OpenMed/multicare-articles huggingface dataset:
Incidental Diagnosis of a Rare Case of Corkscrew Aorta
Authors: M Petullà, G Mazzarella, L Critelli, L Paone, D Laganà
Journal: Case Rep Radiol (2019)
MeSH terms: Case Reports

The corkscrew aorta is a variant of the normal anatomical course of the aorta. This rare condition is characterized by a marked tortuosity of the aorta. In our experience it concerns the tract of subrenal aorta, that is an unusual condition, since there are no other cases in the literature. It is characterized by the presence of at least two kinking, and a coiling interposed among them. It is diagnosed by Angio-CT and its response is incidental, being from an asymptomatic clinical point of view.
Nasal Chondromesenchymal Hamartoma: Rare Case Report in an Elderly Patient and Brief Review of Literature
Authors: Kanish Mirchia, Rana Naous
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Hamartomas are considered a mixture of nonneoplastic tissue, which may be indigenous to a different location in the body. As such, they may be epithelial, mesenchymal, or mixed. In the sinonasal region, the following hamartomatous lesions are considered to lie on a spectrum and include respiratory epithelial adenomatoid hamartoma (REAH), chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH), and nasal chondromesenchymal hamartoma (NCMH). To our knowledge, less than 50 cases of sinonasal hamartomas have been reported in the English literature so far with NCMH being very rare and primarily a tumor in infancy, with only 2 cases reported in individuals older than 16 years of age. We report a highly unusual case of a NCMH in the right maxillary sinus of a 70-year-old female.
A New Intraoral Appliance for Trismus in Oral Submucous Fibrosis
Authors: Nallan C S K Chaitanya, C M S Krishna Prasad, Reshma Priyanka Danam, Madireddy Nithika, Chintada Suvarna, Jampala Nancypriyanka, Rajkumar Badam
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Trismus is the most common sequelae of various pathological processes leading to compromised nutritional state in addition to physical and psychological disabilities. Therapeutic interventions are available to relieve trismus, which range from oral usage of pharmacological agents to intralesional steroid therapy. Intraoral appliance therapy can be employed as an alternative or adjuvant treatment for radiotherapy-induced fibrosis and autoimmune disorders such as scleroderma, psychogenic trismus, and oral submucous fibrosis, decreasing the adverse effects associated with other pharmacological interventions. A novel intraoral appliance-"Nallan C-H"-has been developed and tried for trismus producing better results. A report on three such cases having trismus due to a premalignancy has been presented. It is hypothesized that the same appliance can be used for treating inoperable trismus in palliative care setting additionally or as an adjuvant to pharmacological approach.
Blastomyces antigen detection for monitoring progression of blastomycosis in a pregnant adolescent
Authors: Megan Tarr, John Marcinak, Kanokporn Mongkolrattanothai, Jennifer L Burns, L Joseph Wheat, Michelle Durkin, Mahmoud Ismail
Journal: Infect Dis Obstet Gynecol (2007)
MeSH terms: Antigens, Fungal / urine, Blastomyces / isolation & purification, Blastomycosis / urine, Pregnancy Complications, Infectious / microbiology, Pregnancy Complications, Infectious / urine, Case Reports, Adolescent, Blastomycosis / drug therapy, Blastomycosis / microbiology, Disease Progression, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Infectious / drug therapy, Antigens, Fungal

Although disseminated blastomycosis is a rare complication in pregnancy, delay in diagnosis and treatment can be fatal. We investigate the use of the Blastomyces urine antigen in diagnosis following disease progression in the intrapartum, postpartum, and neonatal periods. We describe a case of disseminated blastomycosis in a pregnant adolescent and review the pertinent literature regarding treatment and monitoring blastomycosis in pregnancy and the neonatal periods. This is the first reported case in which the Blastomyces urine antigen is utilized as a method of following disease activity during pregnancy confirming absence of clinically evident disease in a neonate. Urine antigen detection for blastomycosis can be useful for following progression of disease in patients with disseminated blastomycosis in both the intrapartum and postpartum periods.
Case report: Detection of fetal trisomy 9 mosaicism by multiple genetic testing methods: Report of two cases
Authors: Na Ma, Zhenhua Zhu, Jiancheng Hu, Jialun Pang, Shuting Yang, Jing Liu, Jing Chen, Wanglan Tang, Haiyan Kuang, Rong Hu, Zhuo Li, Hua Wang, Ying Peng, Hui Xi
Journal: Front Genet (2023)
Keywords: chromosomal microarray analysis, copy number variation sequencing, karyotype, mosaicism, non-invasive prenatal testing, trisomy 9
MeSH terms: Case Reports

