OpenMed/multicare-articles huggingface dataset:
A Case of Dapsone-Induced Severe Agranulocytosis Causing Life-Threatening Skin Sepsis in a Sri Lankan Child with Borderline Leprosy: A Success Story!
Authors: Meranthi Fernando, Imalke Kankananarachchi, Pratheep Navabalasooriyar, Bhagya Herath, Pushpa Punchihewa
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Leprosy is a common skin disease in Sri Lanka which is being increasingly diagnosed due to the existing successful public health programme. Dapsone is a drug which holds unique pharmacological properties where it serves as both anti-inflammatory and antimicrobial agents. Of its main adverse effects, agranulocytosis is a serious consequence which is reported mainly in adults and elderly. We report a 7-year-old child who sustained life-threatening skin and subcutaneous tissue sepsis because of dapsone-induced agranulocytosis. Besides, this case highlights the importance of meticulous monitoring of cell counts due to the risk of neutropenia and the natural history of cell recovery following occurrence of neutropenia. Though high mortality rate has been described in most of the similar cases reported, the child we describe made a complete recovery following severe neutropenic sepsis.
Clinical Significance of Pain in Differential Diagnosis between Spinal Meningioma and Schwannoma
Authors: Dorota Olex-Zarychta
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

While common MRI characteristics for schwannomas exist, diagnosis by imaging alone remains challenging. Detailed analysis of symptoms reported by the patient is very important in the differential diagnosis between meningioma and schwannoma in cases where MRI images are not sufficient for determining the tumor type. The pain, its classification of the character, and the timing seem to be an important predictive symptom in the differential diagnosis of spinal schwannoma.
Leprosy in Denmark 1980-2010: a review of 15 cases
Authors: Huma Aftab, Susanne D Nielsen, Ib C Bygbjerg
Journal: BMC Res Notes (2016)
MeSH terms: Leprosy / epidemiology, Review, Adolescent, Adult, Aged, Child, Child, Preschool, Demography, Denmark / epidemiology, Female, Humans, Leprosy / pathology, Leprosy / therapy, Male, Middle Aged, Young Adult

Background:
Leprosy, caused by Mycobacterium leprae, is a chronic and progressive granulomatous disease affecting mainly the skin and the peripheral nervous system. If left unrecognized, the infection can lead to permanent nerve damage and disability. The clinical presentation depends on the immune response of the patient and can result in a wide spectrum of symptoms. Leprosy is a rare encounter in Scandinavia but remains endemic in some parts of the world, with some areas reporting an increasing incidence. We performed a retrospective record review of leprosy cases in Denmark from 1980 to 2010 with the purpose of presenting the most common geographical, demographic and clinical findings and to discuss the diagnostic and therapeutic challenges of patients with leprosy.
Case presentation:
In total 15 cases were reviewed. The majority (87%) of leprosy patients in Denmark were born in South- and Southeast Asia, and were presumed to have contracted the infection in their countries of origin. Patients were predominately young males (mean age: 28.6 years). Anaesthetic skin lesion with or without nerve enlargement were the most common clinical presentations (73%). Immunological leprosy reactions were seen in 40% of the cases. Diagnoses were based on clinical findings and skin biopsies. Treatment length varied but all patients received multidrug regimens.
Conclusion:
Leprosy should be kept in mind when encountering patients with suspicious skin lesions originating from leprosy endemic areas or with history of travel or work in the tropics. Due to the long incubation period with symptoms presenting long after immigration or return, clinicians often do not have the diagnosis in mind. The wide spectrum of symptoms and immunological reactions further complicates the diagnostic process. Treatment of leprosy and the complicated immunological reactions, which frequently accompanies the infection, should be performed in collaboration with a specialist.
An Exceptional Case of Ileocolic Intussusception Secondary to Burkitt's Lymphoma: What Variations Are There in the Presentation and Management of Those Patients Who Approach Adolescence?
Authors: Krish Kulendran, Kay Tai Choy, Cian Keogh, Dinesh Ratnapala
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Intussusception is a common cause of abdominal pain among the paediatric population with up to 10% of cases occurring secondary to a pathological lead point. Burkitt's lymphoma (BL) is a highly malignant and rapidly growing B-cell neoplasm which in extremely rare cases can present as intussusception. We report a case in an otherwise healthy 15-year-old male who presented with atypical abdominal pain. Imaging subsequently indicated an ileocolic intussusception, and given that the suspicion of a pathological lead point mandates a laparotomy and bowel resection, he proceeded to surgery. The histopathology confirmed Burkitt's lymphoma as the aetiology responsible for this intussuscepted mass. A detailed discussion including a systematic review of all previous case reports explore the diagnostic dilemma of intussusceptions secondary to BL. This case report aims to highlight the clinical challenges in establishing such a diagnosis and an appreciation for the subtle variations in clinical features, as well as the differences in management between infants and adolescents.
Photobiomodulation improves frontal lobe cognitive functions and mental health of older adults with non-amnestic mild cognitive impairment: Case studies
Authors: Mei-Chun Cheung, Tsz-Lok Lee, Sophia L Sze, Agnes S Chan
Journal: Front Psychol (2023)
Keywords: aging, frontal lobe cognitive functions, mental health, mild cognitive impairment, photobiomodulation

