OpenMed/multicare-articles huggingface dataset:
Very rare electrocardiograph abnormalities in meningitis: a case report
Authors: Ali Rida Bah, Zeine El Abasse, Othman Benmallem, Rachida Habbal
Journal: Pan Afr Med J (2020)
Keywords: meningitis, osborn, abnormalities, case report
MeSH terms: Arrhythmias, Cardiac / etiology, Electrocardiography, Meningoencephalitis / complications, Case Reports, Adult, Arrhythmias, Cardiac / diagnosis, Fatal Outcome, Female, Humans

Osborn waves are produced when the J point deviates from baseline. While there are many known causes of Osborn waves, hypothermia remains the most common. We report electrocardiographic changes with Osborn wave in a 32-year-old woman with fatal meningoencephalitis, potentially reversible, probably non-ischaemic myocardial dysfunction may occur in association with acute non cardiac illnesses, such as brain injuries or severe infections. The mechanisms of the electrocardiography (ECG) abnormalities in this disease are unclear.
Familial Mediterranean Fever Complicated by a Triad of Adrenal Crisis: Amyloid Goiter and Cardiac Amyloidosis
Authors: Sadi A Abukhalaf, Beesan W Dandis, Tasnim Za'tari, Adham M Amro, Tareq Z Alzughayyar, Yazan A Rajabi
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Background:
FMF is a common disease in the Mediterranean populations and may be complicated by AA amyloidosis. The coexistence of adrenal and thyroid amyloidosis in AA amyloidosis secondary to familial Mediterranean fever (FMF) is an extremely rare reported condition. We presented a previously unreported triad of adrenal, thyroid, and cardiac amyloidosis secondary to FMF. Presentation of Case. We reported a 23-year-old Palestinian male patient presented with hypotension, vomiting, diarrhea, and abdominal pain. The patient was subsequently diagnosed to have an adrenal crisis with both amyloid goiter and cardiac amyloidosis.
Conclusion:
It is crucial to recognize the adrenal crisis in patients with AA amyloidosis secondary to FMF who present similarly to acute FMF inflammatory episodes. The adrenal crisis has high morbidity and mortality, especially if not recognized early in the course of the disease.
An Unusual Position of Retromandibular Vein in Relation to Facial Nerve: A Rare Case Report
Authors: Nabin Lageju, Prabhat Chandra Thakur, Pravin Kumar Jaiswal
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Knowledge of different anatomical structures is very important in parotid surgery to preserve facial nerve. Retromandibular vein is one of the landmarks used to identify facial nerve. So, the relation of the vein with facial nerve is very important in parotid surgery. The typical position of RMV is deep to facial nerve in almost 88% of cases reported in various literatures. Here, we present an unusual position of RMV found during parotid surgery for pleomorphic adenoma.
Neonatal sludge: a finding of congenital hypothyroidism
Authors: Selim Kurtoğlu, Dilek Coban, Mustafa Ali Akın, Leyla Akın, Ali Yıkılmaz
Journal: J Clin Res Pediatr Endocrinol (2009)
Keywords: neonate, hypothyroidism, sludge
MeSH terms: Congenital Hypothyroidism / diagnosis, Case Reports, Congenital Hypothyroidism / complications, Congenital Hypothyroidism / drug therapy, Gallbladder Diseases / diagnostic imaging, Gallbladder Diseases / drug therapy, Gallbladder Diseases / etiology, Humans, Infant, Newborn, Jaundice, Neonatal / diagnostic imaging, Jaundice, Neonatal / drug therapy, Jaundice, Neonatal / etiology, Male, Thyroxine / therapeutic use, Ultrasonography, Thyroxine