Chromosomal mosaicism remains a perpetual diagnostic and clinical dilemma. In the present study, we detected two prenatal trisomy 9 mosaic syndrome cases by using multiple genetic testing methods. The non-invasive prenatal testing (NIPT) results suggested trisomy 9 in two fetuses. Karyotype analysis of amniocytes showed a high level (42%-50%) of mosaicism, and chromosomal microarray analysis (CMA) of uncultured amniocytes showed no copy number variation (CNV) except for large fragment loss of heterozygosity. Ultrasound findings were unmarkable except for small for gestational age. In Case 1, further umbilical blood puncture confirmed 22.4% and 34% trisomy 9 mosaicism by CMA and fluorescent in situ hybridization (FISH) respectively. After comprehensive consideration of the genetic and ultrasound results, the two gravidas decided to receive elective termination and molecular investigations of multiple tissue samples from the aborted fetus and the placenta. The results confirmed the presence of true fetoplacental mosaicism with levels of trisomy 9 mosaicism from 76% to normal in various tissues. These two cases highlight the necessity of genetic counseling for gravidas whose NIPT results highly suggest the risk of chromosome 9 to ascertain the occurrence of mosaicism. In addition, the comprehensive use of multiple genetic techniques and biological samples is recommended for prenatal diagnosis to avoid false-negative results. It should also be noted that ultrasound results of organs with true trisomy 9 mosaicism can be free of structural abnormalities during pregnancy.
Pregnancy complicated by Ludwig's angina requiring delivery
Authors: Kathleen Moorhead, Maryam Guiahi
Journal: Infect Dis Obstet Gynecol (2010)
MeSH terms: Cesarean Section, Ludwig's Angina / microbiology, Periodontal Abscess / complications, Pregnancy Complications, Infectious / drug therapy, Pregnancy Complications, Infectious / surgery, Case Reports, Adult, Anti-Bacterial Agents / therapeutic use, Drainage, Female, Gestational Age, Gram-Negative Bacteria / isolation & purification, Humans, Infant, Newborn, Infant, Premature, Intensive Care, Neonatal, Ludwig's Angina / drug therapy, Ludwig's Angina / surgery, Periodontal Abscess / microbiology, Periodontal Abscess / therapy, Pregnancy, Respiratory Distress Syndrome / etiology, Respiratory Distress Syndrome / therapy, Tooth Extraction, Tracheotomy, Anti-Bacterial Agents

At 33 weeks of gestation, a 24-year-old developed Ludwig's angina that worsened despite aggressive therapy. This is the first reported case of Ludwig's Angina in pregnancy that required an emergent cesarean section for fetal indications. Delivery may have contributed to improvement in the mother's health status.
Is it antiphospholipid syndrome?
Authors: Maria Chiara Ditto, Marco Antivalle, Matteo Badini, Michele Battellino, Chiara Cogliati, Piercarlo Sarzi-Puttini
Journal: Int J Rheumatol (2010)
MeSH terms: Case Reports

The diagnosis of bacterial endocarditis remains a challenge, as nearly half of cases develop in the absence of preexistent heart disease and known risk factors. Not infrequently, a blunted clinical course at onset can lead to erroneous diagnoses. We present the case of a 47-year-old previously healthy man in which a presumptive diagnosis of antiphospholipid syndrome was made based on the absence of echocardiographically detected heart involvement, a negative blood culture, normal C-reactive protein (CRP) levels, a positive lupus anticoagulant (LAC) test, and evidence of splenic infarcts. The patient eventually developed massive aortic endocarditic involvement, with blood cultures positive for Streptococcus bovis, and was referred for valvular replacement. This case not only reminds us of the diagnostic challenges of bacterial endocarditis, but also underlines the need for a critical application of antiphospholipid syndrome diagnostic criteria.
A generalized pustular psoriasis flare after CoronaVac COVID-19 vaccination: Case report
Authors: Nahide Onsun, Gökhan Kaya, Bengisu Güçkan Işık, Begüm Güneş
Journal: Health Promot Perspect (2021)
Keywords: covid, coronovac, psoriasis
MeSH terms: Case Reports

