OpenMed/multicare-articles huggingface dataset:
Interaction of Temporal Lobe Epilepsy and Posttraumatic Stress Disorder: Network Analysis of a Single Case
Authors: Iftah Biran, Roee Admon, Tomer Gazit, Firas Fahoum
Journal: Front Psychol (2020)
Keywords: pnes, ptsd, tle, conversion disorder, fear circuitry

In this case study, we present a 21 years old female with long-standing Temporal Lobe Epilepsy (TLE) who, following a sexual assault, also developed Posttraumatic Stress Disorder (PTSD), leading to a change in her seizure semiology. The new seizures seemed to be a re-enactment of the sexual assault and accordingly were at first thought to be Psychogenic Non-Epileptic Seizures (PNES). Nevertheless, electroencephalography (EEG) recording at the Epilepsy Monitoring Unit (EMU) revealed ictal epileptic brain activity during these new attacks. In order to further explore the nature of the relation between epileptic seizures and PTSD symptomatology, a functional MRI (fMRI) scan was conducted focusing on neural response to threat (fearful faces). The results indicated that the response to threat elicited bilateral amygdala activation, as well as enhanced amygdala connectivity with the insula and anterior cingulate cortex (ACC), all central nodes of the fear circuitry. Accordingly, we suggest that this unique presentation of "pseudo" PNES might stem from the anatomical proximity of the epileptic network in this patient (temporal-insular-frontal) to the fear circuitry, allowing abnormal epileptic activity to "exploit" or activate the fear circuit or vice versa. We further propose that the traumatic experience may have changed the patient's ictal semiology by modifying the course of the spread of the ictal activity toward the PTSD network.
Facial Paresthesia, a Rare Manifestation of Hereditary Neuropathy With Liability to Pressure Palsies: A Case Report
Authors: Lisa De Kock, Fréderic Van der Cruyssen, Leonore Gruijthuijsen, Constantinus Politis
Journal: Front Neurol (2021)
Keywords: pmp22 deletion, case report, hereditary neuropathy with liability to pressure palsy, paresthesia, trigeminal neuropathy
MeSH terms: Case Reports

Trigeminal sensory neuropathy can be caused by a variety of conditions, including local, traumatic, iatrogenic, or systemic causes. Diagnosis and management remain a challenge for maxillofacial surgeons and neurologists. Therefore, a good clinical examination and objective tests and imaging are needed when diagnosing patients who present with facial numbness. We present a case with spontaneous episodes of facial paresthesia. He was diagnosed with hereditary neuropathy with liability to pressure palsies (HNPP), a rare condition that affects the peripheral nerves. Only a few case reports that describe involvement of the cranial nerves in patients with HNPP were found in the literature, and facial paresthesia has not been previously reported.
Case report: The power of immunotherapy in advanced cutaneous squamous cell carcinoma
Authors: Maximilian Brockwell, Marium Husain, Claire Verschraegen, Richard Wu, Gabriel Tinoco
Journal: Front Oncol (2023)
Keywords: cancer intervention, chemotherapy, head and neck cancer, oncology, radiotherapy, skin cancer
MeSH terms: Case Reports

We describe the case of a neglected cutaneous squamous cell carcinoma with extensive facial involvement. The patient is a male in his late 70s who presented to dermatology with a large destructive facial mass that had increased in size gradually over 3 years and then rapidly proliferated, consuming a large portion of his left maxillofacial region. While the immediate reaction was referral to hospice care, medical oncology recommended treatment with cemiplimab, an immune checkpoint inhibitor. Collaboration with multiple providers facilitated the delivery of a multidisciplinary approach utilizing immunotherapy with QUAD shot radiotherapy. The immunotherapy treatment resulted in a dramatic disease regression, but the large facial anatomical defect caused by the carcinoma remained. The patient is undergoing reconstructive surgeries. This case illustrates the potential for significant response with immune checkpoint inhibitors delivered in combination with cyclical hypofractionated radiation therapy for patients with cutaneous squamous cell carcinoma, even in very advanced disease.
Serosurvey of Trypanosoma cruzi in persons experiencing homelessness and shelter workers of Brazil
Authors: Louise Bach Kmetiuk, Gustavo Gonçalves, Anahi Chechia Do Couto, Alexander Welker Biondo, Fabiano Borges Figueiredo
Journal: Front Public Health (2023)
Keywords: chagas disease, epidemiology, health inequalities, homeless people, vulnerability
MeSH terms: Chagas Disease / epidemiology, Ill-Housed Persons, Trypanosoma cruzi, Case Reports, Research Support, Non-U.S. Gov't, Brazil / epidemiology, Humans, Seroepidemiologic Studies

