OpenMed/multicare-articles huggingface dataset:
Liver Abscess due to Fasciola hepatica: A Case Report of the North of Iran
Authors: Somaieh Matin, Farahnaz Joukar, Sara Yeganeh, Arash Daryakar, Fariborz Mansour-Ghanaei
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

One of the rare manifestations of fascioliasis is liver abscess. In this paper, we report the case of a 38-year-old woman with a liver abscess caused by Fasciola hepatica (F. hepatica). The patient was referred to the clinic with recurrent fever, right upper quadrant (RUQ) pain, and a large abscess in her liver. Despite the consumption of an antibiotic drug, she still had symptoms. The symptoms began to disappear upon starting the consumption of triclabendazole (TCBZ). Fascioliasis can manifest itself with unusual symptoms that provide no specific clue for its diagnosis. Therefore, it is important to consider F. hepatica in the differential diagnosis of liver abscess, especially in endemic regions.
Ectopia and partial transposition of mandibular lateral incisors in a child patient
Authors: Viviane Andrade Cancio de Paula, Felipe Giacomet, Ana Maria Bolognese, Lucianne Cople Maia
Journal: ISRN Dent (2011)
MeSH terms: Case Reports

Dental ectopia is a rare clinical finding characterized by a change in the normal tooth eruption pathway. In more severe cases, nontreated ectopia may develop into either partial or total transposition. The early diagnosis is of crucial importance for establishing a treatment planning correctly. Therefore, the present paper is aimed at reporting an unusual case of a 11-year-old boy with ectopic eruption and partial transposition of mandibular permanent lateral incisors as well as the diagnosis and therapeutic outcomes involving such an anomaly.
Biological rhythms and epilepsy treatment
Authors: Jon Andreas Rugstad Næsgaard, Leif Gjerstad, Kjell Heuser, Erik Taubøll
Journal: Front Neurol (2023)
Keywords: biological rhythms, chronopharmacology, chronotherapy, epilepsy treatment, personalized medicine, seizure patterns
MeSH terms: Review

Approximately one-third of patients with epilepsy are drug-refractory, necessitating novel treatment approaches. Chronopharmacology, which adjusts pharmacological treatment to physiological variations in seizure susceptibility and drug responsiveness, offers a promising strategy to enhance efficacy and tolerance. This narrative review provides an overview of the biological foundations for rhythms in seizure activity, clinical implications of seizure patterns through case reports, and the potential of chronopharmacological strategies to improve treatment. Biological rhythms, including circadian and infradian rhythms, play an important role in epilepsy. Understanding seizure patterns may help individualize treatment decisions and optimize therapeutic outcomes. Altering drug concentrations based on seizure risk periods, adjusting administration times, and exploring hormone therapy are potential strategies. Large-scale randomized controlled trials are needed to evaluate the efficacy and safety of differential and intermittent treatment approaches. By tailoring treatment to individual seizure patterns and pharmacological properties, chronopharmacology offers a personalized approach to improve outcomes in patients with epilepsy.
Massive lamotrigine and bupropion overdose resulting in status epilepticus without cardiovascular collapse
Authors: Rebecca E Bruccoleri, Bradley L Demeter, Peter R Chai, Michele M Burns
Journal: Toxicol Commun (2019)
Keywords: bupropion, case report, lamotrigine

An 18 year-old woman presented to an outside hospital with seizure activity after a massive ingestion of lamotrigine, bupropion, trazodone, buspirone, and possibly isoretinoin. Her initial vital signs were remarkable for tachycardia (120 bpm). She was intubated for airway protection. For treatment of status epilepticus, she received a total of 12 mg of IV lorazepam along with a lorazepam infusion titrated to 15 mg/hr, a propofol infusion of unknown dosing, and phenobarbital 650 mg. She was transferred to a receiving hospital. Her initial ECG at the receiving hospital showed a QRS of 117 ms which narrowed with 50 mEq of sodium bicarbonate after approximately 6 hours. She required norepinephrine intermittently for blood pressure support for approximately 2 days. The patient had no dysrhythmias. EEG showed no epileptiform activity from approximately 11 hours-32 hours post ingestion. At the receiving hospital, her serum lamotrigine concentration was 109 mcg/mL (reference 3.0-14.0 mcg/mL) 7 hours after ingestion. Her bupropion concentration was 92 ng/mL (reference 50-100 ng/mL). She was extubated on hospital day 5 and discharged to a psychiatric facility on hospital day 13.
Pfeiffer syndrome type 3 with FGR2 c.1052C>G (p.Ser351Cys) variant in West Africa: a case report
Authors: Kwadwo Apeadu Danso, Rosemary Sefakor Akuaku, Florence Naa Adoley Young, Samuel Agyei Wiafe
Journal: Pan Afr Med J (2021)
Keywords: pfeiffer syndrome, broad big toes, case report, macrocephaly, proptosis
MeSH terms: Acrocephalosyndactylia / diagnosis, Acrocephalosyndactylia / genetics, Craniosynostoses, Case Reports, Africa, Western, Humans, Infant, Newborn