CoronoVac is a non-viable vaccine for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Nowadays, there has been vaccination program for at-risk groups and older adults in Turkey. We here present 72-year-old male psoriasis patient who developed generalized pustular psoriasis flare after administration of CoronoVac. The COVID-PCR test was negative and investigations for flare etiology were all normal. He was first (to the best of our knowledge) psoriasis patient who developed an erythrodermic flare after the first dose of CoronaVac vaccine.
Clinical picture: multiple sites of ectopic pancreatic tissue
Authors: J Straatman, R J Meester, N C T V Grieken, M J A M Jacobs, P D Graaf, G Kazemier, M A Cuesta
Journal: Springerplus (2015)

A case is presented with multiple sites of ectopic pancreatic tissue in the gastro-intestinal tract. The sites were found in the stomach and duodenum, one site of ectopic pancreatic tissue presented with necrotizing pancreatitis. Ectopic pancreatic tissue can be defined as all pancreatic tissue, with no anatomical or vascular continuity with the orthotopic pancreas. The ectopic tissue most likely originates from the spreading of cells, during the allocation of structures derived from the foregut in the embryonic phase. Over ninety percent of ectopic tissue presents in the upper gastrointestinal tract, although other locations have been described. To date this is the first case-report about a patient with multiple localizations of ectopic pancreatic tissue.
Ultrasound-guided quadrilateral space block for the diagnosis of quadrilateral syndrome
Authors: Hamilton Chen, Vincent Reginald Narvaez
Journal: Case Rep Orthop (2015)

Quadrilateral space syndrome (QSS) is a rare nerve entrapment disorder that occurs when the axillary nerve and posterior circumflex humeral artery (PCHA) become compressed in the quadrilateral space. QSS presents as vague posterolateral shoulder pain that is exacerbated upon the abduction and external rotation of the shoulder. Diagnosis of QSS is difficult because of the vague presentation of QSS. In addition, even though MRI and MR angiography can be used in QSS diagnosis, there is currently no "gold standard" diagnostic imaging studies for QSS. In this case report, we describe a novel ultrasound-guided technique for a diagnostic quadrilateral space block and present a case where the diagnostic block was used to diagnose QSS. We believe that a diagnostic block of the quadrilateral space is a useful adjunct in the evaluation of patients with suspected QSS, especially in cases where examination findings and other diagnostic modalities are indeterminate.
Incarcerated paraesophageal hernia complicated by pancreatic damage and unusual comorbidity: Two retrospective case series
Authors: H M Haug, E Johnson, T Mala, D T Førland, T T Søvik, H O Johannessen
Journal: Int J Surg Case Rep (2019)
Keywords: case series, incarcerated paraesophageal hernia, ischemia, pancreatic fistula

Introduction:
About 1% of paraesophageal hernias (PEH) require emergency surgery due to obstruction or gangrene. We present two complicated cases of incarcerated PEH. Presentation of cases: A patient aged 18 with trisomy 21 was admitted after four days of vomiting and epigastric pain. CT scan revealed a large PEH. The stomach was massively dilated with compression of adjacent viscera and the celiac trunk. The stomach was repositioned laparoscopically and deflated by endoscopy in an attempt to avoid resection. During second look laparoscopy a gastrectomy was necessary. The patient was reoperated for intestinal obstruction, and treated for dehiscence of the esophagojejunostomy and a pancreatic fistula. A patient aged 65 with hereditary spastic paresis had two days history of emesis and epigastric pain. Upon arrival he was hemodynamically unstable and a CT scan revealed perforation of the herniated stomach. A subtotal gastrectomy without reconstruction was performed with vacuum closure of the abdomen. Later a gastrectomy was completed with a Roux-en-Y reconstruction. Except from reoperation for wound dehiscence after 14 days, the recovery was uneventful.
Discussion:
Trisomy 21 and hereditary spastic paresis may increase the risk of developing PEH. Challenges in regard to symptom evaluation may delay diagnosis. The pressure of the dilated stomach can give rise to ischemic and mechanical damage from compression of major blood vessels and organs. Urgent diagnosis and gastric deflation is required.
Conclusions:
In patients with known PEH or with comorbidity that may increase the risk of PEH, this diagnosis should be considered early on.
Clinical Pearls - how my patients taught me: The fainting lark symptom
Authors: A Kuiper, M E van Egmond, M P M Harms, M D Oosterhoff, B van Harten, D A Sival, T J de Koning, M A J Tijssen
Journal: J Clin Mov Disord (2016)
Keywords: compulsive valsalva, respiratory stereotypies, stretch syncope
MeSH terms: Case Reports

