OpenMed/multicare-articles huggingface dataset:
Retinocytoma Undergoing Retinoblastoma Transformation in an Adult Patient
Authors: J Navaratnam, R Faber, N Eide, M Lund-Iversen, Ø Garred, F L Munier
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

We report a 46-year-old male patient with retinocytoma who presented at the age of 31 asymptomatically. An intraocular retinal mass was incidentally found in his right eye, when he underwent ophthalmological assessment for refractive surgery. This tumor consisted of a calcified sessile basis partially covered by a pedunculated salmon-pink growth. Initially, the tumor was diagnosed as a retinocytoma with clinical suspicion of malignant transformation into retinoblastoma and treated by four sessions of laser photocoagulation. Six and a half years later, the tumor relapsed, and he was treated with a Ruthenium plaque. Following brachytherapy, he had two episodes of right-sided vitreous hemorrhage that spontaneously cleared up, and the remaining finding in the vitreous cavity was interpreted as asteroid hyalosis. He underwent vitrectomy about five years following brachytherapy. The analysis of the vitreous material revealed the presence of inactive vitreous seeds composed of small round blue cells, compatible with a type 2 regression.
A Case of Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain-Barré Syndrome, with Possible Syndrome of Irreversible Lithium-Effectuated Neurotoxicity
Authors: David Y Liu, Jessica R Hollenbach, Jason A Gregorin, Jonathan H Wynbrandt
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Acute Motor Sensory Axonal Neuropathy (AMSAN) is a rare and severe variant of Guillain-Barré syndrome (GBS) that has a prolonged recovery course. GBS is often suspected due to ascending muscle weakness, sensation difficulties, respiratory compromise, and antecedent diarrhea. The diagnosis of GBS is supported by cerebrospinal fluid analysis showing albuminocytologic dissociation. Electromyogram and nerve conduction study confirm the diagnosis and allow for further classification by variant. Treatment involves either IV immune globulins or plasmapheresis, and patients typically recover. However, depending on the variant and severity, patients may ultimately require prolonged mechanical ventilation with tracheostomy. In these cases, they may continue to have persistent muscle and sensation abnormalities requiring long-term care. We present a unique case of a 38-year-old female patient with decade-long use of lithium for bipolar disorder that presented with acute lithium toxicity. Though she was ultimately diagnosed with AMSAN, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) may have also contributed to her persistent neurological sequelae.
Successful management of a combined abdominal and thoracic trauma with rectal impalement: report of a case
Authors: Konstantinos Kasapas, Anna Daskalaki, George Kaimasidis, George Chalkiadakis
Journal: Case Rep Surg (2013)

Introduction. Combined abdominal and thoracic impalement injuries are a rare form of penetrating trauma. Nowadays, they occur more frequently as an accident and not so often as a deliberate violent action. Case Report. A 35-year-old man was admitted to our emergency department with chest pain and respiratory distress after he had reportedly slipped in his bathtub. Abdominal and thoracic imaging, including computed tomography (CT), confirmed a right-sided pneumothorax and a liver laceration without bleeding or further endoperitoneal trauma. A chest tube was placed. During his hospitalization in the first 24-hour period, he complained of abdominal and right shoulder pain accompanied by fever. A new abdominal and thoracic CT scanning revealed a rupture of the rectosigmoid, a rupture of right hemidiaphragm, and a foreign body in the thoracic cavity. The patient admitted that a broomstick was violently placed through his rectum, and he underwent a thoracotomy with an exploratory laparotomy. The foreign object was removed, the diaphragmatic rupture was repaired, and a Hartmann's procedure was performed. The postoperative course was uneventful. Conclusion. In cases of combined thoracoabdominal trauma, high index of suspicion is required when medical history is misleading and the injuries are not obvious immediately. A coordinated team effort in a well-organized trauma center is also very important.
Intravascular glomus tumor of the forearm causing chronic pain and focal tenderness
Authors: Sang Ki Lee, Dae Geon Song, Won Sik Choy
Journal: Case Rep Orthop (2014)

Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition. Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI) showed a mass measuring 5 × 3 × 2 mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient's symptoms were completely resolved postoperatively. Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis.
Propofol Infusion Syndrome in the Postoperative Period of a Kidney Transplant
Authors: Edgar Dehesa-López, Sergio Saul Irizar-Santana, Rolando Claure-Del Granado, Rafael Valdez-Ortiz
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Sedation during medical procedures poses a risk to any patient, and the use of specific anesthetic agents should be carefully considered to avoid adverse outcomes. We report on a patient with propofol infusion syndrome diagnosed during the post-operative period of a renal transplant. A 58-year-old female on chronic hemodialysis due to end stage kidney disease secondary to microscopic polyangiitis underwent kidney transplant from a deceased donor. Anesthetic induction was performed with fentanyl, propofol, and cisatracurium, and maintained with continuous propofol infusion. In the recovery room, the patient developed somnolence, tachypnea, and thoracoabdominal dissociation secondary to residual neuromuscular block. An arterial-blood gas test indicated acidemia, high pCO2, low HCO3, and mildly increased serum lactate. The patient remained hemodynamically stable, on volume-controlled ventilation, with sedation by continuous propofol infusion. Blood gas tests revealed persistent acidemia without tissue hypoperfusion. Doppler ultrasound of the renal graft reported adequate blood flow and serum triglycerides were elevated. A diagnosis of propofol infusion syndrome was made, and infusion ceased. A decrease in serum lactate levels was observed, with normalization 4 h later. This case highlights the importance of considering adverse effects of anesthetic agents as the cause of post-operative complications when prolonged sedation is required.
Sinonasal diffuse large B-cell lymphoma in a patient with Wiskott-Aldrich syndrome: A case report and literature review
Authors: Xiwen Sun, Chunyu Luo, Ru Tang, Song Mao, Ying Zhu, Chonghui Fei, Mengyu Wang, Shaolin Tan, Shiyao Zhang, Jiayao Zhou, Hai Lin, Zhipeng Li, Weitian Zhang
Journal: Front Immunol (2023)
Keywords: wiskott-aldrich syndrome, case report, diffuse large b cell lymphoma, sinonasal, surgery
MeSH terms: Lymphoma, Large B-Cell, Diffuse / complications, Lymphoma, Large B-Cell, Diffuse / diagnosis, Lymphoma, Large B-Cell, Diffuse / pathology, Lymphoma, Non-Hodgkin / pathology, Paranasal Sinus Neoplasms / complications, Paranasal Sinus Neoplasms / pathology, Paranasal Sinuses, Wiskott-Aldrich Syndrome / diagnosis, Review, Case Reports, Research Support, Non-U.S. Gov't, Humans

Wiskott-Aldrich syndrome (WAS) is a rare primary immunodeficiency disease with a predisposition towards autoimmunity and lymphoproliferative diseases. Non-Hodgkin lymphoma (NHL) is reported to be the predominant form of malignant tumor in WAS sufferers. Diffuse large B-cell lymphoma (DLBCL) is one of the most common types of NHL while it is uncommon to occur in paranasal sinuses and especially when associated with WAS. In this article, we report a unique case of WAS associated with DLBCL in paranasal sinuses and review the major publications of WAS-related lymphomas that occurred in the head and neck area. This study extends the available therapies for WAS-related lymphomas and emphasizes the significance of recognition for sinonasal lymphomas in WAS patients presenting with sinusitis.
Atypical imaging of spinal tuberculosis: a case report and review of literature
Authors: Huijun Zhang, Zenghui Lu
Journal: Pan Afr Med J (2016)
Keywords: spinal tuberculosis, case report, imaging
MeSH terms: Tuberculosis / diagnostic imaging, Tuberculosis, Spinal / diagnostic imaging, Case Reports, Review, Humans, Male, Sacroiliac Joint / diagnostic imaging, Sacroiliac Joint / microbiology, Thoracic Wall / diagnostic imaging, Thoracic Wall / microbiology, Tuberculosis / pathology, Tuberculosis, Osteoarticular / diagnostic imaging, Tuberculosis, Pleural / diagnostic imaging, Tuberculosis, Pulmonary / diagnostic imaging, Tuberculosis, Spinal / pathology, Young Adult

