OpenMed/multicare-articles huggingface dataset:
Case report: Mycetoma caused by Gordonia soli
Authors: João César Beenke França, Bruno Hassunuma Carneiro, Regielly Caroline Raimundo Cognialli, Flávio de Queiroz-Telles
Journal: Rev Soc Bras Med Trop (2023)
MeSH terms: Actinobacteria, Mycetoma / diagnosis, Mycetoma / drug therapy, Mycetoma / microbiology, Nocardia, Case Reports, Fungi, Humans, Middle Aged, Neglected Diseases, Gordonia soli

Mycetoma is a neglected tropical disease caused by fungi (eumycetoma) or bacteria (actinomycetoma), with high morbidity. Gordonia spp. are gram-positive bacteria that have previously been reported to cause mycetoma. Here, we report a case of Gordonia soli (initially misidentified as Nocardia spp.) as the etiological agent of actinomycetoma in a 64-year-old patient. After a literature search in the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PubMed Central databases, we concluded that this is the first case report of mycetoma caused by Gordonia soli. The current case highlights the importance of microbiological diagnosis of mycetoma and the challenges in its management.
A Male Patient with Hydrocephalus via Multimodality Diagnostic Approaches: A Case Report
Authors: Xiuyun Liu, Jingjing Mu, Meijun Pang, Xuehai Fan, Ziwei Zhou, Fang Guo, Kai Yu, Huijie Yu, Dong Ming
Journal: Cyborg Bionic Syst (2024)

Introduction: Idiopathic normal pressure hydrocephalus (iNPH) is a kind of hydrocephalus that is easily to be misdiagnosed with brain atrophy due to the similarity of ventricular dilation and cognitive impairment. In this case, we present an old male patient who was diagnosed with iNPH by multimodality approaches. Outcomes: A 68-year-old male patient, with deteriorated gait, declined cognitive function for at least 3 years and urinary incontinence for 3 months. The doctors suspected him a patient with hydrocephalus or Alzheimer's disease based on his symptoms. We used multimodality diagnostic approaches including brain imaging, cerebrospinal fluid tap test, continuous intracranial pressure monitoring, and infusion study to make the final diagnosis of iNPH. He underwent ventriculoperitoneal shunt surgery and was well recovered. Conclusion: This case demonstrates the efficacy of using multimodality approaches for iNPH diagnosis, which saves patient time and clinical cost, worthy of further promotion.
Pancreatic Panniculitis: A Case Associated With Acute Pancreatic Allograft Rejection
Authors: Avraham Kohanzadeh, Ariel Sher, Olivia Wind, Qiang Liu, Pooja Srivastava, Bijal Amin, Ranon Mann
Journal: Cureus (2024)
Keywords: allograft rejection, dermatology, pancreas transplant, pancreatic panniculitis, transplant rejection
MeSH terms: Case Reports

We present a unique case of pancreatic panniculitis (PP) in a 42-year-old male with a history of pancreas-after-kidney (PAK) transplant. The patient developed PP due to acute pancreas allograft rejection. Clinical manifestations included fevers, myalgias, arthralgias, and tender erythematous subcutaneous nodules on the lower extremities. A recent hospital admission was noted for acute pancreas allograft rejection related to low tacrolimus levels. Rheumatological and infectious disease workups were negative. Skin nodule punch biopsy confirmed PP with lobular panniculitis, necrotic adipocytes, basophilic debris, and calcification. Pancreatic biopsy showed evidence of parenchymal acute cellular rejection. Lipase and amylase levels were elevated (1781 U/L and 881 U/L, respectively). Treatment involved pulse solumedrol and thymoglobulin for pancreatic rejection, alongside adjustments to immunosuppressive medications. This case highlights the rarity of PP in a PAK recipient and its association with acute pancreas allograft rejection. Importantly, it is the first reported case of PP occurring solely in the context of pancreas transplant rejection, without concurrent kidney damage or rejection. Prompt diagnosis and management led to the resolution of skin and systemic symptoms. In conclusion, this report presents a clinically relevant and unique case of PP resulting from acute pancreas allograft rejection in a PAK transplant recipient. The findings underscore the importance of early diagnosis and management for positive patient outcomes, serving as a reminder to consider underlying pancreatic pathology when encountering PP in transplant recipients.
Acinic Cell Carcinoma of the Breast: A Case Report and Review of Literature
Authors: Ihab S Atta Sr
Journal: Cureus (2024)
Keywords: acinic cell carcinoma, alcian blue, amylase, breast cancer, dog-1, etv6-ntrk3
MeSH terms: Case Reports

