OpenMed/multicare-articles huggingface dataset:
Severe reactive ischemic posterior segment inflammation in Acanthamoeba keratitis: Case report of a patient with Sjögren's syndrome
Authors: Christoph Palme, Bernhard Steger, Gertrud Haas, Barbara Teuchner, Nikolaos E Bechrakis
Journal: Spektrum Augenheilkd (2017)
Keywords: acanthamoeba keratitis, cataract surgery, reactive ischemic posterior segment inflammation, sjögren’s syndrome

Purpose:
We report on a case of Acanthamoeba keratitis (AK)-related reactive ischemic posterior segment inflammation following intraocular surgery in a patient with primary Sjögren's syndrome (PSS).
Case report:
A 48-year-old female patient with severe protracted AK underwent uneventful cataract surgery upon development of a corneal scar. Four weeks postoperatively, she experienced a rapid loss of vision to no light perception. Central retinal artery occlusion and ischemic optic neuropathy could be excluded, and a diagnosis of PSS was made. The condition remained unresponsive to systemic steroid treatment and ultimately led to enucleation of the globe. Histologic work-up revealed ischemic posterior segment inflammation and Acanthamoeba cysts in the corneal stroma.
Conclusion:
Autoimmune disease may be a risk factor for AK-related severe reactive ischemic posterior segment inflammation, and intraocular surgery can be a trigger to its manifestation.
Cone beam computed tomography evaluation of the diagnosis, treatment planning, and long-term followup of large periapical lesions treated by endodontic surgery: two case reports
Authors: Vijay Shekhar, K Shashikala
Journal: Case Rep Dent (2013)

The aim of this case report is to present two cases where cone beam computed tomography (CBCT) was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma) from a fluid-filled lesion or cavity (cyst). In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions.
Posterior lung herniation after a coughing spell: a case report
Authors: Kenneth M Jastrow 3rd, Danny Chu, Dawn Jaroszewski, Joseph Huh, Faisal Bakaeen
Journal: Cases J (2009)

Lung hernias are rare, occurring most commonly after trauma or surgery. Spontaneous lung hernias are even rarer and have only been reported as occurring anteriorly. We present a 72-year-old male who developed a spontaneous posterior lung hernia after a severe coughing episode. We describe the evaluation and surgical management of this unusual condition and provide a brief review of the literature.
Extreme Rhabdomyolysis, Acute Renal Failure, and Protracted Ileus in a Case of Legionella Pneumonia
Authors: C Laivier, M-O Bleuze, P Hantson, J Devos
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

A 53-year-old man developed a Legionella pneumophila pneumonia complicated by rhabdomyolysis, acute kidney injury, and protracted ileus. Risk factors were smoking and chronic alcoholism, but the patient had no history of previous abdominal surgery. Hemodialysis was required for a period of 5 weeks with a full renal recovery. Pneumonia required respiratory support but for a limited period of 6 days. The protracted course of the ileus led to explorative laparotomy despite negative computed tomography findings. No cause of mechanical obstruction was found at surgery and common etiologies of intestinal obstruction were excluded. Parenteral nutrition was needed for a total of 4 weeks, before recovery of intestinal motility. This case illustrates the apparent discrepancy between the pulmonary symptoms and the extrapulmonary manifestations that could be seen as a consequence of an exaggerated immune response.
Left main coronary stenosis as a consequence of bentall operation: percutaneous treatment
Authors: Manrico Balbi, Flavio Scarano, Gian Paolo Bezante
Journal: Cardiol Res Pract (2009)
MeSH terms: Case Reports

