OpenMed/multicare-articles huggingface dataset:
Pre-surgical Nasal Molding of a Two-Day-Old Neonate With Complete Unilateral Cleft Lip and Palate Using Passive Nasoalveolar Molding Technique: A Case Report
Authors: Abhijeet Jaiswal, Virat Galhotra, Saraa Angel L, Rhea Gandham
Journal: Cureus (2024)
Keywords: cleft lip & palate, passive molding, presurgical infant orthopedics, presurgical nasoalveolar moulding, unilateral cleft lip
MeSH terms: Case Reports

The occurrence of congenital deformities like cleft lip and palate is not uncommon and is often a traumatizing experience for families. The entire rehabilitation process includes frequent hospital visits and the brunt of numerous procedures. Early intervention with pre-surgical infant orthopedics facilitates better surgical outcomes and additional psychosocial benefits to the infant's family. The present clinical report addresses the pre-surgical management of a non-syndromic two-day-old female baby whose parents presented with the chief complaint of deformed lips, nose, and difficulty while feeding. The neonate had a complete left-sided cleft lip, alveolus, and cleft palate on examination. Early management with pre-surgical passive nasoalveolar molding (PNAM) has favorable outcomes, including desired upper lip, alveolus, and nose shape. Non-invasive pre-surgical intervention with PNAM reduces the severity of the deformities before the primary surgical repair, thus decreasing the overall cost of cleft care and the number of secondary revisions, thus increasing the probability of favorable outcomes.
Concomitant Administration of Vancomycin with a High Dose of Meropenem May Cause Acute Kidney Injury
Authors: Yoshiro Sakai, Seiji Karakawa, Takato Koutaki, Kyoko Higuchi, Aya Hashimoto, Hiroshi Watanabe
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

Coadministering two different classes of antibiotics as empirical therapy can be critical in treating healthcare-associated infections in hospitals. Herein, we report a case of acute kidney injury (AKI) caused by coadministration of vancomycin with high-dose meropenem that manifested as a rapid increase in serum creatinine levels and an associated increase in vancomycin trough concentrations. The patient was diagnosed with meningioma at 50 years and was followed up regularly. The patient underwent surgery and antibiotic treatment between 63 and 66 years for suspected meningitis and pneumonia. Coadministration of vancomycin with high-dose meropenem (6.0 g/day) caused AKI; however, no AKI occurred when vancomycin was administered alone or with a low dose of meropenem (1.5 or 3.0 g/day). To our knowledge, this report is the first to show that administering different dosages of meropenem in combination with vancomycin may contribute to the risk of developing AKI. We suggest that coadministered vancomycin and high-dose meropenem (6.0 g/day) may increase the risk of AKI. Our report adds to the limited literature documenting the coadministration of vancomycin with varying doses of meropenem and its impact on the risk of AKI and highlights the importance of investigating AKI risk in response to varying dosages of meropenem when it is coadministered with vancomycin.
A Case of Autoimmune Neutropenia in a Patient Undergoing Breast Cancer Surgery
Authors: Mio Adachi, Goshi Oda, Masatake Hara, Yuichi Kumaki, Tomoyuki Fujioka, Toshiyuki Ishiba, Ukihide Tateishi
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

Autoimmune neutropenia (AIN) is an extremely rare condition, and there is no effective treatment option for this disorder. AIN can cause major complications in patients with perioperative infection. Herein, we present a 56-year-old female patient who was scheduled for breast cancer surgery. However, she was unexpectedly diagnosed with AIN. Thus, the surgery was postponed, and endocrine therapy was started. After 7 months of treatment, the surgery was performed. Granulocyte colony-stimulating factor was administered before the surgery, but the patient's neutrophil count did not increase. Thus, levofloxacin was administered during the surgery. The patient had fever (38.6°C) 1 day after the surgery. Her surgical wound did not present with redness, and there were no other signs of infection. The fever subsided on the second day after the surgery. Nevertheless, antibiotics were administered for 5 days. The patient was discharged on the sixth day after the surgery.
Case report: Treatment of psoriasiform dermatitis in patients with malignancy
Authors: Jinzhu Mao, Na Du, Yuanyuan Jia, Qiuyu Mao, Jingyi Yang, Yiwen Zhang, Yueyue Li, Lei Cao, Wei Min
Journal: Front Med (Lausanne) (2024)
Keywords: janus kinase inhibitor, pde-4 inhibitor, abrocitinib, apremilast, psoriasiform dermatitis
MeSH terms: Case Reports