Background:
Compulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced.
Case presentation:
We describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck. The attacks consisted of self-induced stereotypic stretching of the neck combined with a compulsive Valsalva-like maneuver. This induced cerebral hypoperfusion and subsequently dysautonomia and some involuntary movements of the arms.
Conclusion:
This patient suffered from a complex tic with compulsive respiratory stereotypies. His symptoms contain aspects of a phenomenon described in early literature as 'the fainting lark'.
Pseudo-gonio synechia: an artifact on two-mirror gonioscopy
Authors: Chandra Sekhar Garudadri
Journal: Indian J Ophthalmol (2010)
MeSH terms: Artifacts, Cornea / pathology, Diagnostic Errors, Glaucoma, Angle-Closure / diagnosis, Gonioscopy / instrumentation, Case Reports, Female, Humans, Middle Aged, Reference Values

Gonioscopy is an important component of evaluation of any glaucoma patient. Goldmann two-mirror and Sussman or Zeiss four-mirror are the commonly used gonioscopes. Presence of synechia in the angle is diagnostic of angle closure disease in an occludable angle. A patient with pseudo-gonio synechia that disappeared on indentation gonioscopy with Sussman lens but persisted with manipulation gonioscopy with a Goldmann lens is reported.
An Argument for Expanding the Role of Pediatric Decision-Making and Preference in Child Abuse/Neglect Assessments and Plan
Authors: Rissa Fedora, Becky Li
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Child maltreatment can have long-term sequelae and thus requires appropriate interventions. In the United States, reports of suspected child maltreatment are primarily handled by the Child Protective Services (CPS). We present a case of a 12-year-old female who was involuntarily hospitalized for suicidal ideation after CPS responded to a report of her abuse by her mother. Despite continuously expressing fear of her mother and pleading to not be discharged home, CPS ultimately determined that the child was safe to return home to her abuser. The child's subsequent loss to follow-up puts the child's safety and long-term well-being into question. In this article, we discuss the current protocol of CPS reporting, investigation, and outcome. We also explore the roles of pediatric decision-making and forensic or custody evaluation when maltreatment is apparent.
A Case of Localized Prostate Cancer Associated with Polymyalgia Rheumatica with Marked Symptomatic Improvement after Robot-Assisted Radical Prostatectomy
Authors: Makoto Kawase, Keita Nakane, Sanae Namiki, Yasumichi Takeuchi, Shota Ueda, Kota Kawase, Chie Nakai, Shinichi Takeuchi, Daiki Kato, Manabu Takai, Koji Iinuma, Masayuki Fuwa, Chiemi Saigo, Tatsuhiko Miyazaki, Hiroyuki Morita, Takuya Koie
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

A 73-year-old man visited our hospital with chief complaints of fever of unknown origin and bilateral shoulder and hip joint pain. He was initially diagnosed with polymyalgia rheumatica (PMR). Although the patient was treated with prednisolone 15 mg/day, his PMR-related symptoms did not improve. Further examination was performed as the patient was suspected of having paraneoplastic syndrome. Assessment results showed prostate cancer without metastases. After undergoing robot-assisted radical prostatectomy, the patient's PMR-related symptoms dramatically improved. Hence, the prednisolone dose was decreased to 4 mg/day. PCa may have triggered the development of PMR through the activation of immune-mediated systemic inflammatory responses.
Acute Psychotic Episode Induced by Antimicrobial Treatment
Authors: Savera I Arain, Majed Al Shakhori, Shabeer A Thorakkattil, Omer Amin
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Psychosis is an abnormal state of mind that leads to losing touch with reality. Symptoms may include delusions and hallucinations, amongst other features. Psychosis is known to increase the risk of other health conditions and may have serious adverse outcomes. This is a case report of a 26-year-old woman with no previous psychiatric history who presented with symptoms and signs suggestive of acute psychosis shortly after starting a postprocedural combination of antimicrobials. The patient's family decided to stop the antimicrobials as they observed an escalation of the psychotic symptoms with the ongoing use of antibiotics. The patient was subsequently brought to the emergency service (EMS) department, and she was admitted to the behavioral health unit. The treatment team managed to stabilize the patient with several interventions, including the administration of antianxiety and antipsychotic medications along with psychosocial intervention. The symptoms of psychosis resolved within 3-4 days, and she was discharged home. Even though transient psychotic episodes have been reported previously with antibiotics, this case emphasizes the increased need for vigilance and reporting in patients receiving antimicrobials.
Rituximab-induced interstitial lung disease: five case reports
Authors: Matiuallah Naqibullah, Saher B Shaker, Karen S Bach, Elisabeth Bendstrup
Journal: Eur Clin Respir J (2015)
Keywords: interstitial pneumonitis, lymphoma, rituximab
MeSH terms: Case Reports