Pfeiffer syndrome is a rare genetic condition that includes anomalies of the head, hands, and feet. It was originally described by Rudolf Pfeiffer in 1964. As a result of varied clinical presentations, there is a low threshold for missing the diagnosis. Three (3) cases were found by the authors in the medical literature from the African continent, all of which lacked molecular studies. The main dysmorphic features we observed in our patient were; macrocephaly with widely gaped sagittal sutures, proptosis with ocular hypertelorism, ankylosed elbows, wide sandal gap and medially deviated broad great toes. In this case, sequence analysis using Illumina technology and deletion/duplication testing of 65 genes for variants associated with craniosynostosis syndromes was performed at Invitae Medical Genetic laboratory. A diagnosis of Pfeiffer syndrome type 3 with FGFR2 c.1052C>G (p.Ser351Cys) variant was made. In conclusion, this case will aid health care providers especially in areas of low accessibility to molecular studies to promptly identify, appropriately manage the condition as well as counselling the parents to offset the risk of abandonment of neonates with dysmorphic features.
Dysphagia caused by a lateral medullary infarction syndrome (Wallenberg's syndrome)
Authors: Amine El Mekkaoui, Hanane Irhoudane, Adil Ibrahimi, Mounia El Yousfi
Journal: Pan Afr Med J (2012)
Keywords: dysphagia, wallenberg's syndrome, deglutition, lateral medullary infarction
MeSH terms: Brain Ischemia / etiology, Deglutition Disorders / etiology, Lateral Medullary Syndrome / diagnosis, Case Reports, Aged, Brain Ischemia / pathology, Diffusion Magnetic Resonance Imaging, Endoscopy, Digestive System, Fluoroscopy, Humans, Lateral Medullary Syndrome / complications, Lateral Medullary Syndrome / pathology, Male

A 68-year-old man was referred to our hospital for a dysphagia evolving for 10 days. Clinical examination had found neurological signs as contralateral Horner's syndrome, ipsilateral palatal paresis, gait ataxia and hoarseness. Video-fluoroscopy showed a lack of passage of contrast medium to the distal esophagus. Esogastroduodenoscopy was normal. The cranial MRI had shown an acute ischemic stroke in the left lateral medullar region and the diagnosis of Wallenberg syndrome (WS) was established. WS remains an unknown cause of dysphagia in the clinical practice of the gastroenterologist.
Transcatheter aortic valve replacement in patients undergoing robotic totally endoscopic coronary artery bypass: A case series
Authors: Ankur Srivastava, Jennifer Smazil, Lauren Roark, Hayla A Shah, Husam H Balkhy, Atman P Shah
Journal: Front Cardiovasc Med (2022)
Keywords: cad, savr, tavr, tecab, survival
MeSH terms: Case Reports

