OpenMed/multicare-articles huggingface dataset:
Incidental Findings of Asymptomatic Fungal Infection
Authors: Nisha Manila, Madhu Nair, Hui Liang
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Fungal sinusitis of the paranasal sinuses is a rare infection in healthy individuals but is relatively common in immunocompromised patients. It is often misdiagnosed and frequently a severe disease, as a few forms of it are linked with a higher mortality rate. Effective handling necessitates a speedy analysis and often counts on radiological findings. On cone-beam computed tomography (CBCT) analysis, a bulky polypoid-shaped lesion with a density close to that of soft tissue in CBCT was visualized in the right ethmoid and sphenoid sinuses. There was a significant expansion of the borders of the right ethmoid sinus, and discontinuity or perforation of the sphenoid sinus floor was suspected from CBCT images. Non-contrasted multi-detector computed tomography (MDCT) exhibited opacification and extension of the lesion into the majority of sinuses with dense inspissated materials in the center, which resembled radiographic features of invasive fungal sinusitis. Computed tomography (CT) scan of the maxillofacial region, specifically paranasal sinuses, plays a considerable role in diagnosing fungal sinusitis. In a majority of cases, fungal sinusitis is noticed and diagnosed in immunocompromised patients. However, it is also seen in healthy patients in very rare circumstances, similar to the patient in this report. If the patient is treated rapidly, the prognosis is fair. We present a case of fungal sinusitis in an otherwise healthy young male patient to increase awareness among dental professionals.
Doxycycline-Induced Antinuclear Antibody and Antineutrophil Cytoplasmic Antibody Associated Vasculitis: A Case Report and Literature Review
Authors: Davisson J Wriston, Evan R Norfolk, Lindsay M Smith, Guoli Chen, David H Bulbin
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Drug-induced antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has been increasingly recognized in the literature with numerous medications listed as causative agents in disease pathology. Doxycycline is a commonly prescribed medication within the United States which is a synthetic, broad-spectrum antibiotic with antimicrobial properties and at low doses exhibits anti-inflammatory effects. In this report, we describe a case of doxycycline-induced ANCA-associated vasculitis with laboratory and biopsy findings supporting the diagnosis, which to the best of our knowledge is the first described case of doxycycline-induced AAV in the literature. The patient was started on doxycycline for treatment of potential Lyme disease. She began to develop progressively worsening myasthenia, erythematous macular rash, anorexia, anemia, and fatigue for several weeks following the course of doxycycline with initial concern of a paraneoplastic process. Ultimately, the patient was discovered to be positive for antinuclear antibody (ANA), perinuclear antineutrophil cytoplasmic antibody (pANCA), and myeloperoxidase (MPO) antibody for which she was treated with a course of prednisone leading to complete remission of disease. A brief review of the pathogenesis of ANCA vasculitides will also be discussed within this article.
Falsely Elevated CA 15-3 Levels in Ovarian Sarcoidosis with Peritoneal Involvement and Ascites
Authors: Sotirios Tsiodras, Alina-Roxani Gouloumi, Zoi Tsakiraki, George Chrelias, Charalambos Chrelias, Stylianos Loukides, Ioannis Panayiotides
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

A rare case of ovarian sarcoidosis with peritoneal and omental involvement presenting as an ovarian malignancy is presented. Clinical, laboratory, and radiological evaluation of the patient revealed ascites and high levels of serum CA 125 and CA 15.3. The diagnosis of sarcoidosis was confirmed with pathology findings on tissues obtained during surgical laparotomy. Establishing the diagnosis of sarcoidosis can be treacherous and was complicated in this case by the falsely elevated biomarkers and ascites.
Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure
Authors: Dimosthenis Chrysikos, Spiros Delis, Dimitra Smerdi, Eugenia Charitaki, Eirini Solia, Theodore Troupis
Journal: J Surg Case Rep (2023)
Keywords: anatomical variations, duplicated inferior vena cava, inferior vena cava, trifurcation portal vein
MeSH terms: Case Reports