This is a case report of spinal tuberculosis combined with sacroiliac joint tuberculosis, pulmonary tuberculosis, chest wall tuberculosis and tuberculous pleurisy and the image of the patient is rare, special and not typical and it looks like a halo sign. It has an important reference value for the diagnosis of spine tuberculosis although it is a rare imaging manifestation and diagnosis was confirmed by pathology after the surgery. Therefore atypical imaging is often appeared in clinical practice and it is meaningful and necessary for the diagnosis of atypical spinal tuberculosis combined with multiple organ tuberculosis.
Whole exome sequencing detects homozygosity for ABCA4 p.Arg602Trp missense mutation in a pediatric patient with rapidly progressive retinal dystrophy
Authors: Maria Carolina Ortube, Samuel P Strom, Stanley F Nelson, Steven Nusinowitz, Ariadna Martinez, Michael B Gorin
Journal: BMC Med Genet (2014)
MeSH terms: ATP-Binding Cassette Transporters / genetics, DNA Mutational Analysis, Disease Progression, Exome / genetics, Homozygote, Mutation, Missense, Retinal Dystrophies / genetics, Case Reports, Research Support, Non-U.S. Gov't, Child, Female, Humans, Male, Phenotype, Retinal Dystrophies / diagnosis, Retinal Dystrophies / pathology, Retinal Dystrophies / physiopathology, ABCA4 protein, human, ATP-Binding Cassette Transporters

Background:
A pediatric patient presented with rapidly progressive vision loss, nyctalopia and retinal dystrophy. This is the first report of homozygosity for the p.Arg602Trp mutation in the ABCA4 gene. The child became legally blind within a period of 2 years.
Case presentation:
An eight year-old Hispanic female presented with bilateral decreased vision following a febrile gastrointestinal illness with nausea and vomiting. Extensive workup involved pediatric infectious disease and rheumatology consultations.Initial visual acuity was 20/60 at distance and 20/30 at near in both eyes. Rapidly progressive vision loss occurred during a 2-year period resulting in visual acuities of 20/200 at distance in both eyes. Fundus exam disclosed attenuated vessels and multiple subretinal blister-like elevations. Optical coherence tomography showed far more lesions than were clinically evident with different levels of elevation. Autofluorescence imagery showed dramatic and widespread geographic areas of atrophy. The deposits that appeared drusen-like on clinical exam were hyperfluorescent, consistent with lipofuscin deposits containing A2e (N-retinylidene-N-retinylethanolamine) indicative of RPE cell dysfunction. Electroretinography was consistent with cone dystrophy, with relative preservation of rod function. Blood analysis and rheumatology evaluation found no evidence of a diffuse post-infectious/inflammatory process. The unique and rapid progression of her subretinal blister-like lesions was documented by fluorescein angiography, optical coherence tomography, autofluorescence imagery, and fundus photography. Family pedigree history disclosed consanguinity, her parents being first cousins. DNA analysis by whole exomic sequencing revealed homozygosity of p.Arg602Trp in the ABCA4 gene.
Conclusion:
The pediatric patient presented with a striking clinical appearance and dramatic rate of progression that was clinically more characteristic of an infectious or inflammatory process. This case expands the diverse range of phenotypes attributed to ABCA4 mutations and further supports the role of whole exome sequencing as a powerful new tool available to aid clinicians in establishing diagnosis for challenging cases.
Immune Reconstitution Inflammatory Syndrome Occurring in a Kidney Transplant Patient with Extrapulmonary Tuberculosis
Authors: Jose Iglesias, Kandria Jumil Ledesma, Paul J Couto, Jessie Liu
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Tuberculosis (TB) occurring in solid organ transplantation (SOT) is associated with significant morbidity and mortality usually due to delays in diagnosis, drug toxicity encountered with antimycobacterial therapy, and drug-drug interactions. TB in SOT patients may mimic other infectious and noninfectious posttransplant complications such as posttransplant lymphoproliferative disorder (PTLD) and systemic cytomegalovirus infection. Immune reconstitution inflammatory syndrome (IRIS) is a host response resulting in paradoxical worsening of an infectious disease which occurs after the employment of effective therapy and reversal of an immunosuppressed state. We describe the development of immune reconstitution inflammatory syndrome (IRIS), a unique complication occurring during the treatment of extrapulmonary tuberculosis occurring after transplant which resulted from decreasing immunosuppression in a patient who received Alemtuzumab induction therapy. Although (IRIS) has been originally described in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART), solid organ transplant recipients with diagnosed or occult TB whose immune system may undergo immune reconstitution during their posttransplant course represent a new high risk group.
A Case of Alveolar Bleeding from Clotting Abnormality by Cefmetazole
Authors: Eri Nakano, Tsubasa Fukuoka, Nao Takeuchi, Tomoyuki Seki, Michihiro Tamai, Makoto Araki
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Cephalosporins are one of the most commonly used first-line antibiotics. In this report, we describe the case of a patient who developed alveolar bleeding due to clotting abnormality following the use of cefmetazole, one of cephalosporins containing an N-methylthiotetrazole (NMTT) side chain. Compared to other antibiotics, cephalosporins with an NMTT side chain cause a higher degree of bleeding events. The bleeding tendency is caused by the depletion of vitamin K-dependent clotting factors via inhibition of the vitamin K epoxide reductase. This mechanism of action is the same as warfarin. Recent years have seen an increase in the number of patients using direct oral anticoagulants that do not require coagulation tests. As a consequence, there may be an increase in the number of bleeding events due to anticoagulant drugs and such antibiotics coprescription. Therefore, this case is an instructive lesson.
Prospecting for Energy-Rich Renewable Raw Materials: Agave Leaf Case Study
Authors: Kendall R Corbin, Caitlin S Byrt, Stefan Bauer, Seth DeBolt, Don Chambers, Joseph A M Holtum, Ghazwan Karem, Marilyn Henderson, Jelle Lahnstein, Cherie T Beahan, Antony Bacic, Geoffrey B Fincher, Natalie S Betts, Rachel A Burton
Journal: PLoS One (2015)
MeSH terms: Agave / chemistry, Cellulose / chemistry, Plant Leaves / chemistry, Renewable Energy, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Agave / metabolism, Biomass, Fermentation, Hydrolysis, Lignin / chemistry, Plant Leaves / metabolism, Polysaccharides / chemistry, Polysaccharides, Cellulose, Lignin