Psoriasis and atopic dermatitis (AD) are prevalent inflammatory skin disorders, each stemming from diverse factors, and characterized by recurring episodes. In certain complex cases, the clinical and pathological features exhibit overlapping and atypical characteristics, making accurate clinical diagnosis and targeted treatment a challenge. Psoriasiform dermatitis is the term used to describe such cases. Moreover, when patients have a history of malignancy, the situation becomes even more intricate, resulting in limited treatment options. Biologic therapies have transformed the management of immune-mediated inflammatory diseases, including psoriasis and AD. Meanwhile, the safety of biologics in special populations, especially among patients with a history of malignancy, should be underlined. The selective Janus kinase 1 (JAK1) inhibitor abrocitinib has been approved for the treatment of AD and has showed satisfying efficacy and safety in the treatment of psoriasis in clinical trials. Although unreported, JAK1 inhibitors are thought to have the potential to increase the risk of potential tumors. Apremilast, an oral phosphodiesterase (PDE)-4 inhibitor, is approved for moderate to severe plaque psoriasis. It has been investigated for its efficacy in AD, and is not contraindicated in malignancy. This report presents three cases of psoriasiform dermatitis in patients with a history of malignancy, showcasing significant improvement following treatment with systemic glucocorticoid, abrocitinib, or apremilast.
Rapidly Progressive Apical Hypertrophic Cardiomyopathy: Not Everything is What It Seems
Authors: Ahmed K Mahmoud, Juan M Farina, Kamal Awad, Milagros Pereyra, Isabel G Scalia, Mohammed Tiseer Abbas, Timothy Barry, Said Alsidawi, Chadi Ayoub, Reza Arsanjani
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: cardiomyopathy, dyspnea, electrocardiography, physical exertion, syncope
MeSH terms: Cardiomyopathy, Hypertrophic / diagnosis, Cardiomyopathy, Hypertrophic / diagnostic imaging, Cardiomyopathy, Hypertrophic / physiopathology, Disease Progression, Electrocardiography, Case Reports, Adult, Apical Hypertrophic Cardiomyopathy, Female, Humans, Magnetic Resonance Imaging, Magnetic Resonance Imaging, Cine, Predictive Value of Tests

Apical hypertrophic cardiomyopathy (HCM) is a rare variant of HCM. A 43-year-old female with a past medical history significant for hypertension and kidney transplantation presented with recurrent syncopal episodes and dyspnea on exertion. Electrocardiogram showed characteristic diffuse giant T-waves inversion, and cardiac magnetic resonance showed HCM with circumferential apical thickening. This case highlights the rapid development of apical HCM and its challenging diagnostic characteristics.
Implicit Bias and Patient Care: Mitigating Bias, Preventing Harm
Authors: Hannah Barber Doucet, Taneisha Wilson, Lauren Vrablik, Robyn Wing
Journal: MedEdPORTAL (2023)
Keywords: anti-racism, diversity, emergency medicine, equity, health equity, implicit bias, inclusion, nonaccidental trauma, pediatric emergency medicine, simulation
MeSH terms: Bias, Implicit, Emergency Medicine, Case Reports, Bias, Child, Computer Simulation, Consultants, Humans

Introduction:
Simulation is a valuable and novel tool in the expanding approach to racism and bias education for medical practitioners. We present a simulation case focused on identifying and addressing the implicit bias of a consultant to teach bias mitigation skills and limit harm to patients and families.
Methods:
Learners were presented with a case of a classic toddler's fracture in an African American child. The learners interacted with an orthopedic resident who insisted on child welfare involvement, with nonspecific and increasingly biased concerns about the child/family. The learners were expected to identify that this case was not concerning for nonaccidental trauma and that the orthopedic resident was demonstrating bias. They were expected to communicate with both the resident and the parent effectively to defuse the situation and prevent harm from reaching the family. A debrief and an anonymous survey followed the case.
Results:
Seventy-five learners participated, including pediatric and emergency medicine residents, fellows, attendings, and medical students. After the case, the majority of learners expressed confidence that they could recognize racial bias in the care of a patient (90%), ensure patient care was not influenced by racial bias (88%), and utilize a tool to frame a concern about bias (79%).
Discussion:
Participants felt that this simulation was relevant and effective and overall left the experience feeling confident in their abilities to identify and manage racially biased patient care. This anti-racist simulation offers an important skill-building opportunity that has been well received by learners.
Chronic kidney disease with malignant peripheral nerve sheath tumor of the ureter: a case report
Authors: Xinyang Yin, Xiaodong Wang, Zhenlin He, Xiaolong Chen, Qing Wang, Kehua Jiang
Journal: Front Oncol (2024)
Keywords: mpnsts, nf1, case report, chemotherapy, chronic kidney disease, malignant tumors
MeSH terms: Case Reports