Transcatheter aortic valve replacement (TAVR) has been utilized to treat patients with symptomatic aortic stenosis (AS). Recent trials suggest comparable efficacy compared to surgical aortic valve replacement (SAVR). Robotic off-pump totally endoscopic coronary artery bypass graft surgery (TECAB) had been shown to be a minimally invasive revascularization strategy with clinical results comparable to traditional coronary artery bypass graft surgery (CABG). Traditionally, pre-surgical coronary evaluation is considered necessary to optimize coronary revascularization at the time of AVR. The 2020 ACC/AHA Guideline for the Management of Patients with Valvular Disease gives a moderate recommendation, based on limited data, for CABG at the time of AVR in patients with significant coronary artery disease (CAD). This paper presents two patients with known significant CAD awaiting robotic TECAB who were treated with TAVR, prior to surgical revascularization. Robotic TECAB is unique in that it offers patients the ability to have complete coronary revascularization without a sternotomy and with early ambulation, discharge, and recovery. The case series demonstrates a hybrid approach that offers complete sternotomy sparing cardiovascular care to treat severe symptomatic AS and CAD. Since patients with severe aortic stenosis are at high risk of developing cardiac arrest and cardiogenic shock upon induction of anesthesia, the ability to treat severe symptomatic AS with TAVR under conscious sedation prior to TECAB can be considered as a safe an effective treatment.
Marjolin's Tumor Complicating Chronic Periprosthetic Infection of a Total Knee Arthroplasty
Authors: Timothy Horan, Matthew T Wallace, Albert J Aboulafia, Janet D Conway
Journal: J Bone Jt Infect (2019)
MeSH terms: Case Reports

Marjolin's tumor is a term used to describe a malignancy developing in the setting of a chronic wound, infection, or other tissue subject to chronic inflammatory changes. These malignancies usually present after many years of chronicity, and can range from lower grade basal cell carcinomas to high-grade sarcomas. We present the case of a squamous cell carcinoma that developed within a chronic periprosthetic infection of a total knee arthroplasty of 7 years duration. The intra-articular location, association with an orthopaedic implant, and brief latency period are all unique features of this case.
Case Report: Treatment of Anti-MDA5-Positive Amyopathic Dermatomyositis Accompanied by a Rapidly Progressive Interstitial Lung Diseases With Methylprednisolone Pulse Therapy Combined With Cyclosporine A and Hydroxychloroquine
Authors: Qia-Chun Zhang, Min-Ying Liu, Zhi-Xin Chen, Yimin Talia Chen, Chang-Song Lin, Qiang Xu
Journal: Front Med (Lausanne) (2020)
Keywords: amyopathic dermatomyositis, anti-mda antibody, combination treatment strategy, cyclosporine a, hydroxychloroquine, interstitial lung diseases, methylprednisolone pulse therapy
MeSH terms: Case Reports

Introduction: Patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive amyopathic dermatomyositis (ADM) often develop rapidly progressive interstitial lung diseases (RP-ILD), with poor treatment success. Many studies have shown that this is the main cause of death in patients with anti-MDA5 antibody-positive ADM. Case Presentation: A 37-years-old woman developed a cough, shortness of breath, and a rash on both hands, which resembled Gottron's signs. Upon laboratory examination, the results were as follows: antinuclear antibody (ANA) positive; anti-Ro52 antibody positive; and anti-MDA5 antibody positive. Pulmonary high-resolution CT (HRCT) scan showed pulmonary interstitial inflammatory changes, and mediastinal and subcutaneous emphysema. She was finally diagnosed with anti-MDA5 antibody-positive ADM accompanied by RP-ILD. She was first given high-dose-steroid pulse therapy with methylprednisolone (500 mg per day for 3 days) followed by methylprednisolone (40 mg, daily), cyclosporine A (100 mg, twice per day), and hydroxychloroquine (200 mg, twice per day). Since her discharge from our hospital in March of 2018, she has maintained the methylprednisolone therapy (tapered to 10 mg daily), cyclosporine A (100 mg, twice per day), and hydroxychloroquine (200 mg, twice per day). Outcomes: Pulmonary HRCT scans taken on 4, 9, and 26 months after her discharge from our hospital showed that the interstitial pneumonitis had significantly improved and that mediastinal and subcutaneous emphysema had been gradually absorbed. The patient can now participate in regular work and activities of daily living. Conclusion: The treatment of methylprednisolone pulse therapy combined with cyclosporine A and hydroxychloroquine may be an option for the RP-ILD accompanied by anti-MDA-positive ADM. After the acute phase, this combination therapy strategy is helpful to the disease control of patients.
Antiangiogenic Therapy as a New Strategy in the Treatment of Endometriosis? The First Case Report
Authors: Jean Bouquet de Joliniere, Arrigo Fruscalzo, Fathi Khomsi, Emanuela Stochino Loi, Floryn Cherbanyk, Jean Marc Ayoubi, Anis Feki
Journal: Front Surg (2021)
Keywords: avastin, bevacizumab, vegf, anti-angiogenesis, case report, endometriosis
MeSH terms: Case Reports