Although Chagas disease, caused by Trypanosoma cruzi, has been associated with social vulnerability worldwide, producing disability and mortality, no study to date has assessed this protozoal infection in persons experiencing homelessness. Accordingly, the present study aimed to assess anti-T. cruzi antibodies by Wiener Chagatest ELISA recombinant v.3.0 in serum samples of persons experiencing homelessness and related shelter workers in São Paulo, a city with reported vectors but no recent autochthonous case report. Overall, seropositivity to T. cruzi resulted in three of 203 (1.5%) persons experiencing homelessness and two of 87 (2.3%) shelter workers, with similar seroprevalence likely associated with their past social vulnerability. Although the seropositivity in persons experiencing homelessness and shelter workers was within 0 to 25.1% seroprevalence for chronic Chagas disease in the general Brazilian population, the disease has almost decreased 2-fold from the 1980s to 2000s, and such a wide range may not reflect the local disease status. In addition, the authors hypothesized that the similar seroprevalence and exposure between homeless persons and shelter workers herein may be more associated with shared past and present low-income social vulnerability than migratory movements, which may also include infection by sharing injecting drugs, vertical transmission, or blood transfusion. Thus, future studies are needed to confirm the active transmission of Chagas disease in São Paulo city. Moreover, Chagas disease should be considered as differential diagnosis in homeless persons and shelter workers, even in major disease-free Brazilian or other worldwide cities, mostly due to early exposure and vulnerable living conditions.
Primary gastric inflammatory myofibroblastic tumor treated with non-exposed endoscopic wall-inversion surgery (NEWS): A case report and literature review
Authors: Yuka Masuda, Yoshikazu Kanazawa, Osamu Goto, Daisuke Kakinuma, Kazutoshi Higuchi, Eriko Koizumi, Ryosuke Nakata, Nobuyuki Sakurazawa, Fumihiko Ando, Mikito Suzuki, Toshiro Yoshiyuki, Shunji Kato, Ryuji Ohashi, Mitsuru Kaise, Katsuhiko Iwakiri, Hiroshi Yoshida
Journal: DEN Open (2023)
Keywords: lecs, news, gastric tumor, inflammatory myofibroblastic tumor, stomach
MeSH terms: Case Reports

Inflammatory myofibroblastic tumor (IMT) is an intermediate malignancy with myofibroblast proliferation and inflammatory cell infiltration with malignant potential. Primary IMTs are predominantly reported in the lungs, while gastric IMTs are very rare. Therefore, no guidelines exist for the diagnosis and treatment of gastric IMTs. The present case is a 39-year-old man diagnosed with an asymptomatic gastric submucosal tumor. Considering the malignancy of the tumor, we selected non-exposed endoscopic wall-inversion surgery as the resection method and successfully performed local resection. Histopathological analysis showed myofibroblast proliferation and inflammatory cell infiltration, with a diagnosis of primary gastric IMT and negative resection margins. Immunohistochemical staining was negative for anaplastic lymphoma kinase. To the best of our knowledge, including our case, there have been 52 reported cases of primary gastric IMTs that have been treated, with several recurrent cases. In this study, we report the first case of local resection of gastric IMT using non-exposed endoscopic wall-inversion surgery, with a literature review.
Case Report: Genetic analysis and anesthetic management of a child with Niemann-Pick disease Type A
Authors: Priti G Dalal, Melissa Coleman, Meagan Horst, Dorothy Rocourt, Roger L Ladda, Piotr K Janicki
Journal: F1000Res (2015)
Keywords: anesthesia, niemann-pick disease, genomic and biochemical analysis

A 14-month-old child, recently diagnosed with Niemann-Pick disease type A, presented for a laparoscopic placement of a gastrostomy tube under general anesthesia. The disease was confirmed and further characterized by genetic testing, which revealed evidence of the presence of two known pathogenic mutations in the SMPD1 gene, and enzyme studies showed a corresponding very low level of enzymatic activity of acidic sphingomyelinase. The anesthetic management involved strategies to manage an anticipated difficult intubation and avoid post-operative ventilation.
Cesarean section after laparoscopic hysterosacropexy with Richardson's lateral repair and Burch operation-Case report
Authors: Paweł Szymanowski, Wioletta Katarzyna Szepieniec, Krzysztof Stuwczyński, Paweł Gruszecki
Journal: Int J Surg Case Rep (2019)
Keywords: case report, delivery, laparoscopic hysteropexy, pregnancy