Acinic cell carcinoma (ACC) is an exceedingly rare type of triple-negative breast cancer (TNBC). We are reporting a case of a 46-year-old female patient who presented with a palpable lump in her left breast not associated with pain, pruritis, or change of skin color. An open biopsy revealed a mass of about 20 x 25 mm of fleshy, white tan with a lobular configuration and necrosis. The histopathological examination revealed cells with cytoplasmic granularity arranged in a microglandular pattern and a solid pattern, and the case was initially reported as ACC. The most remarkable feature was the presence of small and large, brightly eosinophilic cytoplasmic granules, and some cells are clear or multivacuolated, resembling lipoblasts. Cellular pleomorphism and anaplasia are very mild, and the mitotic activity was very low. The tumor showed a scant and vascularized stroma in the area of hyalinization. Small clusters of lymphoid infiltration in the stroma were seen. Histochemical stains revealed that the acinar cells in ACC contain abundant diastase-resistant, periodic acid Schiff (PAS)-positive cytoplasmic granules. Mucicarmine and Alcian blue were negative. The immunohistochemistry workup revealed that the case was positive for discovered on gastrointestinal stromal tumors-1 (DOG-1) and the positivity pattern ranged from apical membranous, cytoplasmic, and complete membranous. In addition, the tumor cells were positive for low-molecular-weight cytokeratin, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA). The FISH workup for the ETV6-NTRK3 fusion was negative, arguing against secretory carcinoma (SC). A diagnosis of acinar cell carcinoma of the breast is very rare, and the presence of cytoplasmic granules is helpful for its diagnosis. In the absence of these granules, the diagnosis is very difficult, and other diagnoses will be put in the differential diagnosis, particularly SC, lactating adenosis, and microglandular adenosis. Immunohistochemical and histochemical stains and genetic workups will support the diagnosis of ACC.
Isolated Pediculosis Presenting With Hypereosinophilia and Iron Deficiency Anemia: A Case Report and Review of Literature
Authors: Susmitha Devi Chalamalasetti, Taniszahera Momin, Nicole Koutras, Juliana Cazzaniga, Premalkumar Patel
Journal: Cureus (2024)
Keywords: homelessness, hypereosinophilia, iron deficiency anemia, microcytic anemia, pediculosis
MeSH terms: Case Reports

In recent years, there has been growing recognition of the association between lice infestation and iron deficiency anemia (IDA). The head lice, known as Pediculosis humanus capitis, and the body lice, known as Pediculosis humanus corporis, are responsible for causing these infestations. This case report focuses on the clinical findings of a 63-year-old woman who sought medical attention in the emergency department because of severe pruritus and generalized pain. Upon initial physical examination, the patient was found to have a severe lice infestation, and laboratory findings revealed IDA (Hb: 6.8 g/dL, MCV: 70 fL, iron: 21 mcg/dL) and hypereosinophilia (3,500/μL). Treatment involved the administration of Permethrin 1% lotion, Ivermectin, and intravenous iron sucrose supplementation. On the fifth day of presentation, the patient's hemoglobin level improved to 8.6 g/dL, and the eosinophil count decreased to 2,000/μL. Despite extensive investigation of the patient's IDA and hypereosinophilia, no clear etiology of IDA was identified. Consequently, the patient was diagnosed with hypereosinophilia and IDA, secondary to severe chronic pediculosis. This case report aims to raise awareness of the possibility of severe pediculosis as a risk factor for iron deficiency and hypereosinophilia.
Air embolism complicating endoscopic retrograde cholangiopancreatography
Authors: Mouna Medhioub, Becem Trabelsi, Amal Khsiba, Mohamed Saied, Moufida Mahmoudi, Asma Ben Mohamed, Manel Yacoubi, Lamine Hamzaoui, Mechaal Ben Ali
Journal: Future Sci OA (2024)
Keywords: air embolism, cardiac ultrasound, cardiovascular collapse, complication, diagnostics, endoscopic retrograde cholangiopancreatography
MeSH terms: Case Reports