Congenital hypothyroidism is one of the most urgent diseases of the neonate. When diagnosed and treated at an early stage, its most important complication, mental retardation, is preventable. The signs of congenital hypothyroidism are nonspecific in neonates. Only 5% of the cases have characteristic clinical findings. One of the most important and earliest signs is prolonged jaundice during the neonatal period. We report herein a case of congenital hypothyroidism, who presented with icterus accompanied with sludge formation into the gallbladder, which disappeared after treatment with L-thyroxine.
Osler-Weber-Rendu Disease Uncovered by Preeclampsia in a Case Report
Authors: Jamal Ouachaou, Hamza Mimouni, Mohammed Maarad, Yassine Mellagui, Asmae Oulad Amar, Houssam Bkiyar, Imane Kamaoui, Brahim Housni
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Osler-Weber-Rendu disease (OWRD), called hereditary hemorrhagic telangiectasia, is an uncommon genetic illness with the dominant autosomal transmission. It cannot be easily or quickly diagnosed because of both its infrequency and its various associated symptoms. As far as its symptoms are concerned, the patient experiences recurring epistaxis, mucocutaneous telangiectasia, and arteriovenous malformations that can lead to severe undesirable symptoms. In our case, we report a 32-year-old female that was diagnosed with postpartum preeclampsia and whose paraclinical examinations showed that she suffers from hereditary hemorrhagic telangiectasia disease. Management of OWRD includes systematic diagnosis of visceral arteriovenous malformations (AVMs) in regular intervals, measures to prevent complications, and symptomatic treatment.
CD5-Positive Primary Cutaneous Diffuse Large B-Cell Lymphoma-Leg Type
Authors: Alexandra Papoudou-Bai, Leonidas Marinos, Amalia Vassou, Eleni Kapsali, Panagiotis Kanavaros
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

Most primary cutaneous B-cell lymphomas (PCBCL) are CD5 negative, and only a few cases were found to express CD5. We report the first well-documented CD5+ primary cutaneous diffuse large B-cell lymphoma-leg type (PCDLBCL-LT). A 71-year-old woman with a history of Multiple Sclerosis was admitted because of a nodule at the left thigh. Histological examination of the skin biopsy disclosed a diffuse dermal infiltration by large lymphoid cells. Immunohistochemistry revealed that these large cells were positive for CD5, CD20, CD79a, MUM1/IRF4, Bcl6, Bcl2, and cytoplasmic IgM/λ, whereas CD3, CD56, CD23, CD21, CD10, CD30, cyclin D1, CD68, lysozyme, myeloperoxidase, and CD34 were not detected. Thus, the diagnosis of a CD5+ PCDLBCL-LT was made. Despite treatment, the patient died 11 months after initial diagnosis.
Ischiopagus tetrapus conjoined twins: 22 years after separation
Authors: Subir K Chatterjee, Amal K Chakravarty, N Demajumdar, Kalyan K Sarkar, Sukanta Misra
Journal: J Indian Assoc Pediatr Surg (2009)
Keywords: conjoined twins, ischiopagus twins, twins seperation
MeSH terms: Case Reports

There is no record of both separated ischiopagus tetrapus conjoined twins leading normal lives 22 years after separation. We separated a pair of such twins in 1986 and have followed them up till date. Details regarding the technique of separation and the procedures required to ensure normal defecation and micturition and normal musculoskeletal function have been described by us in earlier communications. In this paper we describe their present status and ability to face the world as independent adult females. The outcome reflects the responsibilities and dedication of pediatric surgeons for infant patients with congenital problems after they have become adults, taking a pivotal role to involve surgeons of other disciplines as and when necessary.
Intra-household Variation in Pathways to Care for Epilepsy and Mental Disorders in Eastern Uganda
Authors: Nandini D P Sarkar, Azucena Bardaji, Florence K Baingana, Joan Muela Rivera, Bart Criel, Joske Bunders-Aelen, Koen Peeters Grietens
Journal: Front Public Health (2021)
Keywords: uganda, caregivers, epilepsy, help-seeking behavior, low middle income country, mental health, pathways to care, qualitative research
MeSH terms: Epilepsy / therapy, Mental Disorders / therapy, Research Support, Non-U.S. Gov't, Ambulatory Care Facilities, Child, Humans, Patient Acceptance of Health Care, Uganda