Angiogenesis plays a pivotal role in implantation and development of ectopic endometrial lesions. Thus, the potential usefulness of anti-angiogenic therapies has been speculated. Several reports describe their usefulness in animal models. Nonetheless this therapy has not been tested on humans yet. Here we report the outcome of a patient treated for a severe endometriosis with Bevacizumab (Avastin®), a monoclonal antibody directed against the vascular endothelial growth (VEGF). After a first-look laparoscopy with confirmatory biopsies was performed, three doses of Bevacizumab at 2-week intervals were administered. The therapy showed a well-tolerated profile and the prompt disappearance of the therapy-refractory chronic dysmenorrhea. A suppression of metabolic activity at the PET-scan compared to the basal one performed at diagnosis was also recorded. Furthermore, compared to the diagnostic biopsies prior the treatment, we documented a shift in the hormonal receptors profile toward a higher expression of progesterone and estrogen receptors in the endometriotic lesions.
Is microsporidial keratitis an emerging cause of stromal keratitis? A case series study
Authors: Geeta K Vemuganti, Prashant Garg, Savitri Sharma, Joveeta Joseph, Usha Gopinathan, Shashi Singh
Journal: BMC Ophthalmol (2005)
MeSH terms: Corneal Stroma / microbiology, Corneal Ulcer / microbiology, Eye Infections, Fungal / microbiology, Microsporidia / isolation & purification, Microsporidiosis / microbiology, Case Reports, Research Support, Non-U.S. Gov't, Adult, Aged, Antifungal Agents / therapeutic use, Child, Preschool, Corneal Ulcer / diagnosis, Corneal Ulcer / therapy, Drug Therapy, Combination, Eye Infections, Fungal / diagnosis, Eye Infections, Fungal / therapy, Female, Humans, Keratoplasty, Penetrating, Male, Microsporidiosis / diagnosis, Microsporidiosis / drug therapy, Retrospective Studies, Antifungal Agents

Background:
Microsporidial keratitis is a rare cause of stromal keratitis. We present a series of five cases of microsporidial keratitis from a single centre in southern India with microbiologic and histopathologic features.
Case presentation:
Patient charts of five cases of microsporidial stromal keratitis diagnosed between January 2002 and June 2004 were reviewed retrospectively for clinical data, microbiologic and histopathologic data. The presence of microsporidia was confirmed by special stains on corneal scrapings and/or corneal tissues, and electron microscopy. All patients were immunocompetent with a preceding history of trauma in three. Four patients presented with unilateral, small, persisting deep stromal infiltrates, of uncertain etiology, in the cornea, which were not responding to conventional antimicrobial treatment and required penetrating keratoplasty in three. Fifth case was unsuspected and underwent keratoplasty for post-traumatic scar. Three of five cases were diagnosed on corneal scrapings, prior to keratoplasty, while two were diagnosed only on histology. The microsporidia appeared as oval well defined bodies with dense staining at one pole. None of the patients showed recurrence following keratoplasty.
Conclusion:
Microsporidia, though rare, should be suspected in chronic culture-negative stromal keratitis. Organisms could lie dormant without associated inflammation.
Progression of Infection after Surgical CT Navigation-Assisted Aspiration Biopsy of a Vertebral Abscess
Authors: Vasiliki Spyropoulou, Raimunda Valaikaite, Amira Dhouib, Romain Dayer, Dimitri Ceroni
Journal: Case Rep Orthop (2016)

Background Context. Computed tomography- (CT-) guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA). Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body.
Study protocol for cholera vaccination as a model to measure the inflammatory response in the gut: A case of modulation with a Lactobacillus plantarum K8 lysate
Authors: Min Young Park, Soo-Yeon Park, Anita Hartog, Els van Hoffen, Alwine Kardinaal, Joohee Kim, Hee Jung Choi, Oran Kwon, Ji Yeon Kim
Journal: PLoS One (2023)
MeSH terms: Cholera Vaccines, Cholera / prevention & control, Lactobacillus plantarum, Case Reports, Research Support, Non-U.S. Gov't, Double-Blind Method, Humans, Inflammation / drug therapy, Male, Vaccination, Cholera Vaccines