Aim: Venous air embolism is a rare but potentially life threatening complication of endoscopic retrograde cholangiopancreatography. Diagnosis is difficult because of the lack of specific signs or symptoms. Case: A 62-year-old man underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis. A cardiovascular collapse occurred during the procedure. The echocardiography showed air within the right ventricle. Aspiration of air from the right ventricle was done and saved the patient's life. Conclusion: We highlight through this case that increased awareness is essential for prompt recognition of the air embolism to allow life-saving therapy.
Successful application of chemosaturation with percutaneous hepatic perfusion in metastatic uveal melanoma patient progressing after systemic treatment options: a case report
Authors: Damla Gunenc, Ahmet Anil Ozluk, Utku Mahir Yıldırım, Paolo A Ascierto, Burcak Karaca
Journal: Front Oncol (2024)
Keywords: chemosaturation, immune checkpoint inhibitors, liver, percutaneous hepatic perfusion, tebentafusp, uveal melanoma
MeSH terms: Case Reports

Uveal melanoma (UM) is a rare subtype of melanoma, accounting for less than 5% of all melanoma cases. Metastatic UM differs notably from cutaneous melanoma, exhibiting variations in etiology, prognosis, driver mutations, metastatic patterns, and poor responses to immune checkpoint inhibitors (ICI). Beyond local treatment options, such as resection, radiation therapy, and enucleation, and systemic treatments, such as ICIs, the approval of tebentafusp, a bispecific gp100 peptide-HLA-directed CD3 T-cell engager, marks a breakthrough in treating HLA-A*02:01 metastatic UM. Despite the advancements in treatment options, the long-term survival rates remain inadequate. We report a patient with metastatic UM who previously received ICI and progressed on tebentafusp treatment but subsequently exhibited a remarkable response to local treatment targeting liver metastasis. Such observations highlight the significance of exploring sequential therapeutic strategies for advanced UM, offering potential avenues to enhance treatment efficacy and patient prognosis.
Bouveret's syndrome: An old diagnosis. A modern multimodality approach (endoscopic and robotic surgical) of gastric outlet obstruction: Report of two cases
Authors: Tika Ram Bhandari, John Lin Hieng Wong, Jawad Ahmad, Khalid Akbari, Vinod Menon
Journal: Int J Surg Case Rep (2024)
Keywords: bouveret's syndrome, case report, endoscopy, gallstone disease, robotic surgery
MeSH terms: Case Reports

Introduction and importance:
Bouveret's syndrome is an uncommon condition characterized by the impaction of a gallstone in the pylorus or duodenum via a cholecysto-enteric fistula causing gastric outlet obstruction. We report two unusual cases of Bouveret's syndrome causing gastric outlet obstruction in two elderly patients.
Case presentation:
Two elderly female patients presented to the surgical assessment unit with features of gastric outlet obstruction. In both cases, an urgent computed tomography (CT) of the abdomen showed pneumobilia, gastric distension, and gallstones impaction at the duodenal bulb. In Patient 1, endoscopic removal of the impacted gallstones was done successfully. She was discharged three days following an uneventful recovery. In Patient 2, an endoscopic removal of a single large gallstone was attempted, which was unsuccessful. She underwent robotic gastrotomy with extraction of the large gallstone with primary repair. She was discharged on 8th postoperative day.
Clinical discussion:
Treatment options for Bouveret's syndrome include endoscopic management and surgery. The selection of treatment options depends upon factors like the degree of obstruction, the impaction site, number, type or size of gallstones, patient co-morbidities and clinical parameters at presentation, as well as expertise available, both endoscopic and surgical.
Conclusions:
Bouveret's syndrome is one of the rare complications of gallstone. Endoscopic management can be effective at removing the impacted gallstones, which is particularly helpful for those elderly patients who have multiple medical co-morbidities, as in our first patient. Surgical management like minimal invasive surgery (robotic) can be beneficial in failed endoscopic attempt of removal of stone like in the second patient.
Congenital Hepatic Fibrosis in a 2-Year-Old Child Presenting with Fever of Unknown Origin
Authors: Michael P Penfold, Wentiirim B Annankra, Nathan C Hull, Margarita Corredor
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Congenital hepatic fibrosis is a rare, autosomal recessive, fibro-polycystic disease resulting from ductal plate malformation, leading to proliferation and fibrosis of bile ducts. Progressive hepatic fibrosis leads to portal hypertension and varices which can present with life threatening gastrointestinal hemorrhage. We report a case of congenital hepatic fibrosis in a 2-year-old child who presented with 8 days of fever without any significant medical history or physical examination findings.
Unveiling the Enigma: A Confluence of Two Case Reports for the Negotiation of Mid-Mesial Canals
Authors: Swayangprabha Sarangi, Manoj Chandak, Shweta Sedani, Paridhi Agrawal, Mrinal Nadgouda, Unnati Shirbhate
Journal: Cureus (2024)
Keywords: endodontics, magnification, mandibular molar, mid-mesial canal, obturation
MeSH terms: Case Reports