Malignant peripheral nerve sheath tumors (MPNSTs) are a complex group of malignant tumors originating from nerve cells or benign peripheral nerve sheath tumors and are commonly found in major plexus/nerve root sites such as the limbs, head, and neck. Malignant peripheral nerve sheath tumors originating in the ureter are extremely rare. Herein, we report the case of a 63-year-old patient with a malignant peripheral nerve sheath tumor of the right ureter who underwent laparoscopic radical resection of the right kidney and ureter. The patient also had stage 5 chronic kidney disease (CKD). Therefore, chemotherapy and radiotherapy were not considered. No tumor recurrence was observed during the follow-up period.
Concurrent squamous cell carcinoma and non-hodgkin lymphoma: a rare case report and multidisciplinary approach
Authors: Abdulwahid Salih, Ari Abdullh, Hiwa Baba, Aras Qaradaqhy, Rebaz Ali, Rebaz Mohammed, Aso Muhialdeen, Hardi Dhahir, Yadgar Saeed, Fahmi Kakamand
Journal: Case Reports Plast Surg Hand Surg (2024)
Keywords: skin malignancy, non-hodgkin lymphoma, squamous cell carcinoma, surgical resection
MeSH terms: Case Reports

Introduction:
Squamous cell carcinoma (SCC) is a skin malignancy typically treated with surgical resection. Non-Hodgkin lymphoma (NHL) is a group of lymphoid tissue malignancies treated with various strategies, including chemotherapy and radiotherapy.
Case presentation:
A 64-year-old male with prior SCC presented with a new scalp lesion. Examination revealed an elevated, irregular, non-tender lesion with mild yellow discoloration. Imaging showed a scalp lesion, cervical lymphadenopathies, and a well-defined mass. Ultrasonography uncovered lymph node involvement and splenomegaly. Fine needle aspiration, biopsy, and immune stains of the lymph node confirmed NHL. Wide local excision of the scalp lesion, reconstruction, and lymph node biopsies were performed, confirming SCC and NHL. The patient received radiotherapy and chemotherapy.
Conclusion:
This unique rare case emphasizes the complex interplay of SCC and NHL, necessitating vigilant SCC patient follow-up.
Metachronous Squamous Cell Carcinomas of the Uterine Cervix and Lung: True Metachrony or Metastasis
Authors: Pavel Pavlov, Ivan Galev, Helia Bojilova, George S Stoyanov
Journal: Cureus (2024)
Keywords: cervical carcinoma, human papillomavirus, metachronous tumors, metastasis, pulmonary carcinoma, squamous cell carcinoma
MeSH terms: Case Reports

Human papillomaviruses (HPV) are a big group of infection agents with oncogenic potential, especially regarding squamous epithelium. Some high-risk variants are key in the development of squamous cell carcinomas (SCC) across multiple systems, the most affected of which is the female reproductive system, but also parts of the gastrointestinal tract, head, and neck SCC, and cutaneous and pulmonary (bronchogenic) SCCs. In cases where a patient develops two SCCs in different systems, often the main question is whether these tumors are synchronous, metachronous, or if one of the tumors is a metastasis from the other, with HPV testing and stereotype identification often being of aid in differentiating between these. Herein, we report the case of a female patient in her 50s, initially diagnosed with SCC of the uterine cervix. The patient remained stable for three calendar years after completing preoperative radiotherapy, surgical resection, and postoperative chemo-radiotherapy. At that point, she developed respiratory symptoms, and radiography suggested a pulmonary malignancy. After undergoing surgical resection of the pulmonary lesion, histological specimens were initially interpreted to be a metachronous pulmonary SCC. Immunohistochemical testing proved that both the cervical and pulmonary lesions were HPV-associated, with further testing proving that both lesions were associated with high-risk HPV (genotype 16). Based on the clinical history and aggregated data, the pulmonary lesion was interpreted as a metastatic and not a metachronous one, and the patient is currently undergoing treatment for metastatic disease.
New-onset egg allergy in an adult: A case report
Authors: Michimasa Fujiwara, Takashi Kimura, Junya Ohira, Motohiro Inotani, Tomoko Sakane, Mizue Iwase, Sadanori Yamashita, Tooru Araki
Journal: Front Allergy (2024)
Keywords: gal d 2, adult-onset, case report, egg allergy, ovalbumin
MeSH terms: Case Reports