Introduction:
This study investigated the effects of transcranial photobiomodulation (tPBM) on improving the frontal lobe cognitive functions and mental health of older adults.
Methods:
Three older adults with mild cognitive impairment (MCI) of the non-amnestic type received 18-session tPBM stimulation for 9 weeks and were assessed with neuropsychological tests of memory and executive functions and standardized questionnaires on depressive and anxiety symptoms, global cognitive functions, and daily functioning abilities before and after tPBM stimulation.
Results:
At baseline, their intrusion and/or perseveration errors in a verbal memory test and a fluency test, as measures of the frontal lobe cognitive functions, were in the borderline to severely impaired range at baseline. After tPBM stimulation, the three older adults showed various levels of improvement in their frontal lobe cognitive functions. One older adult's intrusion and perseveration errors improved from the <1st-2nd percentile (moderately to severely impaired range) to the 41st-69th percentile (average range), another older adult's intrusion errors improved from the 11th percentile to the 83rd percentile, and the third older adult's intrusion errors improved from the 5th percentile to the 56th percentile. Moreover, improvements in their anxiety and/or depressive symptoms were also observed. One older adult's depressive and anxiety symptoms improved from the severe range at baseline to the mild range after the intervention. The other two older adults' depressive symptoms improved from the mild range at baseline to the normal range after the intervention.
Discussion:
These findings provide preliminary support for the potential of tPBM to improve the frontal lobe cognitive functions and mental health of older adults with MCI. Given the small sample size of only three older adults and the absence of a placebo control group, larger randomized controlled studies are needed to confirm its potential.
Cryptococcal Neoformans and Varicella Zoster Meningitis in a Patient With Selective Innate Immunodeficiency: A Case Report
Authors: Sophiya Karki, Kenneth P Byrd
Journal: Cureus (2023)
Keywords: cryptococcus meningitis, hypereosinophilia, hypereosinophilic syndrome, hypocomplementemia, immunodeficiency, immunosuppressed, nk-cell deficiency, varicella meningitis
MeSH terms: Case Reports