Mandibular molars display a wide spectrum of intricate anatomical variations among the Indian population. This case report details the diagnosis and successful endodontic management of a mid-mesial canal in the mandibular first molar tooth, emphasizing the importance of radiographic imaging and meticulous instrumentation. The patient presented with symptoms of irreversible pulpitis that led to accurate relief of symptoms after shaping and cleaning protocols were followed. This case series discusses the challenges encountered during canal negotiation, cleaning, shaping, and obturation, providing insights into the complexities associated with mid-mesial canals.
Hantavirus infection in central Sri Lanka - an unusual clinical presentation: a case report
Authors: T T Pattiyakumbura, S H Pathirathne, M A R V Muthugala
Journal: Access Microbiol (2024)
Keywords: asia, atypical presentation, puumala/ puumala-like virus, sri lanka, zoonoses, hantavirus cardio-pulmonary syndrome, hantavirus infection
MeSH terms: Case Reports

Hantavirus infections are emerging zoonoses. In Asia, the hantavirus commonly manifests as haemorrhagic fever with renal syndrome (HFRS), apparent with fever, thrombocytopenia and acute kidney injury. There are a few cases with the atypical clinical course with cardiopulmonary symptoms in Asia including Sri Lanka. Here, we report a case of hantavirus infection with an atypical cardiopulmonary syndrome-like illness with serological evidence of the Puumala/Puumala-like virus.
Long-term disease stability with bicalutamide in a man with aggressive angiomyxoma: case report and state of art
Authors: Andrea Franza, Eleonora Gusmaroli, Chiara Fabbroni, Raffaella Vigorito, Sandro Pasquali, Paolo Giovanni Casali, Roberta Giovanna Sanfilippo
Journal: Front Oncol (2024)
Keywords: aggressive angiomyxoma (aa), angiomyxoma, connective and soft tissue neoplasms, myxoma, neoplasm (mesh term), therapy
MeSH terms: Case Reports

Aggressive angiomyxoma (AA) is a rare mesenchymal neoplasm, which is commonly diagnosed in females and located in the perineal and pelvic region. Tissue specimens of AA patients often show positivity for estrogen (ER) and progesterone receptors (PgR), while some cases of androgen receptor (AR) positivity have been reported in males. When feasible, surgical excision represent the most effective treatment of AA; however, when experiencing advanced or recurrent disease, local disease control could be achieved with systemic hormonal treatment. To date, evidence regarding AA management in male patients is scarce, and only a few cases have been reported in literature. Hereby, we describe the case of a 59-year-old-man suffering from perineal AA with positivity for androgen receptors (AR) showing a long-lasting disease stability during the treatment with an AR-blocking drug (bicalutamide). A literature review regarding the state of art of AA management with a particular look to male patients is also provided.
Case Report: Nonverbal approaches in the treatment of a patient with fibromyalgia with anger rooted in adverse childhood experiences
Authors: Yuri Adachi, Masako Hosoi, Tomoe Nishihara, Naoki Hirabayashi, Takako Sawa, Tomoko Matsushita, Keita Tatsushima, Kozo Anno, Mitsunao Tomioka, Nobuyuki Sudo
Journal: Front Pain Res (Lausanne) (2024)
Keywords: aces, anger, drawing therapy, fibromyalgia, nonverbal approach, therapeutic relationship
MeSH terms: Case Reports