The inferior vena cava (IVC) is the largest single vein in humans. However, during embryogenesis, abnormalities can occur resulting in a duplicated IVC. The portal vein (PV) offers the main blood flood to the liver, forming by the left and right PV. A number of anatomical variations are noticed, underlying the great importance of the pre-operative imaging workup. This case report presents a duplicated IVC and a trifucated PV that were incidentally found in an 82 year-old Caucasian male with pancreatic ductal adenocarcinoma who underwent pancreatoduodenectomy (Whipple procedure). Although some anatomical variations, including the duplication of the IVC and the trifurcation of PV, may be rare to the general population, the suspicion of their existence should always be taken under consideration from surgeons during hepatobiliary or retroperitoneal operations.
Different mechanisms of mitral regurgitation in hypertrophic cardiomyopathy: A clinical case and literature review
Authors: Michela Molisana, Adelina Selimi, Germana Gizzi, Simone D'Agostino, Umberto Ianni, Vito Maurizio Parato
Journal: Front Cardiovasc Med (2022)
Keywords: lvot obstruction, case report, chordal rupture, hypertrophic cardiomyopathy, mitral regurgitation, mitral valve flail, review, systolic anterior motion (sam)
MeSH terms: Review

Background:
Abnormalities of the mitral valve (MV) apparatus are typical features of hypertrophic cardiomyopathy (HCM). These abnormalities include leaflet elongation, thick leaflets, displacement of papillary muscle, and systolic anterior motion (SAM) of the MV anterior leaflet. Mitral valve chordal rupture associated with HCM is a rare but serious issue capable of change the clinical apparence and the prognosis of the patient.
Case summary:
A 57-year-old lady with a history of diabetes, dyslipidemia, and a previous single episode of atrial fibrillation (treated with pharmacological cardioversion), presented to the Emergency Department for worsening dyspnea (New York Heart Association Classification class IV). A trans-thoracic echocardiogram (TTE) showed a significant, septal, and asymmetric left ventricular hypertrophy (basal anteroseptal wall diastolic thickness of 19 mm) with normal left ventricle systolic function. A SAM of AML was evident together with a left ventricular outflow tract gradient of 56 mmHg at rest, rising to 136 mmHg during the Valsalva maneuver. In addition, there was evidence of moderate to severe mitral regurgitation (MR) with an anteriorly directed jet, not very typical of MR related to SAM. A 2D-3D trans-esophageal echocardiogram (2D-3D TEE) revealed a combined MR mechanism based on PML degenerative prolapse with P2-flail from ruptured chordae with related eccentric anteriorly directed regurgitant jet, together with a second regurgitant posteriorly directed jet, related to SAM of AML. The patient underwent MV repair together with septal myectomy, with a good final outcome.
Conclusion:
Pre-operative echocardiography (both TTE and 2D-3D TEE) is an essential tool in order to detect different MV abnormalities in patients with HCM. These types of patients should never be treated by septal reduction alone. Surgical MV repair or replacement, together with septal myectomy, may be the preferred approach.
Case report: Hepatotoxicity and nephrotoxicity induced by methotrexate in a paediatric patient, what is the role of precision medicine in 2023?
Authors: Ali El Rida El Masri, Caroline Tobler, Breunis Willemijn, Andre O Von Bueren, Marc Ansari, Caroline Flora Samer
Journal: Front Pharmacol (2023)
Keywords: hepatotoxicity, nephrotoxicity, pediatric case report, pharmacogenomic, pharmacokinetic and pharmacodynamic parameters
MeSH terms: Case Reports

Methotrexate is an immunosuppressant and chemotherapeutic agent used in the treatment of a range of autoimmune disorders and cancers. Its main serious adverse effects, bone marrow suppression and gastrointestinal complications, arise from its antimetabolite effect. Nevertheless, hepatotoxicity and nephrotoxicity are two widely described adverse effects of methotrexate. Its hepatotoxicity has been studied mainly in the low-dose, chronic setting, where patients are at risk of fibrosis/cirrhosis. Studies of acute hepatoxicity of high dose methotrexate, such as during chemotherapy, are scarce. We present the case of a 14-year-old patient who received high-dose methotrexate and subsequently developed acute fulminant liver failure and acute kidney injury. Genotyping of MTHFR (Methylene tetrahydrofolate reductase gene), ABCB1 (codes for P-glycoprotein, intestinal transport and biliary excretion), ABCG2 (codes for BCRP, intestinal transporter and renal excretion) and SLCO1B1 (codes for OATP1B1, hepatic transporter) identified variants in all the genes analysed that predicted a reduced rate of methotrexate elimination and thus may have contributed to the clinical situation of the patient. Precision medicine involving pharmacogenomic testing could potentially avoid such adverse drug effects.
Case Report: Severe acute respiratory distress by tracheal obstruction due to a congenital thyroid teratoma
Authors: Jose Colleti Junior, Uenis Tannuri, Felipe Monti Lora, Eliana Carla Armelin Benites, Walter Koga, Janete Honda Imamura, Patricia Rute Moutinho, Werther Brunow de Carvalho
Journal: F1000Res (2015)
Keywords: children case report, hypothyroidism, pediatric neck mass, pediatric respiratory distress, thyroid teratoma