Cryptococcal neoformans (C. neoformans) and varicella-zoster (VZV) meningitis are opportunistic infections that are primarily seen in immunocompromised patients, including those with HIV, cancer, or receiving transplants. Despite treatment, infection in immunocompromised patients can be lethal, including those with T-cell dysfunction or deficiency. Whether innate immunodeficiencies also predispose to these infections remains less clear. Here, we report a case of disseminated C. neoformans and VZV meningitis in a young male with idiopathic hypereosinophilic syndrome and hypocomplementemia and no history of HIV infection, malignancy, or transplant. The patient presented with a pulsating headache, myalgia, joint pain, insomnia, night sweats, and subjective fever, along with clusters of vesicular lesions on his neck and back. A lumbar puncture and an MRI of the brain confirmed C. neoformans and VZV meningitis. Vesicular skin lesions proved to be VZV, and blood culture confirmed fungemia, suggesting disseminated disease. We investigated his medical history further to determine the underlying cause of his prior hypereosinophilia and current meningitis. The patient had idiopathic hypereosinophilia with high IgE levels, low complement levels, high rheumatoid factor levels, and an intermittent rash dating back two years, which had been treated intermittently with prednisone and hydroxyurea, with the most recent admission three weeks prior to this admission. Prior to admission, the patient had a peak absolute eosinophil count of 18.6 x103/uL. The patient was discharged on a daily dose of 60 mg of prednisone without hydroxyurea. In further evaluating his immune status, we found he was HIV-negative, with a normal CD4 count and high IgE. We also tested lymphocyte subsets and proliferation, which showed a low CD16/56 level, suggesting possibly reduced natural killer (NK) cell quantity. The patient responded well to acyclovir, amphotericin, and flucytosine therapy. After follow-up cerebrospinal fluid (CSF) and blood cultures were negative, the patient was discharged with fluconazole as maintenance therapy.
Occupational Silica Exposure and Pericarditis: An Uncommon Link
Authors: Aung Hein, Robert Willington, Yin Wai, Mahima Charan
Journal: Cureus (2023)
Keywords: echocardiography, granulomatosis with polyangiitis, pericarditis, silica exposure, vasculitis
MeSH terms: Case Reports

Granulomatosis with polyangiitis (GPA) is a multi-system necrotising vasculitis, particularly affecting small vessels. Upper respiratory tracts, lungs and kidneys are common target organs, while cardiac involvement would also be the first and rare manifestation of the disease. In GPA with cardiac involvement, structures such as the pericardium, myocardium, endocardium and conduction system could be involved. In the literature, there are reports of an association between autoimmune diseases and silica exposure. In our case, a 73-year-old sculptor with regular exposure to silica presented with pericarditis and was later diagnosed with granulomatosis with polyangiitis. This report provides additional evidence of an association between silica exposure and autoimmune vasculitis.
Case Report: Efficiency of Embolization Microcoils for the Repair of Brachiocephalic Vein Perforation During Hemodialysis Catheter Placement
Authors: Ying Hu, Fujia Gu, Ping Yuan, Min Shi, Liang Ma, Yan Zha, Ping Fu
Journal: Front Med (Lausanne) (2021)
Keywords: brachiocephalic vein perforation, case report, chest repairing, embolization micro coils, hemodialysis cuff catheter
MeSH terms: Case Reports

Background: The cuff catheter is one of the most common routes of vascular access in hemodialysis patients, while severe complications can occur during cuff catheter placement, such as bleeding, hematoma, and artery or vein damage. During catheterization, brachiocephalic vein perforation associated with a mediastinal lesion is rare. Open chest repair is effective for brachiocephalic vein perforation during catheter placement, but it entails a risk of potentially lethal trauma. Interventional treatment can be considered to reduce injury in this context, but relevant reports are limited. Case report: Herein, we describe our experience with a 68-year-old male hemodialyzed patient in whom cuff catheter vascular access was required for regular hemodialysis. He complained of mild pain in the left side of his chest during cuff catheter placement. The surgeon immediately checked the location of the catheter. Digital subtraction angiography revealed that the hemodialysis cuff catheter had punctured the mediastinal area from the left brachiocephalic vein. The patient was diagnosed with left brachiocephalic vein perforation (d ≈ 5 mm). Fortunately, the brachiocephalic vein perforation was successfully repaired with two embolization microcoils after comprehensive assessment and multidisciplinary consultation. Conclusion: Brachiocephalic vein perforation can be repaired with embolization microcoils during hemodialysis catheter placement, and this method of interventional treatment is safe and effective.
Prenatal diagnosis of a de novo interstitial deletion of 11q (11q22.3 → q23.3) associated with abnormal ultrasound findings by array comparative genomic hybridization
Authors: Nian Liu, Jiong Yan, Xinlin Chen, Jieping Song, Bo Wang, Yanyi Yao
Journal: Mol Cytogenet (2014)
Keywords: array cgh, chromosome 11q deletion, fra11b, fra11g, fragile sites, g-band karyotyping
MeSH terms: Case Reports