Rituximab (RTX), a mouse/human chimeric anti-CD20 IgG1 monoclonal antibody has been effectively used as a single agent or in combination with chemotherapy regimen to treat lymphoma since 1997. In addition, it has been used to treat idiopathic thrombocytopenic purpura, systemic lupus erythematous, rheumatoid arthritis, and autoimmune hemolytic anemia. Recently, RTX has also been suggested for the treatment of certain connective tissue disease-related interstitial lung diseases (ILD) and hypersensitivity pneumonitis. Rare but serious pulmonary adverse reactions are reported. To raise awareness about this serious side effect of RTX treatment, as the indication for its use increases with time, we report five cases of probable RTX-ILD and discuss the current literature on this potentially lethal association.
Adenovirus serotype 14 infection, New Brunswick, Canada, 2011
Authors: Gabriel Girouard, Richard Garceau, Louise Thibault, Youcef Oussedik, Nathalie Bastien, Yan Li
Journal: Emerg Infect Dis (2013)
MeSH terms: Adenovirus Infections, Human / diagnosis, Adenovirus Infections, Human / virology, Adenoviruses, Human / genetics, RNA, Viral / genetics, Case Reports, Adenovirus Infections, Human / pathology, Adenoviruses, Human / classification, Adenoviruses, Human / isolation & purification, Aged, Fatal Outcome, Female, Humans, Infant, Male, Middle Aged, New Brunswick, Phylogeny, RNA, Viral / classification, RNA, Viral / isolation & purification, Serotyping, RNA, Viral

We describe 3 culture-proven cases of adenovirus serotype 14 infection in New Brunswick, Canada, during the summer of 2011. Strains isolated from severely ill patients were closely related to strains of a genomic variant, adenovirus 14p1, circulating in the United States and Ireland. Physicians in Canada should be aware of this emerging adenovirus.
Early, Patient-Centered, and Multidisciplinary Approach in Newly Diagnosed Multiple Myeloma: What Are We Talking About? A Case Description and Discussion
Authors: Jonas Sørensen, Tanja Vibeke Sørensen, Kasper Hasseriis Andersen, Anne Dorthe Schou Nørøxe, Anne Kærsgaard Mylin
Journal: Palliat Med Rep (2022)
Keywords: caregiver issues, hematology-specific issues, hospital-specific palliative care issues, pain control, symptom assessment
MeSH terms: Case Reports

Specialized palliative care (SPC) is a multidisciplinary need-based approach from the time a life-threatening disease is diagnosed. Patients with multiple myeloma (MM) will, at the time of diagnosis, often present with symptoms and needs that require a multidisciplinary approach. This case describes the course of a patient with newly diagnosed MM, involving all vertebrae and with no common analgesic treatment providing sufficient relief. High symptom burden and psychosocial and existential factors contribute to his total suffering. SPC, anesthesiological, and radio-oncological disciplines are integrated early, and the multidisciplinary approach includes support from social worker, psychologist, and physiotherapist. The needs and distress of the patients' wife are addressed. Barriers for further integration and the role of standardized care pathways are discussed, and the importance of systematic screening for symptoms and needs is highlighted. Integrating several disciplines may be a prerequisite for antineoplastic treatment being initiated for patients with newly diagnosed malignant disease.