Integrating mental, neurological, and substance use (MNS) health care into the public health system has become a global priority, with mental health, and well-being now being part of the Sustainable Development Goals. In the aim to provide good quality care for MNS disorders, understanding patients' pathways to care is key. This qualitative study explores the pathways to care of patients attending an outpatient mental health clinic of a district hospital in eastern rural Uganda, from the perspectives of their caregivers. Twenty seven in-depth interviews were conducted with caregivers of MNS patients visiting the clinic, with a focus on four case-presentations. Data analysis consisted of thematic and emergent content analyses using NVivo 11. Results across all interviews highlight that chosen help-seeking itineraries were largely pluralistic, combining and alternating between traditional healing practices, and biomedical care, regardless of the specific MNS disorder. Intra-household differences in care seeking pathways-e.g., where one patient received traditional help or no care at all, while the other received biomedical care-depended on caregivers' perceived contextual illness narrative for each patient, in combination with a variety of other factors. If interpreted as a form of bewitchment, traditional medicine and healing was often the first form of care sought, while the mental health clinic was seen as a recourse to "free" care. Patients, especially younger children, who showed visible improvements once stabilized on psychotropic medication was a source of motivation for caregivers to continue with biomedical care at the mental health clinic. However, stock-outs of the free psychotropic medication at the clinic led to dissatisfaction with services due to out-of-pocket expenses and precipitated returning to alternative therapy choices. This article showcases the importance of understanding the complex and varied combinations of individual, cultural, socioeconomic and structural factors that may affect caregivers' choices of pathways to care for patients with MNS disorders in eastern rural Uganda. These cumulative complex processes and context-specific help-seeking behaviors, which ultimately impact patient treatment and MNS health outcomes, need to be first acknowledged, understood and taken into account if we are to promote more inclusive, effective and integrated public mental health systems globally.
Pulmonary epidermoid carcinoma in a patient with acromegaly: a rare entity
Authors: Siham El Aziz, Asma Chadli, Atika Obbiba, Hassan El Ghomari, Ahmed Farouqi
Journal: Pan Afr Med J (2012)
Keywords: acromegaly, carcinoma, epidermoid carcinoma, pituitary adenoma, pulmonary neoplasia
MeSH terms: Acromegaly / complications, Carcinoma, Squamous Cell / complications, Lung Neoplasms / complications, Case Reports, Female, Humans, Middle Aged

A 56-years-old woman was referred to our unit for partially treated acromegaly. She had a high level of insulin growth factor. She did not complain of any pulmonary symptoms and was a non-smoker. Physical examination revealed clinical features of acromegaly. She had a 13 mm pituitary adenoma and was proposed for surgical intervention. Her chest X-ray showed a right paracardiac tumor. Computed tomography scan revealed a large right-sided fowler tumor. Pituitary surgery was cancelled and lobectomy after biopsy with lymph nodes excision was performed through thoracotomy. Histological study of the tumor revealed a medium differentiated epidermoid carcinoma with positive lymph nodes and extension to pleura. She was referred to chemotherapy protocol. Association between carcinoma and acromegaly has previously been reported. Most common tumors are colorectal and thyroid neoplasia. As we see in this case report, we need to consider other carcinomas in acromegalic patients like pulmonary carcinoma, despite their rarity in women.
Case Report: First report of Elizabethkingia miricola infection in a patient with cystic fibrosis
Authors: Freddy Frost, Dilip Nazareth
Journal: F1000Res (2018)
Keywords: cystic fibrosis, chest infection, exacerbation, fluoroquinolone, shortness of breath

Elizabethkingia miricola is a rare non-fermenting Gram-negative rod that has previously been reported to be associated with blood stream and pulmonary abscess infections, but never before in cystic fibrosis (CF). Here we present the first reported case of Elizabethkingia miricola infection in a patient with CF and discuss the management options. We describe a patient with CF in whom we observed clinical and spirometric evidence of pulmonary exacerbation with the associated growth of E. miricola in sputum culture. The period of clinical instability was observed to coincide with the obtainment of four sputum samples from which E. miricola was cultured; improvement was seen following treatment with ciprofloxacin and the subsequent eradication of E. miricola. We conclude that E. miricola is able to survive in the CF lung and in this case was associated with pulmonary exacerbation. Empirical treatment with fluoroquinolones is appropriate, based on our experience.
Reversible atrial fibrillation following Crotalinae envenomation
Authors: Dan Quan, Kenneth Zurcher
Journal: J Venom Anim Toxins Incl Trop Dis (2017)
Keywords: atrial fibrillation, bite, crotalidae, envenomation, rattlesnake, snakebite
MeSH terms: Case Reports