A 65-year-old man suffering from ascending aorta aneurysm and atherosclerotic three vessel disease without left main involvement underwent aortic root replacement with coronary ostia reimplantation according to the modified Bentall technique and multiple coronary artery bypass grafts. Gelatin-resorcin-formaldehyde glue was used to reinforce the aortic coronary buttons and to facilitate hemostasis. Five months after surgery, the patient experienced rapidly worsening effort angina. Coronary angiography showed severe left main narrowing. The considerable amount of time that elapsed between surgery and the onset of symptoms implies that the problem was not related to an imperfect suture technique, but was most likely caused by an inflammatory and proliferative response to the glue that had been used. We performed elective percutaneous coronary intervention and stenting of the protected coronary vessel without technical difficulties and with a satisfactory final result. The patient is currently symptom-free after 1 year's follow-up.
Maxillary Swing Approach for Removal of Palatal Carcinoma: A Modified Procedure
Authors: Tsutomu Nomura, Megumi Kishimoto, Hirohisa Iwaki, Atsushi Ochi, Seiji Kishimoto
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Introduction:
We report a modification of the maxillary swing approach to remove a palatal tumor while preserving the anterior alveolar area.
Methods:
Case report using clinical records.
Results:
The patient was a 54-year-old male. TNM grade was T4bN0M0, and invasion to the base of the pterygoid process was seen. Two courses of induction chemotherapy were administered prior to the operation. Because there was no evidence of anterior maxillary invasion, the maxillary swing approach was chosen. The left anterior maxilla was cut and swung laterally, preserving the blood supply. After removal of the palatal tumor, the maxilla was repositioned and the defect was restored with an anterior lateral thigh flap. Postoperative course was typical, and facial appearance, speech, and masticatory function were satisfactory.
Conclusions:
This technique is particularly useful for preserving appearance as well as speech and mastication.
Reintroduction of 5-Fluorouracil Post-cardiac Arrest Secondary to Chemotherapy-Induced Cardiotoxicity
Authors: Kathie Wu, Prianka Bhattacharya
Journal: Cureus (2023)
Keywords: 5-fluorouracil, cardiac arrest, chemotherapy, chemotherapy-induced cardiotoxicity, out-of-hospital cardiac arrest, rectal cancer, toxicity
MeSH terms: Case Reports

5-fluorouracil (5-FU) has been known to have cardiotoxic side effects, including coronary vasospasm, myocardial infarctions, heart failure, arrhythmias, and cardiac arrest. These cases have been reported in patients with either known coronary disease or known risk factors. In cases of acute cardiotoxicity, cessation of fluoropyrimidines is recommended, and reintroduction of the medication is generally avoided. We present a case of a young patient with no known risk factors for coronary disease, who presented with an acute cardiac arrest suspected secondary to vasospasm from the administration of 5-FU for the treatment of rectal cancer and was successfully maintained on treatment with 5-FU post-arrest after transitioning from an infusion to bolus administration.
Antenatal ultrasound diagnosis of small bowel non-rotation in complex left isomerism: a case report
Authors: Charles Arcus, Usha Sennaiyan, Amit Trivedi, Thushari I Alahakoon
Journal: Int J Surg Case Rep (2019)
Keywords: antenatal diagnosis, case report, heterotaxy, isomerism, laterality, non-rotation

Presentation of case:
A multiparous expectant mother was referred to our tertiary unit at 23 weeks with a complex fetal cardiac anomaly in the context of suspected heterotaxy syndrome. The cardiac findings were consistent with isomerism: the fetal cardiac position was levocardia with a single functioning double outlet ventricle and AV valve, pulmonary stenosis, and interrupted inferior vena cava (IVC) with azygous continuation. The fetal abdominal situs was also altered, with the stomach to the right, and the hepatobiliary system midline to left. The spleen was not identified antenatally or postnatally. At 36 weeks, ultrasound revealed an abnormal bowel pattern with small bowel loops on the right side of the abdomen and large bowel on the left, suggesting a diagnosis of non- rotation. The infant was delivered vaginally at 39 weeks. The cardiac diagnosis and non-rotation of the small bowel were confirmed by postnatal echocardiography and contrast fluoroscopy.
Discussion:
Heterotaxy syndrome is traditionally classified into right or left isomerism depending on how and where the organs are anatomically arranged. The case presented here demonstrates mixed laterality and prenatal ultrasound features of non-rotation.
Conclusion:
It is important to be informed of the embryological variants of isomerism and actively seek antenatal evidence of bowel non-rotation in such cases.
Prefrontal damage in childhood and changes in the development of personality: a case report
Authors: Valéria Santoro Bahia, Leonel Tadao Takada, Leonardo Caixeta, Leandro Tavares Lucato, Claudia Sellitto Porto, Ricardo Nitrini
Journal: Dement Neuropsychol (2013)
Keywords: frontal lobe, neuropsychology, social behavior, traumatic brain injury
MeSH terms: Case Reports