Congenital teratoma is a rare condition and is a germ cell tumor composed of elements from one or more of the embryonic germ layers and contain tissues usually foreign to the anatomic site of origin. We report a case of a neck tumor diagnosed during pregnancy, initially thought to be a goiter. After birth the neck mass kept growing until it compressed the trachea and produced respiratory failure. The infant had a difficult tracheal intubation because of the compressing mass. The staff decided to surgically remove the neck mass. After that, the infant became eupneic. The histological analysis showed a mature teratoma with no atypias.
Adding of apatinib and camrelizumab to overcome de novo trastuzumab resistance of HER2-positive gastric cancer: A case report and literature review
Authors: Huifang Lv, Yunduan He, Caiyun Nie, Feng Du, Xiaobing Chen
Journal: Front Pharmacol (2023)
Keywords: apatinib, camrelizumab, case report, gastric cancer, literature review, resistance, trastuzumab
MeSH terms: Case Reports

Background: Studies confirmed that trastuzumab plus fluorouracil-based chemotherapy improves the survival to more than 1 year in human with human epidermal growth factor receptor-2 (HER2)-positive advanced gastric cancer. However, there are still a small proportion of patients who do not benefit from trastuzumab treatment. Case summary: Here, we described a case report of de novo trastuzumab resistance in HER2-positive gastric cancer. Concomitant cyclin-E1 (CCNE1) and HER2 amplification are associated with de novo trastuzumab resistance. Genomic analysis demonstrated CCNE1 amplification and TP53 mutation in a HER2-positive gastric cancer patient. This patient achieved significant survival benefit and good safety when the patient received triple regimens consisting of trastuzumab, apatinib, and camrelizumab. Conclusion: Trastuzumab plus camrelizumab plus apatinib has the potential efficacy in HER2-positive gastric cancer patients who were previously treated with trastuzumab plus chemotherapy. This may lead to a new solution to trastuzumab resistance.
Stroke in the setting of giant cell arteritis: a case report
Authors: S McDermott, N Casey, D J Robinson, K M Tan
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

WE DESCRIBE AN UNUSUAL COMPLICATION OF A COMMON DISEASE: stroke presenting in a man recently diagnosed with polymyalgia rheumatica. Initial inflammatory markers were misleading. We discuss pitfalls in diagnosis, and approach to management.
CASE REPORT Simultaneous Latissimus Dorsi Myocutaneous Flap Transfer and Revision Total Knee Arthroplasty With Allograft Extensor Mechanism Reconstruction: A Case Report
Authors: Daniel E Verbist, Travis G Boyd, Arthur L Malkani, Bradon J Wilhelmi
Journal: Eplasty (2012)

Introduction:
We present the case of a patient undergoing simultaneous reconstruction of a massive soft tissue deficit of the right knee along with total knee arthroplasty and allograft reconstruction of the extensor mechanism after multiple failed attempts to repair and revise the affected joint.
Methods:
A latissimus dorsi myocutaneous flap was transferred to fill the soft-tissue deficit of the right knee. During the same procedure, a previously placed antibiotic-cement spacer was removed and a new total knee prosthesis was implanted. What remained of the damaged extensor mechanism was excised and replaced with a cadaveric allograft.
Results:
The latissimus dorsi flap provided the necessary soft-tissue coverage of the revision. The new knee components and allograft extensor mechanism were satisfactorily implanted. One year after simultaneous reconstruction, the knee remains functional and free of infection.
Discussion:
Although current literature may have indicated conversion to arthrodesis or prophylactic soft-tissue repair prior to revision, simultaneous soft-tissue and extensor mechanism repair along with revision total knee arthroplasty have yielded promising results in this patient.
IgG4-related disease: a case report with duration of more than 16 years and review of literature
Authors: Tao Peng, Zhao Hu, Tingting Xie, Baodong Jiang, Junhui Zhen, Xiangdong Yang
Journal: Springerplus (2016)
Keywords: chronic kidney disease, glucocorticoids, igg4-related disease, misdiagnosis, prognosis, pseudotumor
MeSH terms: Case Reports