Background:
Conventional G-band karyotyping offers low-resolution detection of chromosome abnormalities and cannot provide information about the involved genomic content. On the other hand, array comparative genomic hybridization can offer a rapid and comprehensive detection of genomewide gains and losses with higher resolution, thus providing the genetic basis for prenatal diagnosis of fetal abnormalities.
Case presentation:
A 35-year-old primigravid underwent cordocentesis at 28 weeks gestation due to the presence of polyhydramnios, intrauterine growth retardation, persistent right umbilical vein and mild stenosis of aortic arch at the ultrasound scan. Conventional G-band chromosome analysis revealed an apparently normal karyotype whereas the array CGH detected a de novo 8.97 Mb deletion at chromosome 11q22.3 → q23.3 and offered a precise characterization of the genetic defect.
Conclusions:
The array CGH detected a de novo interstitial 11q deletion with its precise location and size which could be missed or confused by G-band chromosome analysis. The breakpoint was close to the folate sensitive rare fragile site FRA11B and the aphidicolin inducible common fragile site FRA11G, the co-localization fragile site could have caused instability and constitutional chromosomal breakage. This case study indicates that array CGH is a useful technique for detecting small unbalanced chromosomal abnormalities and should be an integral part of prenatal diagnosis for fetal malformations.
Successful Liposteroid Therapy for a Recurrent Idiopathic Pulmonary Hemosiderosis with Down Syndrome
Authors: Hiromi Tobai, Jun Yano, Norio Sato, Fumitaka Amanuma, Mikio Takahashi, Mikiya Endo, Masataka Ishimura, Shouichi Ohga, Hidekazu Maruyama
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Idiopathic pulmonary hemosiderosis (IPH) is a rare and life-threatening disorder. Early diagnosis and appropriate management are essential for their better prognosis and patients' quality of life (QOL). It is considered that Down syndrome patients with IPH have a worse prognosis compared to other IPH cases. A 2-year-old girl with Down syndrome received the diagnosis of IPH after two episodes of massive pulmonary hemorrhage requiring assist ventilation, who suffered from recurrent IPH during tapering period of oral corticosteroid, started liposteroid therapy. We report here a case of successful control of recurrent IPH and improved QOL enormously with tapering dose of corticosteroid after starting liposteroid therapy.
Cutaneous tuberculosis: An infrequent manifestation of a common pathogen in South Africa
Authors: Jennifer K van Heerden, Alistair G B Broadhurst, Ruan S de Jager, Wesley du Plessis, Nabilah Ebrahim, Ayanda T Mnguni, Denzil Schietekat, Graeme Meintjes
Journal: S Afr J Infect Dis (2023)
Keywords: hiv, south africa, tb, cutaneous tuberculosis, human immunodeficiency virus, tuberculosis
MeSH terms: Case Reports

Cutaneous tuberculosis is an infrequent form of extra-pulmonary tuberculosis, even in high-prevalence settings. We present the case of a patient living with advanced HIV who developed extensive cutaneous tuberculosis. The polymorphic skin lesions were the most striking clinical manifestation of underlying disseminated tuberculosis.
Contribution:
This case report highlights an unusual presentation of tuberculosis. Cutaneous tuberculosis has a wide spectrum of clinical presentations and may be under-recognised by clinicians. We recommend early biopsy for microbiological diagnosis.
Garre's Osteomyelitis of the Mandible Caused by Infected Tooth
Authors: Hayati Murat Akgül, Fatma Çağlayan, Sevcihan Günen Yılmaz, Gözde Derindağ
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Aim:
Garre's osteomyelitis is a local thickening of the periosteum caused by a slight irritation or infection. We aimed to present the extraoral, intraoral, and radiographic findings and postoperative pursuits of two patients diagnosed with Garre's osteomyelitis. In this case report, although clinical findings indicate infection source, these clinical findings are strongly supported by cone-beam computed tomography images. In addition, it can be seen that when we have followed the case I, we have chosen the right path in treatment.
Case reports:
Two patients presented to our clinic due to severe swelling and facial asymmetry in the right and left mandibular region. As a result of the clinical and radiological examinations, the patients were diagnosed with Garre's osteomyelitis. Infected teeth that were responsible for the formation of Garre's osteomyelitis were extracted under antibiotic treatment in both cases. A complete improvement in postoperative control was observed in case I. On the other hand, the other case could not be followed up postoperatively.
Conclusion:
In Garre's osteomyelitis, new bone formation can occur in many pathological conditions. Therefore, it should be distinguished from other pathologies that cause new bone formation, such as Ewing's sarcoma, Caffey disease, and fibrous dysplasia.
Endoscopic papillary large balloon dilatation-assisted retrieval of a proximally migrated double pigtail stent from the bile duct: A case report
Authors: Hidehiro Kamezaki, Hiroshi Yoshikawa, Terunao Iwanaga, Mamoru Tokunaga, Takahiro Maeda, Junichi Senoo, Hiroshi Ohyama, Naoya Kato
Journal: DEN Open (2023)
Keywords: choledocholithiasis, endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, stent migration, stents
MeSH terms: Case Reports