Most adult cases of hen's egg allergy are carried over from childhood, and new-onset adult cases are rare. Such cases may result from cross-reactivity or sensitization by inhalation. Here we present a rare case of adult-onset egg allergy due to monosensitization to ovalbumin (Gal d 2) with an unclear sensitization pathway. A 27-year-old woman developed recurrent gastrointestinal symptoms after ingestion of raw and under-cooked eggs. She had never suffered from atopic dermatitis or food allergies. She had never kept birds as pets and had no history of exposure to egg allergens. Prick to prick testing was positive only with raw egg white. Specific IgE testing revealed monosensitization to Gal d 2. She was advised to avoid raw and undercooked eggs and her symptoms resolved. In the management of adult-onset egg allergy, evaluation of allergen components will lead to appropriate elimination guidelines, and investigation of sensitization pathways may help identify the cause of this disease.
Case report: MRI-negative myelitis following COVID-19 with SEP abnormalities: a case series and literature review
Authors: Kentaro Kawama, Rui Shimazaki, Yoko Sunami, Natsuki Miyakoshi, Shinsuke Tobisawa, Toshio Shimizu, Kazushi Takahashi
Journal: Front Neurol (2023)
Keywords: covid-19, mri, seps, microglia, myelitis
MeSH terms: Case Reports

Coronavirus Disease 2019 (COVID-19) is known to have various, neurological manifestations. We herein report three patients with MRI-negative myelitis following COVID-19 with abnormal somatosensory evoked potentials (SEPs). Decreased amplitude of the cortical potential and prolonged latency in the SEPs contributed to diagnosing myelitis in the present patients. The SEP findings improved as the neurological symptoms improved. Despite a delay in initiating immunosuppressive treatment after myelitis onset, all the patients improved clinically. In the light of recent progress in COVID-19 research, several hypotheses can be made to explain the pathophysiology underlying MRI-negative myelitis, including antibody-binding and microglial synapse elimination.
Small-Cell Carcinoma of the Gall Bladder: A Rare Tumor of the Gall Bladder
Authors: Anuradha S Dnyanmote, Kuldip Patil, Vidita Modi, Rushi Kanani
Journal: Cureus (2024)
Keywords: chemotherapy, cholecystectomy, neuroendocrine tumours, resection, small-cell carcinoma
MeSH terms: Case Reports

Small-cell carcinoma (SCC) of the gallbladder is a rare and distinctive clinicopathological entity, characterized by its aggressive nature with early metastasis and a poor prognosis. We present a rare case of a 53-year-old female who came with a perforated gall bladder and was later diagnosed with SCC. This report details how the patient was managed preoperatively, intraoperatively, and postoperatively. The patient is under follow-up and has survived so far with subsequent chemotherapy.
Plasma exchange treatment of a diabetic ketoacidosis child with hyperlipidemia to avoid pancreatitis: a case report
Authors: Shuyue Huang, Fuying Song, Kang Gao, Yi Song, Xiaobo Chen
Journal: Front Pediatr (2024)
Keywords: diabetes ketoacidosis, pancreatitis, therapeutic intervention, triglycerides, type 1 diabetes mellitus
MeSH terms: Case Reports