Frontal lobe lesions are associated with behavioral abnormalities and executive dysfunction. When these lesions occur early in life, the symptoms are even more severe as the anatomical and functional substrates underlying personality and behavior are damaged, distorting normal modulation by interaction with the psychosocial environment. We present a case of a 40-year-old man who suffered a frontal lobe lesion at the age of nine years and developed impulsivity, disinhibition and inappropriate behaviors while showing some preservation of insight. Brain MRI revealed lesions to bilateral orbitofrontal cortex, ventromedial prefrontal cortex, anterior cingulate gyri and genu of the corpus callosum, which were more extensive on the right side. The right prefrontal dorsolateral cortex was severely damaged, whereas the right ventrolateral prefrontal cortex was spared. We will discuss the correlation of the damaged pre frontal regions with the symptoms presented by the patient.
Suicidal behavior in a patient with burning mouth syndrome
Authors: Konstantinos Kontoangelos, Evmorfia Koukia, Vasilis Papanikolaou, Aris Chrysovergis, Antonis Maillis, George N Papadimitriou
Journal: Case Rep Psychiatry (2014)

Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety. Case Presentation. This is a case of a 93-year-old patient suffering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. The patient was suffering from depression and also a diagnosis of "burning mouth syndrome" (BMS) was made. Discussion. Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major) and suicidal thoughts.
Chronic elevation of liver enzymes in acute intermittent porphyria initially misdiagnosed as autoimmune hepatitis
Authors: A González Estrada, S García-Morillo, L Gómez Morales, P Stiefel García-Junco
Journal: Int J Hepatol (2011)
MeSH terms: Case Reports

Autoimmune hepatitis is a disease characterized by an elevation of liver enzymes, as well as specific autoantibodies. It is more common in women than men. We describe a 32-year-old woman with elevated transaminases, autoantibodies, and a liver biopsy result suggestive of autoimmune hepatitis. The indicated treatment was administered without showing a satisfactory response. The patient had a family history of acute intermittent porphyria (AIP) so we decided to begin treatment with hematin, achieving a complete remission of the symptoms. Acute intermittent porphyria is a rare condition characterized by neurovisceral symptoms, abdominal pain being the most common of them. The disease has a higher prevalence among young women and certain European countries such as Sweden, Great Britain, and Spain. A correct diagnosis and prompt treatment are essential because patients affected by AIP must have a strict followup due to the fatal outcome of the outbreaks.
Off-label MRI examination of an MR conditional pacemaker
Authors: Jonathon Delve, Peter Wright, Ashish Patwala, Dipti Patel, Matthew Stevenson
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

An 18-year-old patient was implanted with an MR-conditional pacemaker using a lead plug which negated the manufacturer CE approved MR conditional status of the pacing system. The patient was referred for a lumbar spine MRI. The clinical opinion was that the risk of proceeding with the MRI was acceptable given the alternatives of: (a) changing the pacing system or (b) not performing the scan. A risk assessment revealed that the additional risk was very low and easily mitigated by an established technique. Informed consent was obtained and the scan was completed without incident following a slightly modified MR-conditional pacemaker scanning protocol.
A case of benign periosteal chondroma seeding into humeral medullary bone via percutaneous needle biopsy tract
Authors: J P Learmont, G Powell, J Slavin, M Facey, M Pianta
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