Background:
Cardiotoxicity is a documented complication of Crotalinae envenomation. Reported cardiac complications following snake envenomation have included acute myocardial infarction, electrocardiogram abnormalities and arrhythmias. Few reports exist describing arrhythmia induced by viper envenomation and to our knowledge none describe arrhythmia induced by Crotalinae envenomation. This report concerns the first known case of atrial fibrillation precipitated by rattlesnake bite.
Case presentation:
A 73-year-old Caucasian man with a past medical history of hypertension, hyperlipidemia, type 1 diabetes mellitus, and a baseline first-degree atrioventricular block presented to the emergency department following a rattlesnake bite to his left lower leg. He developed pain and swelling in his left leg two-hour post-envenomation and subsequently received four vials of Crotalidae polyvalent immune fab (ovine). At three-hour post-envenomation following transfer to the intensive care unit, an electrocardiogram revealed new-onset atrial fibrillation. An amiodarone drip was started and the patient successfully converted to normal sinus rhythm approximately six hours after he was found to be in atrial fibrillation. A transthoracic echocardiogram revealed mild concentric left ventricular hypertrophy and an ejection fraction of 72%. He was discharged the following day with no hematological abnormalities and a baseline first-degree atrioventricular block.
Conclusion:
This is the first documented case of reversible atrial fibrillation precipitated by Crotalinae envenomation. In patients with pertinent risk factors for developing atrial fibrillation, physicians should be aware of the potential for this arrhythmia. Direct toxic effects of venom or structural and electrophysiological cardiovascular abnormalities may predispose snakebite patients to arrhythmia, warranting extended and attentive cardiac monitoring.
Primary dumbbell-shaped lymphoma of the thoracic spine: a case report
Authors: Antonio Meola, Paolo Perrini, Nicola Montemurro, Paolo di Russo, Giacomo Tiezzi
Journal: Case Rep Neurol Med (2012)

Primary spinal non-Hodgkin's lymphoma is extremely rare, and the occurrence of spinal dumbbell-shaped lymphoma is exceptional. We present a case of primary spinal dumbbell-shaped lymphoma to clarify the diagnosis and the management of these lesions. A 45-year-old man presented with sensory symptoms for 8 months. Magnetic resonance imaging of the thoracic spine demonstrated a dumbbell-shaped lesion at the D4-D6 level with spinal cord compression and right foraminal extension at D4-D5 level. The patient underwent D4-D6 laminectomy, with a subtotal resection of the mass. Diffuse large B-cell lymphoma was diagnosed in the pathological examination. He underwent local spinal radiotherapy and chemotherapy. Follow-up evaluation at one year demonstrated no evidence of relapse. Although highly unusual, lymphoma should be included in the differential diagnosis for spinal dumbbell-shaped tumours. After surgery and adjuvant therapy a long-term clinical and neuroradiological followup is mandatory.
Pulmonary Actinomyces graevenitzii Infection: Case Report and Review of the Literature
Authors: Yuan Yuan, Ziliang Hou, Dan Peng, Zhenchuan Xing, Jinxiang Wang, Shuai Zhang
Journal: Front Med (Lausanne) (2022)
Keywords: actinomyces graevenitzii, bronchoscopy, consolidation, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, pulmonary actinomycosis (pa)
MeSH terms: Case Reports

Background:
Pulmonary actinomycosis (PA), a chronic indolent infection, is a diagnostic challenge. Actinomyces graevenitzii is a relatively rare Actinomyces species isolated from various clinical samples.
Case presentation:
A 47-year-old patient presented with a 3-month history of mucopurulent expectoration and dyspnea and a 3-day history of fever up to 39.0°C. He had dental caries and a history of alcoholism. Computed tomography (CT) images of the chest revealed a consolidation shadow in the right upper and middle lobes, with necrosis containing foci of air. Actinomyces graevenitzii was isolated from bronchoalveolar lavage fluid (BALF) culture and was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. He received treatment with intravenous piperacillin-sulbactam for 10 days and oral amoxicillin-clavulanate for 7 months. His clinical condition had considerably improved. The consolidation shadow was gradually absorbed.
Conclusion:
Early diagnosis and treatment of pulmonary actinomycosis are crucial. Bronchoscopy plays a key role in the diagnostic process, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) is an accurate tool for Actinomyces identification.
Subserosal hematoma of the sigmoid colon after vaginal delivery
Authors: N Bacalbașa, R E Bohîlțea, M Dumitru, N Turcan, M M Cîrstoiu
Journal: J Med Life (2017)
Keywords: hematoma, sigmoid colon, vaginal delivery complication
MeSH terms: Colon, Sigmoid / pathology, Delivery, Obstetric / adverse effects, Hematoma / etiology, Case Reports, Female, Hematoma / diagnostic imaging, Humans, Pelvis / diagnostic imaging, Peritoneum / diagnostic imaging, Peritoneum / pathology, Pregnancy, Tomography, X-Ray Computed