Introduction:
In psychotherapy, it is important to establish and deepen a therapeutic trusting relationship, but patients who have experienced extreme adversity in childhood tend to have difficulty in building such a relationship. This paper reports a case of fibromyalgia with adverse childhood experiences (ACEs) in which a nonverbal approach was successful in building a trusting relationship.
Case and methods:
The patient is a woman in her late 40s. She had strong anger rooted in ACEs, including neglect by her father, a feeling of unfair parenting by her mother compared to her younger brother, overcontrol of her life by her mother, and sexual abuse by her uncle. She was filled with strong interpersonal distrust and anger, and the experience of an unsuccessful surgery compounded her distrust of medical care. The therapist initially had severe difficulty in verbal interaction with the patient. When conducting "drawing" therapy, she ignored the therapist's comments and completely blacked out the drawing paper. However, the patient-therapist relationship gradually changed, and verbal interaction became possible through the use of nonverbal approaches such as framing her drawing paper and "Towel Baby Holding."
Results:
The therapist was able to understand the patient's emotions through these nonverbal approaches and to communicate with the patient that she understood her feelings. This approach was also successful in the patient's understanding of her own pathology. The patient became able to honestly express her feelings in words, which eventually enabled her to be introduced to mindfulness therapy, leading to a favorable treatment course.
Conclusion:
For patients with ACEs, a nonverbal approach helps build a therapeutic relationship and plays an important role in understanding the patient.
Case report: Diagnostic and therapeutic challenges of fungal endocarditis by Trichosporon asahii in a child with congenital heart defects
Authors: Amanda Baptistella, Ana Júlia A Rossato, Beatriz C de Gusmão, Carolina M Cunha, Luiza F Trafane, Paulo C M Colbachini
Journal: Front Pediatr (2023)
Keywords: trichosporon asahii, case report, fallot’s tetralogy, infective endocarditis, prosthetic valve
MeSH terms: Case Reports

Background:
patients with congenital cardiopathies are the main group at risk for infective endocarditis (IE) in the pediatric population. Fungal etiology is responsible for 2%-4% of all IEs, and the Trichosporon genus is an increasingly prevalent cause of infections in human beings.
Case presentation:
We describe a 9-year-old male with multiple surgical procedures to correct congenital cardiopathy defects, including insertion of RV-PA conduit, who was admitted due to suspicion of pneumonia and needed a surgical approach after being diagnosed with a mycotic pseudoaneurysm in the right ventricle's outflow tract, with dilation of the RV-PA conduit. The conduit was removed and antifungal treatment was started with Voriconazole after the agent was identified (T. asahii), with satisfactory therapeutic response. Approximately 4 years later, the patient was readmitted, presenting with intermittent fever, associated with nocturnal diaphoresis, dry cough, anxiety and chest pain. Vegetations consistent with T. asahii were evidenced in the RV-PA conduit, and a surgical approach was once again necessary.
Discussion:
diagnostic methods and treatment of T. asahii endocarditis aren't yet standardized, and recurrent surgical approaches are needed due to the inefficacy of antifungal treatment.
A Complete Hydatidiform Mole Complicated by Theca Lutein Cysts in a Teenager: A Rare Case
Authors: Saloni, Jyotsna Potdar, Swati M Dahiphale
Journal: Cureus (2024)
Keywords: gestation, molar pregnancy, ovarian cyst, pregnancy, theca lutein cysts during pregnancy
MeSH terms: Case Reports

A hydatidiform mole (HM), often known as molar pregnancy, is a type of prenatal trophoblastic illness that develops in the placenta and has the potential to spread. HMs are caused by genetic issues with either the egg or the sperm. They are typically discovered in the first trimester of pregnancy. Abnormal bleeding is one of the initial symptoms, which can seldom be accompanied by the passage of hydropic villi. Theca lutein cysts, absent fetal heart tones, enlarged uterus more than anticipated for gestational age, pregnancy-induced hypertension in the first trimester, hyperemesis, and increased levels of human chorionic gonadotropin (HCG) for gestational dates are other characteristic symptoms and signs. A rare type of follicular cyst known as a theca lutein cyst is a benign ovarian disease caused by natural overstimulation of follicles, also known as hyperreactio lutealis (HL). This is linked to choriocarcinomas, multiple gestations, and prenatal trophoblastic illness (molar pregnancy). Unless exacerbated by torsion, rupture, or bleeding, the majority of theca lutein cysts are treated conservatively. Theca lutein cysts do not impact the course of pregnancy and spontaneously recede following delivery. However, HL may mistakenly be diagnosed by doctors as a cancer during pregnancy if it has the potential to look like one. Frequently, inappropriate surgical intervention is caused by the fear of failing to diagnose malignancy. These treatments may therefore result in decreased fertility in the future. Here we present a case of a young unmarried female with an HM and cysts.