Introduction:
Pelvic floor disorders are common also in young patient population. Their quality of life is lessened because of their condition, but they would also like to avoid any complicated operations. The minimal invasive procedures and fertility sparing are very important.
Case presentation:
32 year old caucasian female (BMI: 22,6) was admitted to our clinic in August 2016 with the following symptoms: the feeling of a foreign body in the vagina, prolapse of the bladder and stage II stress urinary incontinence. She had 2 vaginal deliveries. A gynecological examination of the pelvic organ prolapse was classified as follows: prolapse of the uterus POP-Q II, and a cystocele with a lateral defect POP-Q III, after reposition of uterus cystocele POP-Q II, urethrocele, positive cough test. She underwent a laparoscopic hysteropexy with lateral repair and Burch operation. Effect of the operation was satisfied. It revealed an improvement in the QoL-Questionnaire PIFQ-7. Pregnancy in 2018 was delivered by cesarean section. The effect of the prolapse operation was not affected and the quality of life maintained.
Conclusion:
Laparoscopic hysteropexy should be a standard procedure for the repair of a level I defect in young patients, particularly as a fertility sparing procedure.
Moraxella lacunata infection accompanied by acute glomerulonephritis
Authors: Nami Sawada, Tamaki Morohashi, Tomokazu Mutoh, Tsukasa Kuwana, Junko Yamaguchi, Kosaku Kinoshita, Ichiro Morioka, Hiroyuki Hao
Journal: Open Med (Wars) (2020)
Keywords: moraxella lacunata, children, complement activity, hemodialysis, sepsis
MeSH terms: Case Reports

Moraxella lacunata (M. lacunata) is a Gram-negative bacterium, which rarely causes serious infection. This is a rare case report of acute glomerulonephritis diagnosed by pathological findings in a child accompanied by M. lacunata infection. The patient showed hematuria, proteinuria and hyperkalemia requiring emergency hemodialysis. After hospitalization, M. lacunata bacteremia became apparent. Pathological findings showed an increase in glomerulus inflammatory cells and glomerular C3 deposition was observed in the renal tissue biopsy. Final diagnosis was endocapillary proliferative glomerulonephritis. Clinical reports of M. lacunata infection requiring emergency hemodialysis in children are rare. Previous reports have suggested that lowered immune competency with chronic kidney disease may be a risk factor associated with serious invasive cases of M. lacunata infection. However, detailed clinical laboratory data and pathological findings have not been identified in previous case reports. Our case directly indicated complement activity and acute glomerulonephritis with M. lacunata infection. Although there are various causes for acute glomerulonephritis, infection-related glomerulonephritis (IRGN) is an important concept. M. lacunata infection might have a potential risk for IRGN with dysregulation of complement activity leading to serious and invasive clinical conditions than previously considered.
Boerhaave syndrome - case report
Authors: Biljana Radovanovic Dinic, Goran Ilic, Snezana Tesic Rajkovic, Tatjana Jevtovic Stoimenov
Journal: Sao Paulo Med J (2017)
MeSH terms: Esophageal Perforation / diagnosis, Mediastinal Diseases / diagnosis, Case Reports, Fatal Outcome, Female, Humans, Middle Aged, Rupture, Spontaneous / diagnosis, Boerhaave syndrome

Context::
Boerhaave syndrome consists of spontaneous longitudinal transmural rupture of the esophagus, usually in its distal part. It generally develops during or after persistent vomiting as a consequence of a sudden increase in intraluminal pressure in the esophagus. It is extremely rare in clinical practice. In 50% of the cases, it is manifested by Mackler's triad: vomiting, lower thoracic pain and subcutaneous emphysema. Hematemesis is an uncommon yet challenging presentation of Boerhaave's syndrome. Compared with ruptures of other parts of the digestive tract, spontaneous rupture is characterized by a higher mortality rate.
Case report::
This paper presents a 64-year-old female patient whose vomit was black four days before examination and became bloody on the day of the examination. Her symptoms included epigastric pain and suffocation. Physical examination showed hypotension, tachycardia, dyspnea and a swollen and painful abdomen. Auscultation showed lateral crackling sounds on inspiration. Ultrasound examination showed a distended stomach filled with fluid. Over 1000 ml of fresh blood was extracted by means of nasogastric suction. Esophagogastroduodenoscopy was discontinued immediately upon entering the proximal esophagus, where a large amount of fresh blood was observed. The patient was sent for emergency abdominal surgery, during which she died. An autopsy established a diagnosis of Boerhaave syndrome and ulceration in the duodenal bulb.
Conclusion::
Boerhaave syndrome should be considered in all cases with a combination of gastrointestinal symptoms (especially epigastric pain and vomiting) and pulmonary signs and symptoms (especially suffocation).
Nocardiosis in a kidney-pancreas transplant
Authors: I Fontana, G Gasloli, A Magoni Rossi, C Bornacina, F Dodi, M Bertocchi, O Soro, P Diviacco, A De Negri, E Bocci, C Ferrari, A Giannone, Umberto Valente
Journal: J Transplant (2010)
MeSH terms: Case Reports