Introduction:
IgG4-related disease was first reported in 2001 and was officially named in 2010. It is now considered as a systemic disease that might affect any organ system. The characteristic pathological changes of IgG4-related disease are extensive infiltration of IgG4-positive plasma cells. IgG4-related disease is a kind of benign lesions, but there has not been well-defined standard treatment so far. Patients usually respond well to corticosteroids. The prognosis of IgG4-related disease is perhaps good as long as early detection and treatment.
Case description:
We report one case of IgG4-related disease with a 16-years anamnesis with multi-pseudotumor masses. He was diagnosed with chronic kidney disease with wide interstitial renal fibrosis. And he received glucocorticoids therapy. After 2 month therapy, the serum creatinine, erythrocyte sedimentation rate, and serum IgG4 decreased significantly. The discussion includes presentation, clinical course, diagnosis, and prognosis of IgG4-related disease. The case and discussion highlight the importance of diagnosis and the good prognosis of IgG4-related diseases.
Discussion and evaluation:
Our case highlights the importance of diagnosis and the good prognosis of IgG4-related diseases. IgG4-related disease is a systemic fibro-inflammatory immune-mediated disorder and now recognized in almost every major organs. Characteristics of the disease is multiple lymph nodes and the response to glucocorticoids therapy is well. In such case, he had a history of 16 years with multi-pseudotumor masses and misdiagnosed for 16 years, if the doctors were not awareness of higher serum immunoglobulin G4 (IgG4) than normal, the correct diagnosis may be missed or delayed. Consequently, appropriate treatment for IgG4-related disease would also be delayed or not provided and likely result in increased morbidity and mortality.
Conclusions:
IgG4-related disease is a systemic fibro-inflammatory immune-mediated disorder and progresses slowly. In the present patient the course of IgG4-related disease appears to be benign. The prognosis of IgG4-related disease depend on early diagnosis and treatment.
Surgical Intervention for Spinal Lesions Due to Multiple Myeloma: A Case Report
Authors: Metrek A Almetrek, Ahood A Mahjari, Sarah S Aldharman, Khaled A Amer, Manar F Balobaid, Abdullah Madkhali, Aisha M Alsayary, Sarah F Alsubaie
Journal: Cureus (2023)
Keywords: fractures, multiple myeloma, osteolytic lesions, saudi arbia, spinal fracture
MeSH terms: Case Reports

Vertebral disease is a main source of morbidity (MM) in individuals with multiple myeloma. The effects of associated osteolytic lesions and vertebral fractures on severe pain, functional limits, spinal deformity, and cord compression are well recognized. Systemic therapy, radiation, cementoplasty (vertebroplasty/kyphoplasty), and radiofrequency ablation are now available therapeutic options for severe MM spinal pain. We here reported a case of a 45-year-old male who had complained of progressive symptoms of pathological spine fractures. He had been examined and investigated for the cause of lytic lesions and found to have multiple fractures in the spine. A computed tomography (CT) revealed multiple osteolytic lesions noted in the thoracolumbar spine, ribs (bilaterally), and pelvic bones. Magnetic resonance imaging (MRI) showed a compression fracture of the T8 vertebral body with evidence of retro-bulging and a spinal canal narrowing. However, there was no evidence of spinal cord abnormal signal intensity. T2 weighted image (T2WI) keeping with edema is noted. A surgical intervention fixed the fracture and improved the quality of life. Vertebroplasty, a minimally invasive procedure, as a treatment option for vertebral lesions and pathologic fractures in the MM, showed good clinical improvement in the patient.
Bipolar Dislocation of the Arm (Shoulder And Elbow): About One Case in an African Teaching Hospital
Authors: D A Songahir Christophe, Korsaga Alexandre, Tinto Sayouba, Sawadogo Mamoudou, Kafando Hamado, Ouedraogo Anatole Jean Innocent, Zeida Charles, Keita Namori, Tall Mohamed
Journal: Open Orthop J (2018)
Keywords: bipolar, dislocation, elbow, fracture, shoulder, swinging arm
MeSH terms: Case Reports