Plant biomass from different species is heterogeneous, and this diversity in composition can be mined to identify materials of value to fuel and chemical industries. Agave produces high yields of energy-rich biomass, and the sugar-rich stem tissue has traditionally been used to make alcoholic beverages. Here, the compositions of Agave americana and Agave tequilana leaves are determined, particularly in the context of bioethanol production. Agave leaf cell wall polysaccharide content was characterized by linkage analysis, non-cellulosic polysaccharides such as pectins were observed by immuno-microscopy, and leaf juice composition was determined by liquid chromatography. Agave leaves are fruit-like--rich in moisture, soluble sugars and pectin. The dry leaf fiber was composed of crystalline cellulose (47-50% w/w) and non-cellulosic polysaccharides (16-22% w/w), and whole leaves were low in lignin (9-13% w/w). Of the dry mass of whole Agave leaves, 85-95% consisted of soluble sugars, cellulose, non-cellulosic polysaccharides, lignin, acetate, protein and minerals. Juice pressed from the Agave leaves accounted for 69% of the fresh weight and was rich in glucose and fructose. Hydrolysis of the fructan oligosaccharides doubled the amount of fermentable fructose in A. tequilana leaf juice samples and the concentration of fermentable hexose sugars was 41-48 g/L. In agricultural production systems such as the tequila making, Agave leaves are discarded as waste. Theoretically, up to 4000 L/ha/yr of bioethanol could be produced from juice extracted from waste Agave leaves. Using standard Saccharomyces cerevisiae strains to ferment Agave juice, we observed ethanol yields that were 66% of the theoretical yields. These data indicate that Agave could rival currently used bioethanol feedstocks, particularly if the fermentation organisms and conditions were adapted to suit Agave leaf composition.
Report of Four Cases with Equestrian Injury: Therapeutic Approach and Outcome
Authors: Kiyohiro Oshima, Masato Murata, Makoto Aoki, Jun Nakajima, Yusuke Sawada, Yuta Isshiki, Yumi Ichikawa, Shuichi Hagiwara
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Equestrianism is associated with a risk of severe trauma due to falls and/or direct injury from the horse, depending on the mechanism of injury. This article presents four cases of equestrian injury treated in Gunma University Hospital: Case 1: hepatic injury (fall and kick by the horse); Case 2: left hemopneumothorax and pulmonary contusion with multiple rib fractures (fall and trampling by the horse); Case 3: lumbar compression fracture (fall); and Case 4: scrotum injury (horse bite). Equestrian injuries may be high-energy traumas. Therefore, adhering to relevant primary care guidelines may prevent mortality by trauma.
Vaginal Vault Prolapse in an Elderly Woman
Authors: Nidhi Shah, Anuja Bhalerao
Journal: Cureus (2023)
Keywords: abdominal sacrocolpopexy, mccall’s culdoplasty, sacral colpopexy, surgical approach, vaginal vault, vaginal vault prolapse, vault prolapse
MeSH terms: Case Reports