34-year-old man with chronic renal and pancreas failure in complicated diabetic disease received a kidney-pancreas transplantation. On the 32nd postoperative day, an acute kidney rejection occurred and resolved with OKT3 therapy. The patient also presented refractory urinary infection by E. Fecalis and M. Morganii, and a focal bronchopneumonia in the right-basal lobe resolved with elective chemotherapy. During the 50th post-operative day, an intense soft tissue inflammation localized in the first left metatarsal-phalangeal articulation occurred (Figure 1) followed by an abscess with a cutaneous fistula and extension to the almost totality of foot area. The radiological exam revealed a small osteo-lacunar image localized in the proximal phalanx head of the first finger foot. From the cultural examination of the purulent material, N. Asteroides was identified. An amoxicillin-based treatment was started and continued for three months, with the complete resolution of infection This case is reported for its rarity in our casuistry, and for its difficult differential diagnosis with other potentially serious infections.
Exacerbation of autoimmune pulmonary alveolar proteinosis that improved with lone treatment of complicating nontuberculous mycobacterial infection: A case report
Authors: Shunya Shiohira, Masashi Sakayori, Keiichiro Yoshioka, Hajime Kasai, Ryutaro Hirama, Mitsuhiro Abe, Hiroki Nishimura, Takuji Suzuki
Journal: Respir Med Case Rep (2021)
Keywords: antibiotics, exacerbation, mycobacterium avium complex, pulmonary alveolar proteinosis
MeSH terms: Case Reports

Herein, we present the case of a 63-year-old man with autoimmune pulmonary alveolar proteinosis (APAP) complicated by Mycobacterium avium complex (MAC) infection. APAP was diagnosed based on serum anti-granulocyte-macrophage colony-stimulating factor antibody, bronchoalveolar lavage fluid (BALF) findings, and transbronchial lung biopsy. Nodular shadows with cavities were visible on chest CT images, and Mycobacterium intracellulare was identified by BALF culture. Rifampicin, ethambutol, and clarithromycin were administered, and 4 months later, the nodular shadows of MAC had disappeared, and APAP was remarkably improved. Thus, in cases of APAP exacerbation complicated with infections, such as MAC, control of the infections may improve APAP.
Case Report: Rare site for intraoral meningioma
Authors: Hatem Wael Amer, Layla Hafed, Sally Ibrahim, Shady Shaker
Journal: F1000Res (2020)
Keywords: benign tumor, ectopic meningioma, intra-oral meningioma, palatal lesion
MeSH terms: Meningeal Neoplasms / diagnosis, Meningioma / diagnosis, Mouth Neoplasms / diagnosis, Case Reports, Egypt, Female, Humans, Middle Aged

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence. We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs. An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.
Vulnerability to Meningococcal Disease in Immunodeficiency Due to a Novel Pathogenic Missense Variant in NFKB1
Authors: Manfred Anim, Georgios Sogkas, Gunnar Schmidt, Natalia Dubrowinskaja, Torsten Witte, Reinhold Ernst Schmidt, Faranaz Atschekzei
Journal: Front Immunol (2021)
Keywords: nfkb1, nfkb1 (p50), common variable immune deficiency (cvid), hypogammaglobulinemia, primary antibody deficiency (pad)
MeSH terms: Common Variable Immunodeficiency / genetics, Genetic Predisposition to Disease / genetics, Meningococcal Infections / genetics, Mutation, Missense, NF-kappa B p50 Subunit / genetics, Case Reports, Research Support, Non-U.S. Gov't, Active Transport, Cell Nucleus / genetics, Cell Nucleus / metabolism, Cells, Cultured, Common Variable Immunodeficiency / metabolism, Family Health, Female, HEK293 Cells, Humans, Male, Meningococcal Infections / metabolism, Middle Aged, NF-kappa B p50 Subunit / metabolism, Pedigree, Sequence Analysis, DNA / methods, Young Adult, NF-kappa B p50 Subunit, NFKB1 protein, human