Double-pigtail stents are commonly used for drainage in cholangitis to prevent stent migration. We report a case in which a double pigtail stent had migrated proximally into the bile duct and was successfully retrieved after endoscopic papillary large balloon dilatation (EPLBD). An 86-year-old man underwent endoscopic papillary sphincterotomy for cholangitis due to common bile duct stones and had a double-pigtail stent placed in the common bile duct. The patient presented a week later for endoscopic biliary stone removal, but the stent had migrated proximally and could not be visualized during the endoscopy. Endoscopic papillary large balloon dilatation was performed to dilate the papilla to a diameter of 12 mm, following which the stent was grasped and removed. The biliary calculi were subsequently extracted, and the procedure was completed without any complications. This case highlights the potential usefulness of endoscopic papillary large balloon dilatation for retrieving a double-pigtail stent that has migrated to the bile duct.
Anesthesia for suboccipital craniotomy in a patient with lymphangioleiomyomatosis: a case report
Authors: Robert A Peterfreund, Emily Luman, Robert L Martuza
Journal: Case Rep Pulmonol (2012)

Lymphangioleiomyomatosis (LAM) is a rare pulmonary condition often presenting with spontaneous pneumothorax. Imaging or biopsy confirm the diagnosis. Published case reports describe the anesthetic management of patients with LAM undergoing brief procedures. No reports describe the anesthetic management for lengthy neurosurgical procedures. We describe anesthetic management for craniotomy in a patient with LAM. Clinical Features. A woman presented with 2 spontaneous left pneumothoraces. She received a diagnosis of LAM by imaging. She did well after pleurodesis. Hearing loss and tinnitus led to brain imaging demonstrating a large left cerebello-pontine angle mass. She presented for elective craniotomy to remove the mass while preserving cranial nerve function. Our technique for general endotracheal anesthesia aimed to reduce the likelihood of another pneumothorax while providing good surgical conditions and permitting neuromonitoring. Conclusion. We demonstrate the successful anesthetic management of a patient with LAM undergoing a lengthy suboccipital craniotomy for a posterior fossa mass.
Eight-and-a-half syndrome: a rare potentially life-threatening disease
Authors: Bryan Vincent Q Mesina, George Michael N Sosuan, Karen B Reyes
Journal: GMS Ophthalmol Cases (2018)
Keywords: cavernoma, eight-and-a-half syndrome, neuro-ophthalmology
MeSH terms: Case Reports

Purpose: To report a case of eight-and-a-half syndrome presenting with a conjugate horizontal gaze palsy, an ipsilateral internuclear ophthalmoplegia, and an ipsilateral lower motor neuron-like facial palsy. Methods: A 56-year-old male who came in for limitation of extraocular muscle motion - wherein the only remaining movement is abduction of the left eye - and right-sided facial weakness. Magnetic resonance imaging revealed a well-defined lesion resembling a cavernoma, at the level of the ponto-medullary junction. Results: Eight-and-a-half syndrome results from a lesion affecting the paramedian pontine reticular formation, the median longitudinal fasciculus, and the facial nerve fascicle on one side. In this case, a cavernoma at the level of the ponto-medullary junction was compressing the important pontine structures. Conclusion: Although eight-and-a-half syndrome is most commonly caused by an infarction or demyelination, in rare instances, a space-occupying lesion at the level of the pons can be the etiology. It is of utmost importance to recognize the features of this disease entity to be able to exhaust the proper diagnostic exams, localize the lesion and determine the proper treatment regimen catered to each patient.