Vaginal vault prolapse is a painful condition in which the vaginal cuff descends. This report presents a case of a 65-year-old obese and diabetic female who was suffering from a third-degree vault prolapse. Conventionally used non-surgical treatments, such as exercises for the pelvic floor, are not as effective as surgical approaches for the treatment of third-degree vault prolapse. Post-hysterectomy vaginal vault prolapse can be treated safely and effectively with abdominal sacral colpopexy using a permanent mesh. Due to several risk factors, such as grand parity, advancing age, and poor lifestyle mainly involving exercise to strengthen pelvic floor musculature, the vaginal route of surgery was employed, which was found to be effective, and thus the treatment was successful. In conclusion, such individualized as well as unique approaches to such rare cases can produce efficacious results.
Post-traumatic osteoid osteoma in an 18-year-old adolescent
Authors: E Vancamp, F M Vanhoenacker, G Vanderschueren
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Osteoid osteoma (OO) is a painful, benign bone-forming lesion, which often poses a diagnostic challenge. The aetiology of OO is still poorly understood. Although not generally accepted, an association with previous trauma or infection has occasionally been suggested. We present a case of an OO 12 years following an ulnar fracture. Radiologists should consider OO as a potential delayed "complication" of a previous fracture. Persistent pain at a previous fracture site should alert the clinician to request cross-sectional imaging. CT scanning plays a pivotal role in the correct diagnosis of OO.
Oesphageal stenting for palliation of malignant mesothelioma
Authors: Enoch Akowuah, Joseph Rahamim
Journal: J Cardiothorac Surg (2008)
MeSH terms: Esophageal Neoplasms / surgery, Esophageal Stenosis / surgery, Mesothelioma / surgery, Palliative Care / methods, Stents, Case Reports, Aged, Endoscopy, Gastrointestinal, Esophageal Neoplasms / complications, Esophageal Neoplasms / diagnosis, Esophageal Stenosis / diagnosis, Esophageal Stenosis / etiology, Follow-Up Studies, Humans, Male, Mesothelioma / complications, Mesothelioma / diagnosis, Tomography, X-Ray Computed

Dyspahgia in patients with malignant mesothelioma is usually due to direct infiltration of the eosophagus by the tumour. It can be distressing for the patient and challenging for the physician to treat. We describe three cases in which this condition has been successfully palliated with self expanding esophageal stents.
MELAS syndrome presenting as an acute surgical abdomen
Authors: S Dindyal, K Mistry, N Angamuthu, G Smith, D Hilton, P Arumugam, J Mathew
Journal: Ann R Coll Surg Engl (2014)
MeSH terms: Abdomen, Acute / etiology, MELAS Syndrome / complications, Megacolon, Toxic / etiology, Case Reports, Abdomen, Acute / surgery, Adult, Basal Ganglia Diseases / diagnostic imaging, Basal Ganglia Diseases / etiology, Calcinosis / diagnostic imaging, Calcinosis / etiology, Colon / blood supply, Female, Humans, Ischemia / diagnosis, Ischemia / surgery, MELAS Syndrome / diagnosis, Megacolon, Toxic / surgery, Tomography, X-Ray Computed

MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.