NF-κB1 deficiency is suggested to be the most common cause of common variable immunodeficiency (CVID). NFKB1 encodes for the p105 precursor protein of NF-κB1, which is converted into the active transcriptional subunit p50 through proteasomal processing of its C-terminal half upon stimulation and is implicated in the canonical NF-kB pathway. Rare monoallelic NFKB1 variants have been shown to cause (haplo) insufficiency. Our report describes a novel NFKB1 missense variant (c.691C>T, p.R230C; allele frequency 0.00004953) in a family vulnerable to meningitis, sepsis, and late-onset hypogammaglobulinemia. We investigated the pathogenic relevance of this variant by lymphocyte stimulation, immunophenotyping, overexpression study and immunoblotting. The ectopic expression of p50 for c.691 C>T restricted transcriptionally active p50 in the cytoplasm, and immunoblotting revealed reduced p105/50 expression. This study shows that the deleterious missense variant in NFKB1 adversely affects the transcriptional and translational activity of NFκB1, impairing its function. Patients immunological parameters show a progressive course of hypogammaglobulinemia, which may partially account for the incomplete disease penetrance and suggest the need for closer immunological monitoring of those mutation carriers.
Multiple Hepatic and Renal Hydatid Cysts Managed with Laparoscopic Surgery
Authors: Lamia Kouba, Bayan Alsaid, Taisser Almeree, Mazen Allouche, Abdulghani Alshalabi
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Cystic echinococcosis is a parasitic disease caused by Echinococcus granulosus. The liver and lungs are the most commonly infected organs. We present the first-of-a-kind case of laparoscopic excision of 8 hydatid cysts, of which seven were in the liver and one was in the kidney of a 40-year-old patient. The patient presented with fatigue and fever and a one-year history of vague abdominal pain. Albendazole was administered before surgical intervention. The postoperative follow-up period was notable for a renal fistula. The patient subsequently underwent CT-guided percutaneous removal of a central hepatic hydatid cyst that was inaccessible using laparoscopic techniques. Cystic echinococcosis is endemic in the Mediterranean region. The growing number of immigrants and refugees from endemic areas could increase the prevalence of the disease in nonendemic countries. Therefore, it is important for physicians worldwide to be familiar with the diagnostic modalities and possible treatment options for hydatid disease.
Gastrointestinal Mucormycosis following a Streptococcus pyogenes Toxic Shock Syndrome in a Previously Healthy Patient: A Case Report
Authors: Jean-François Roussy, Catherine Allard, Guy St-Germain, Jacques Pépin
Journal: Case Rep Infect Dis (2012)

Mucormycosis is an uncommon opportunistic infection and the gastrointestinal form is the rarest. Rhizopus sp. is the most frequent pathogen and infection occurs almost exclusively in immunocompromised patients. We describe the first case of intestinal mucormycosis occurring after a Streptococcus pyogenes toxic shock syndrome in a previously healthy patient caused by Rhizopus microsporus var. azygosporus.
Burkholderia cepacia complex Cervical Osteomyelitis in an Intravenous Drug User
Authors: Sui Kwong Li, William B Messer
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Gram-negative vertebral osteomyelitis infections are increasing due to rising intravenous drug use but overall remain uncommon. Here, we present a case of Burkholderia cepacia complex cervical osteomyelitis in an intravenous drug user. Burkholderia cepaciacomplex vertebral osteomyelitis has been infrequently described in the literature thus far with varied antibiotic treatment regimens. A 68-year-old male presented to the emergency department with neck pain after minor trauma. He endorsed active intravenous heroin and methamphetamine use. CT and MRI imaging of the cervical spine revealed destructive changes of C5-C6 vertebral bodies consistent with osteomyelitis. Neurological exam was stable and vital signs were within normal limits; so, antibiotics were held, and he was admitted for diagnostic evaluation. Five sets of blood cultures were drawn on admission and were ultimately negative. He subsequently underwent C5-C6 corpectomy, C4-C7 anterior fusion, and C3-T1 posterior fusion with allograft placement. Deep operative tissue cultures grew Burkholderia cepacia complex. He was treated with 6 weeks of intravenous ceftazidime followed by indefinite oral minocycline due to hardware placement. Burkholderia cepacia complex should be considered among pathogenic etiologies of pyogenic vertebral osteomyelitis, particularly among patients with intravenous drug use. Ceftazidime monotherapy was an effective treatment in this particular case.