We report an occurrence of periosteal chondroma seeding into the medulla of humerus via percutaneous needle biopsy tract. To our knowledge, this is the first described case of benign cartilage tumour biopsy tract seeding in the literature. We discuss the clinical, radiological and histological features of periosteal chondroma, as well as the diagnostic challenges associated with distinguishing this entity from periosteal chondrosarcoma. Finally, we briefly discuss the safety of imaging-guided percutaneous needle biopsy and methods to minimize the risk of iatrogenic tumour seeding.
Severe Noncardiogenic Pulmonary Edema Secondary to Massive Verapamil Overdose and Treatment with Venovenous Extracorporeal Membrane Oxygenation
Authors: An Ho, Abigail Go, Christopher Barrios, Anthony Scalzo
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Calcium channel blocker (CCB) poisoning frequently presents with cardiovascular complications such as cardiogenic shock and arrhythmia. We present a case of massive verapamil overdose causing refractory noncardiogenic pulmonary edema successfully treated with extracorporeal membrane oxygenation. To our knowledge, this is the first case with these features reported in literature. A 27-year-old female patient presented with an overdose of 18,000 mg of verapamil. Her clinical condition deteriorated to severe hypoxic respiratory failure despite being treated with calcium, high-dose insulin, and full invasive ventilation support. She eventually required venovenous extracorporeal membrane oxygenation (VV-ECMO) for three days with full recovery. Large ingestion of verapamil could lead to noncardiogenic pulmonary edema. VV-ECMO might play an important role to support the treatment in severe cases with refractory hypoxia.
Harnessing social media in mental health practice in Kenya: a community case study report
Authors: Linnet Ongeri, Gathoni Mbugua, Frank Njenga, Anna Nguithi, Jacqueline Anundo, Maryann Mugane, Zawadi Kimari, Loice Wanjiru Cushny Kaigwa, Lukoye Atwoli
Journal: Pan Afr Med J (2021)
Keywords: kenya, lmic, social media, mental health awareness, mental health promotion
MeSH terms: Mental Health Services / organization & administration, Mental Health, Social Media, Humans, Kenya, Mental Disorders / therapy, Peer Group, Social Support

The use of social media to increase awareness on mental health is rapidly gaining momentum globally. However, despite evidence of a growing trend in social media use in sub Saharan Africa, little has been reported on tapping the potential of social media within a mental health practice to not only increase awareness but also facilitate linkage to specialist care. We describe one such mental health practice and its process of integration of the different social media platforms to promote mental health and increase linkage to specialist care. We further highlight the challenges and practical implication of social media use in the Kenyan setting. We conclude by advocating for this integration to raise awareness and also encourage peer support for persons with mental health problems and recommend research that measures the impact of such interventions in sub-Saharan Africa.
Complications after Dynamic Hip Screw Osteosynthesis of Proximal Femoral Fractures at Army Instructional Hospital-Libreville
Authors: F M Bombah, M Diawara, B Y Ekani, T Nana, A Mikiela
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The DHS system is an effective means of open reduction and internal fixation of proximal femur fractures. Postoperative complications are little described and deserve to be studied for better preventive and curative treatment. We report the observations of five (5) patients who presented postoperative complications specific to the DHS system at army instructional Hospital-Libreville. These described complications are related to deterioration of internal fixation leading to callus, nonunion, or infection. Those found are the cut out phenomenon, avascular necrosis of the femoral head, and the fracture of the DHS system. All these complications required surgical revision without functional repercussions at the last follow-up. Complications of internal fixation by the DHS system can be avoided by rigorous asepsis, adequate indications for surgery, and rigorous surgical techniques. Good management can restore hip function.
Lessons learnt from the painful shoulder; a case series of malignant shoulder girdle tumours misdiagnosed as frozen shoulder
Authors: Gerald My Quan, Derek Carr, Steven Schlicht, Gerard Powell, Peter Fm Choong
Journal: Int Semin Surg Oncol (2005)