Postpartum hemorrhage is an obstetrical emergency that represents the leading cause of maternal mortality. Severe hemorrhagic complications that could appear postpartum are the abdomino-pelvic hematomas, which result from the rupture of the pelvic vessels. We reported a very rare case of puerperal retroperitoneal subserosal hematoma of sigmoid colon following vaginal delivery, which was successfully managed by conservative methods. As far as we know, there are only a few case reports of intramural hematoma of sigmoid colon in literature, having other etiologies than vaginal delivery trauma. The particularities of the case consisted in the association of hemangiomas and the low risk thrombophilia. Diagnosis was based on the clinical exam and the paraclinical founding. Laparotomy is generally considered the last choice, in life threatening cases with hemodynamic instability, compression signs, and presence of contrast leakage on noninvasive imaging methods, but avoiding colonic resection after dissection represented the true challenge of the case.
Class II, Division 1 Angle malocclusion with severe proclination of maxillary incisors
Authors: Kátia Montanha
Journal: Dental Press J Orthod (2016)
MeSH terms: Incisor, Malocclusion, Angle Class II / therapy, Case Reports, Brazil, Cephalometry, Extraoral Traction Appliances, Female, Humans

Protrusion of maxillary incisors is a common complaint among patients seeking orthodontic treatment. This report addresses the correction of Class II Angle malocclusion with excessively bucally proclined maxillary incisors, in an adolescent female patient, through the use of extraoral and fixed appliances. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements for obtaining the title of certified by the BBO.
Membranoproliferative glomerulonephritis in patients with chronic venous catheters: a case report and literature review
Authors: John Sy, Cynthia C Nast, Phuong-Thu T Pham, Phuong-Chi T Pham
Journal: Case Rep Nephrol (2014)

Chronic indwelling catheters have been reported to be associated with membranoproliferative glomerulonephritis (MPGN) via the activation of the classical complement pathway in association with bacterial infections such as coagulase negative staphylococcus. We herein provide supporting evidence for the direct causal relationship between chronic catheter infections and MPGN via a case of recurrent MPGN associated with recurrent catheter infections used for total parenteral nutrition (TPN) in a man with short gut syndrome. We also present a literature review of similar cases and identify common clinical manifestations that may serve to aid clinicians in the early identification of MPGN associated with infected central venous catheterization or vice versa. The importance of routine monitoring of kidney function and urinalysis among patients with chronic central venous catheterization is highlighted as kidney injury may herald or coincide with overtly infected chronic indwelling central venous catheters.
Transformation of T-Cell Acute Lymphoblastic Lymphoma to Peripheral T-Cell Lymphoma: A Report of Two Cases
Authors: Michael Markow, Abu-Sayeef Mirza, Lia Perez, Haipeng Shao, Pedro Horna, Claudio Anasetti, Lubomir Sokol, Mohammad O Hussaini
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Nonhepatosplenic/noncutaneous γδ peripheral T-cell lymphoma (NHNCγδ PTCL) represents a miscellaneous group of unrelated T-cell lymphomas of which only isolated cases have been reported. We describe two cases of transformation from T-lymphoblastic leukemia/lymphoma to NHNCγδ PTCL. Transformation into more aggressive disease is a rare event in T-cell lineage-derived hematologic malignancies compared to B-cell neoplasms. Nevertheless, both of our cases involved relapse as PTCL manifested with skin involvement and an overt shift from blastic morphology to large granular leukemia-like mature T cells. Among other notable molecular characteristics, expression of immature markers such as TdT was lost in both cases. Based on cytogenetics, phenotype, and morphology, both patients represent a novel phenomenon of clonal transformation from T-ALL to PTCL which has rarely been reported in the literature. Such transformation may carry important diagnostic and biological implications.
Phaeochromocytoma mimicking scleroderma
Authors: Joan Joo-Ching Khoo, Edward John Pratt
Journal: Int J Endocrinol (2011)
MeSH terms: Case Reports

We describe a patient with adrenal phaeochromocytoma who presented with peripheral vasospasm and ischaemia and other manifestations mimicking features of systemic sclerosis, which resolved after resection of the tumor. Phaeochromocytoma should be suspected in patients with features of scleroderma who are negative for auto-antibodies.