We report an exceptional clinical case of an ipsilateral dislocation fracture of the shoulder and right elbow, realizing a "swinging arm". Following a violent road accident, patient S.I, a 43-year-old left-handed sports educator, presented with an antero-medial shoulder dislocation fracture and a posterolateral ipsilateral elbow fracture-dislocation. The reduction in urgency, followed by the orthopedic compression by Mayo Clinic and functional rehabilitation, allowed obtaining a good result after seven months. The ipsilateral bipolar dislocation of the shoulder and elbow is an exceptional lesional entity. Its adequate care in emergency makes it possible to obtain good anatomical and functional results.
Acute Lymphocytic Myocarditis in a Young Male Post-COVID-19
Authors: Mintje Bohné, Sebastian Bohnen, Stephan Willems, Karin Klingel, Dietmar Kivelitz, Edda Bahlmann
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

Background:
Lymphocytic myocarditis is a rare form of myocarditis, associated with a high mortality rate due to a high risk of sudden cardiac death. Lymphocytic myocarditis might present as a relevant extrapulmonary manifestation after coronavirus disease 2019 (COVID-19) infection. Case presentation. We report a case of a 26-year-old male with lymphocytic myocarditis, presenting with a 1-month history of increasing fatigue, palpitations, and shortness of breath. Eight weeks before, he was tested positive for SARS-CoV-2. He had received 2-dose schedule of the COVID-19 mRNA vaccine Comirnaty® (BioNTech/Pfizer) 6 months prior to his admission. Diagnostic work-up by echocardiography and cardiac magnetic resonance (CMR) imaging demonstrated a severely reduced left ventricular function and a strong midmyocardial late gadolinium enhancement (LGE). Histology and immunohistology of the endomyocardial biopsies revealed an acute lymphocytic myocarditis. Immunosuppressive therapy with a steroid taper in combination with azathioprine 300 mg/day was initiated. The patient was equipped with a LifeVest®. On day 17, a non-sustained ventricular tachycardia was documented. Follow-up CMR imaging after 3 months showed a slightly improved systolic left ventricular function, and a strong LGE was still detectable.
Conclusions:
The case highlights the significance of recognizing lymphocytic myocarditis correlated to COVID-19. It is important to be vigilant also of a later presentation of cardiomyopathy in patients diagnosed with COVID-19 due to high mortality without immediate support.
Unusual paraneoplastic syndrome accompanies neuroendocrine tumours of the pancreas
Authors: Helga Bertani, Alessandro Messerotti, Fabrizio Di Benedetto, Raffaele Manta, Milena Greco, Federica Casoni, Luisa Losi, Rita Conigliaro
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Neuroendocrine tumours comprise a small percentage of pancreatic neoplasia (10%) (1). Diagnosis of neuroendocrine tumours is difficult, especially if the tumours are small and nonfunctional. CT scans, MRI, and nuclear scans are sufficiently sensitive assessment tools for tumours with diameters of at least 2 cm; otherwise, the sensitivity and specificity of these techniques is less than 50% (2). Myasthenia gravis (MG) is a heterogeneous neuromuscular junction disorder that is primarily caused when antibodies form against the acetylcholine receptors (Ab-AchR). MG can develop in conjunction with neoplasia, making MG a paraneoplastic disease. In those cases, MG is most commonly associated with thymomas and less frequently associated with extrathymic malignancies. The mechanism underlying this paraneoplastic syndrome has been hypothesized to involve an autoimmune response against the tumour cells (3). No published reports have linked malignant pancreatic diseases with MG. Here, we report the case of a young woman, negative for Ab-AchR, with a neuroendocrine tumour in the pancreatic head, who experienced a complete resolution of her MG-like syndrome after surgical enucleation of the tumour.
Acute idiopathic compartment syndrome of the forearm in an adolescent
Authors: Kelley Smith, Robert W Wolford
Journal: West J Emerg Med (2015)
MeSH terms: Compartment Syndromes / diagnosis, Case Reports, Adolescent, Compartment Syndromes / etiology, Female, Forearm, Humans

Acute compartment syndrome (ACS) is a condition typically associated with long bone fractures or severe trauma; however, non-traumatic etiologies also occur. We describe a case of an otherwise healthy female pediatric patient presenting with unilateral forearm pain without an inciting injury. Intracompartmental pressures of the forearm were measured and she was diagnosed with idiopathic compartment syndrome. Our goal is to encourage clinicians to consider acute compartment syndrome even in the absence of trauma.