It is crucial for human health that the immune system of the gastrointestinal tract works effectively. Dietary modulation is one of the factors that regulate the immune response in the gut. This study aims to develop a safe human challenge model to study gastrointestinal inflammation and immune function. This study focuses on evaluating gut stimulation induced by the oral cholera vaccine in healthy people. In addition, this paper describes the study design for assessing the efficacy and safety of a probiotic lysate, identifying whether functional ingredients in food can modulate inflammatory response induced by oral cholera vaccine. Forty-six males aged 20 to 50 with healthy bowel habits will be randomly allocated to the placebo or intervention group. Participants will consume 1 capsule of probiotic lysate or placebo twice daily for 6 weeks, take oral cholera vaccines on visit 2 (day 15) and visit 5 (day 29). The level of fecal calprotectin, a marker of gut inflammation, will be the primary outcome. The changes of cholera toxin-specific antibody levels and local/systemic inflammatory responses will be evaluated in blood. The purpose of this study is to evaluate gut stimulation of the oral cholera vaccine and investigate the effect of a probiotic lysate on improving the mild inflammatory response induced by the vaccine or supporting the immune response in healthy subjects. Trial registration: * This trial is registered in the International Clinical Trials Registry Platform of WHO (ICTRP, registration number: KCT0002589).
Retinal sensitivity and photoreceptor arrangement changes secondary to congenital simple hamartoma of retinal pigment epithelium
Authors: M W Rodrigues, D B Cavallini, C Dalloul, C L Shields, R Jorge
Journal: Int J Retina Vitreous (2019)
Keywords: adaptive optics, hamartoma, multimodal imaging, oct-a, rpe, tumor
MeSH terms: Case Reports

Background:
The congenital simple hamartoma of the retinal pigment epithelium is a benign lesion and previous observations with noninvasive imaging have detected potential photoreceptor abnormalities and retinal function interplay.
Case presentation:
A 35-year-old woman was found to have an asymptomatic, solitary, circumscribed, pigmented lesion in her left eye. The patient underwent ophthalmic examination including multimodal evaluation with fluorescein angiography, near-infrared reflectance scanning laser ophthalmoscopy, blue autofluorescence, enhanced-depth imaging spectralis B-scan optical coherence tomography (EDI-SBOCT), en face OCT angiography (OCT-A) and microperimetry plus adaptive optics imaging. Ophthalmoscopic examination revealed a juxtafoveolar pigmented lesion with feeding retinal arteriole, consistent with congenital simple hamartoma of RPE. There was no macular edema, exudation, hemorrhage, traction or subretinal fluid. Multimodal imaging of the mass using fluorescein angiography revealed intra-lesion late staining, near-infrared reflectance imaging demonstrated intrinsic hyperreflectivity, short-wavelength autofluorescence and red-free filter photography revealed blocked signal, and SBOCT showed abrupt shadowing. On OCT-A, an exclusive ring-shaped vascular circuit with increased foveal avascular zone was noted. Adaptive optics revealed cell density arrangement and retinal sensitivity correlations on microperimetry.
Conclusion:
These findings suggest that this hamartomatous lesion might cause specific cellular changes that impact retinal sensitivity response and potentially result from vasculature malnourishment to the outer retinal layers.
Community-acquired Acinetobacter baumannii pneumonia: a rare case in Brazil
Authors: Izadora Raduan Brigo, Leandro de Resende Yamamoto, Rodrigo Juliano Molina
Journal: Rev Soc Bras Med Trop (2022)
MeSH terms: Acinetobacter Infections / diagnosis, Acinetobacter Infections / drug therapy, Acinetobacter baumannii, Community-Acquired Infections / diagnosis, Community-Acquired Infections / drug therapy, Pneumonia / drug therapy, Case Reports, Brazil, Humans

Acinetobacter baumannii, a common pathogen in nosocomial infections, is a rare cause of community-acquired pneumonia. This report highlights the difficulties in its early diagnosis and effective treatment, as it is a multidrug-resistant microorganism with rapid, unfavorable progression. To better understand its clinical outcome, we searched the literature for similar cases but found no community-acquired cases in Brazil.