated, which then showed infiltration by Langerhans cells. Hence, he was diagnosed with LCH and showed resolution of symptoms on initiating steroids and vinblastine. Discussion. Gastrointestinal involvement by LCH is unusual and only rarely has represented a prominent clinical manifestation. In most cases, such involvement suggests widespread multisystem disease. Its distinctive morphologic and immunohistochemical features allow LCH to be distinguished from other inflammatory infiltrations found in mucosal biopsy specimens. Conclusion. Preceding CDI and hypopituitarism may predict LCH in patients with IBD-like diseases.
Spontaneous rupture of giant gastric stromal tumor into gastric lumen
Authors: Rajiv M Mehta, Vayoth O Sudheer, Anil K John, Raghavan R Nandakumar, Puneet S Dhar, Surendran Sudhindran, Vallath Balakrishnan
Journal: World J Surg Oncol (2005)

BACKGROUND: Gastrointestinal stromal tumors (GIST) constitute a large majority of mesenchymal tumors of the gastrointestinal (GI) tract, which express the c-kit proto-oncogene protein, a cell membrane receptor with tyrosine kinase activity. GI stromal tumors of the stomach are usually associated with bleeding, abdominal pain or a palpable mass. CASE PRESENTATION: A 75-year-old male presented with upper abdominal pain and palpable mass. Computed tomographic (CT) scan of the abdomen showed a large mass arising in the posterior aspect of fundus, body, and greater curvature of the stomach. Second day after the admission, there was significant reduction in the size of the tumor, clinically as well as radiologically. Endoscopic biopsy showed large bulge in fundus and corpus of the stomach posteriorly with an opening in the posterior part of the corpus, and biopsy from the edge of the opening reveled GIST. Patient underwent curative resection. CONCLUSION: Spontaneous ruptured of giant gastric stromal tumor is very rare presentation of stomach GIST. Thorough clinical examination and timely investigation can diagnose rare complication.
Vancomycin-Induced DRESS Syndrome: An Important Concern in Orthopedic Surgery
Authors: Emma Littlehales, Odhrán Murray, Robert Dunsmuir
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

DRESS (drug reaction with eosinophilia and systemic symptoms) is a potentially serious complication when prolonged courses of antibiotics are given to patients, with an average onset of 2-6 weeks after commencement. There is a high mortality rate (1-10%). We report the case of a 62-year-old male who developed DRESS after seven weeks of antibiotic treatment with vancomycin for a deep spinal metalwork infection. We describe the typical rash and biochemical results, including eosinophilia, as well as the systemic signs seen in this case. The criteria for diagnosis of DRESS, including the RegiSCAR scoring system and commonly affected systems (renal, cardiac, and hepatic), are detailed, and we also discuss evidence for steroid treatment and considerations important in the use of this.