Type 1 diabetes mellitus (T1DM) is a metabolic disorder characterized by an absolute deficiency of insulin due to pancreatic failure. Diabetes ketoacidosis (DKA) has emerged as one of the most common complications of T1DM. Although exceedingly rare, the onset of T1DM with DKA may result in lipemia secondary to severe hypertriglyceridemia (HTG), accounting for several cases in the pediatric population. Along this line, plasma exchange treatment in children with DKA and severe hyperlipidemia has only been reported in some cases. In this case report, the diagnosis of an 11-year-old girl with diabetes ketoacidosis accompanied by severe HTG, along with subsequent plasma exchange treatment, is presented. Initially, the patient received initial management with crystalloid fluid bolus and intravenous insulin therapy. Despite rapid correction of acidosis, persistent HTG subsequently prompted the plasma exchange treatment. A total of three sessions were administered over 2 days, leading to a significant reduction in the triglyceride levels and corneal opacity resolution, indicating a successful therapeutic intervention.
Fever, convulsions, and rash: a case report of neonatal lupus erythematosus with macrophage activation syndrome
Authors: Jing Yu, Guohui Xue, Xiaohui Liu, Chunlei Zhan, Jinshi Huang
Journal: Front Pediatr (2024)
Keywords: fever, macrophage activation syndrome, neonatal lupus, rash, treatment
MeSH terms: Case Reports

Neonatal lupus erythematosus (NLE) is a rare acquired autoimmune disease associated with the entry of maternal antibodies into the fetal circulation via the placenta during pregnancy. Macrophage activation syndrome (MAS) is a severe hyperinflammatory disease. Herein, we present a case of NLE with MAS accompanied by fever, convulsions, and rash. High-dose gamma globulin and non-shock doses of steroids can be used as a first-line treatment for NLE with MAS. Fever can be a clinical manifestation of NLE, especially cutaneous lupus. Rash recession could be used to judge whether the disease is effectively controlled by treatment.
A Case of Painful Growing Abdominal Wall Mass during Pregnancy Requiring Resection in the Second Trimester
Authors: Shlomo M Stemmer, Cintia Gomes, Elyce H Cardonick
Journal: Case Rep Obstet Gynecol (2024)
MeSH terms: Case Reports

Desmoid fibromatosis (DF) is a rare and locally aggressive neoplasm. We present a case of a 28-year-old previously healthy multigravida who noticed a lump in her abdomen near the umbilicus two months before becoming pregnant. It underwent rapid growth during pregnancy, causing pain and discomfort. Targeted ultrasound of the area showed an irregular mass measuring 0.9 × 1.7 × 1.4 cm. The origin of the mass was unclear, suggesting a connection with the intra-abdominal contents. An MRI done three weeks later revealed a subcutaneous ovoid mass measuring 3.0 × 2.3 × 3.0 cm, which was significantly larger. Due to pain and rapid growth, surgical resection was done at 25 weeks of pregnancy. Histopathological examination revealed a desmoid tumor. The patient had an uneventful recovery and term vaginal delivery without complications. Hence, our case serves as evidence that DF tumors can be surgically managed during pregnancy with minimal to no complications.
Case Report: Invasive fungal infection after anti-CD19 CAR-T cell therapy. Implication for antifungal prophylaxis
Authors: Elsa Pennese, Prassede Salutari, Luigi Carriero, Francesco Restuccia, Antonio Fabio De Filippis, Giulia De Luca, Raffaella Giancola, Francesco Guardalupi, Giulia Corradi, Bianca Fabi, Stefano Baldoni, Mauro Di Ianni
Journal: Front Immunol (2023)
Keywords: car-t cell therapy, antifungal prophylaxis, case report, immunotherapy, invasive aspergillosis
MeSH terms: Invasive Fungal Infections / drug therapy, Invasive Fungal Infections / etiology, Invasive Fungal Infections / prevention & control, Receptors, Chimeric Antigen, Case Reports, Research Support, Non-U.S. Gov't, Antifungal Agents / therapeutic use, Antigens, CD19 / therapeutic use, Cell- and Tissue-Based Therapy, Humans, Middle Aged, Neoplasm Recurrence, Local / drug therapy, Receptors, Chimeric Antigen, Antifungal Agents, Antigens, CD19

CAR-T therapy has revolutionized the treatment of relapsed/refractory B-cell malignancies. Patients who are receiving such therapy are susceptible to an increased incidence of infections due to post-treatment immunosuppression. The need for antifungal prophylaxis during the period of neutropenia remains to be determined. The clinical outcome of a 55-year-old patient with relapsed/refractory DLBCL who received axicabtagene ciloleucel is described here. The patient developed CRS grade II and ICANS grade IV requiring tocilizumab, prolonged use of steroids and anakinra. An invasive pulmonary aspergillosis arose after 1 month from CAR-T reinfusion, resolved with tracheal sleeve pneumonectomy. The patient is now in Complete Remission. This case suggests that antifungal prophylaxis should be considered. We have now included micafungin as a standard prophylaxis in our institution.