Adhesive capsulitis or frozen shoulder is a common condition characterized by shoulder pain and stiffness. In patients in whom conservative measures have failed, more invasive interventions such as arthrographic or arthroscopic distension can be very effective in relieving symptoms and improving range of movement. However, absolute contraindications to these procedures include the presence of neoplasia around the shoulder girdle. We present five cases referred to our institution where the diagnosis of shoulder joint malignancy was delayed, following prolonged, ineffective treatment for frozen shoulder. These cases highlight the importance of careful review of the radiology and the need for reconsideration of the diagnosis in refractory "frozen shoulder".
"Surface epithelial changes" in uterine endometrioid carcinoma mimicking micropapillary serous borderline tumor of ovary: report of two cases and review of the literature
Authors: Kamaljeet Singh, Rochelle A Simon, Cunxian Zhang, M Ruhul Quddus
Journal: Diagn Pathol (2011)
MeSH terms: Carcinoma, Endometrioid / diagnosis, Carcinoma, Papillary / diagnosis, Endometrial Neoplasms / diagnosis, Epithelial Cells / pathology, Ovarian Neoplasms / diagnosis, Case Reports, Review, Aged, Carcinoma, Endometrioid / metabolism, Carcinoma, Endometrioid / pathology, Carcinoma, Papillary / metabolism, Carcinoma, Papillary / pathology, Diagnosis, Differential, Endometrial Neoplasms / metabolism, Endometrial Neoplasms / pathology, Epithelial Cells / metabolism, Female, Humans, Middle Aged, Ovarian Neoplasms / metabolism, Ovarian Neoplasms / pathology, PTEN Phosphohydrolase / metabolism, Tumor Suppressor Protein p53 / metabolism, Tumor Suppressor Protein p53, PTEN Phosphohydrolase, PTEN protein, human

We encountered two cases of endometrioid carcinoma of uterus with extensive surface epithelial changes (SECs) mimicking serous borderline tumor (SBT) of the ovary. The first case was a well-differentiated endometrioid carcinoma arising in a background of complex atypical hyperplasia. The second case was moderately-differentiated endometrioid carcinoma with squamous and mucinous differentiation. The SECs comprised of thin microapapillae without hierarchal branching, lined by cuboidal cells with eosinophilic cytoplasm and mild to moderate nuclear atypia. These areas were reminiscent of SBTs of ovary, micropapillary type. This report expands the existing spectrum of SECs. Serous borderline tumor of ovary like surface epithelial changes could be misleading if present in an endometrial biopsy or curettings. Therefore, knowledge of this morphologic variation is important.
Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women
Authors: Ines Mack, Marie-Anne Burckhardt, Ulrich Heininger, Friederike Prüfer, Sven Schulzke, Sven Wellmann
Journal: Front Pediatr (2017)
Keywords: blueberry muffin, calcification, cytomegalovirus infections, hearing loss, magnetic resonance imaging, neuroimaging, pregnancy
MeSH terms: Case Reports

Cytomegalovirus (CMV) is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV) transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV) contribute to a much greater proportion of symptomatic cCMV than was previously thought. Here, we describe a case of symptomatic cCMV infection in the newborn of a woman with proven immunity prior to pregnancy. Diagnosis was confirmed by CMV PCR from amniotic fluid and fetal MR imaging. The newborn presented with typical cCMV symptoms including jaundice, hepatosplenomegaly, cholestasis, petechiae, small head circumference, and sensorineural hearing loss, the most common neurologic sequela. CMV was detected in infant blood and urine by PCR, and intravenous ganciclovir was initiated and continued orally for 6 weeks totally. Apart from persisting right-sided deafness, the child exhibited normal neurological development up through the last follow-up at 4.5 years. To date, the most effective strategy to prevent vertical CMV transmission is hygiene counseling for women of childbearing age, which, in our case, and in concordance with recent literature, applies to seronegative, as well as seropositive, women. Once an expecting mother shows seroconversion or signs of an active CMV infection, there are no established procedures to reduce the risk of transmission, or therapeutic options for the fetus with signs of infection. After birth, symptomatic infants can be treated with ganciclovir to inhibit viral replication and improve hearing ability and neurodevelopmental outcome. A comprehensive review of the literature, including our case study, reveals the most current and significant diagnostic and treatment options available. In conclusion, the triad of maternal hygiene counseling, postnatal hearing screening of all newborns, followed by CMV PCR in symptomatic infants, and antiviral therapy of infants with symptomatic cCMV provides an outline of best practice to reduce the burden of CMV transmission sequelae.