OpenMed/multicare-articles huggingface dataset:
Lemierre Syndrome: A Diagnosis behind the Veil
Authors: Pak-Ho Au, Kelechi Nwabara, Nanuli Gvazava, Shannon Ejiofor, Ghulam Ghous
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Lemierre syndrome (LS) is a rare, serious infection that is often misdiagnosed, as it frequently mimics common upper respiratory infections. It is even rarer for LS to be preceded by a viral infection. We share a case of LS in a young man who presented to the Emergency Department with COVID-19 viral infection followed by a subsequent LS diagnosis. The patient's condition initially worsened despite treatments for COVID-19 and was subsequently started on broad-spectrum antibiotics. He was then diagnosed with LS after blood cultures grew Fusobacterium necrophorum, and antibiotics were adjusted accordingly, resulting in improvement of symptoms. Even though LS is often recognized as a sequela of bacterial pharyngitis, preceding viral infections, including COVID-19, might be a risk factor that contributes to the development of LS.
Rhino-Orbital-Cerebral Mycosis and Extranodal Natural Killer or/and T-Cell Lymphoma, Nasal Type
Authors: Dong Ming Li, Li De Lun
Journal: Front Med (Lausanne) (2022)
Keywords: rhizopus arrhizus, extranodal nk/t-cell lymphoma, facial destruction, lethal midline granuloma, mucor irregularis, nasal type, rhino-orbital-cerebral mycosis

Background:
Extranodal natural killer/T-cell lymphoma, nasal type is a syndrome of middle face destruction with an association to Epstein-Barr virus. Fungi have been recovered from the diseased tissue now and then but were often seen as a lymphoma-associated secondary infection. However, there are ENKTL-NT cases with the recoveries of fungi and complete recovery with antifungal therapy, which are quite similar to rhino-orbital-cerebral mycosis (ROCM) that often confuses the physicians.
Methods:
We searched Medline for English-language manuscripts limited to "human" and "case reports," "letters," "reviews," and "clinical conferences" from 1966 to 2022. We used MeSH terms "lymphoma, extranodal nk-t-cell" [MeSH Terms] or "lethal midline granuloma" [MeSH Terms], in combination with MeSH terms "microbiology" [subheading] or "microbiology" [all fields] or "fungi" [all fields] or "fungi" [MeSH Terms] for ENKTL-NT with infections. We used MeSH terms "Mycoses" in combination with "Nose" [Mesh] OR "Orbital Diseases" [Mesh] for rhino-orbital-cerebral fungal infections.
Results:
We appraised 149 included articles and extracted references related to ENKTL-NT and/or ROCM. Themes and subcategories were subsequently derived. Our findings revealed that ROCM and ENKTL-NT are characterized by progressive and destructive ulcers in the midline face or rhino-orbital structures. ROCM is mainly caused by fungi in the order of Mucorales, and ENKTL-NT is usually associated with Epstein-Barr virus and sometimes fungi. Radiologically, both are characterized by non-specific features of sinusitis, soft tissue infection, and necrosis. Pathologically, ROCM and ENKTL-NT share the same characteristics of inflammation, necrosis, and granuloma. ROCM is characterized by the detection of fungi in tissue, while ENKTL-NT is typically positive for NK/T-cell markers and cytotoxic granule-associated proteins, proliferation, and vascular damage of angioinvasion, which could be incited by Mucor irregularis and Rhizopus arrhizus in patients and mice.
Conclusion:
ENKTL-NT and ROCM share many similarities in clinical presentations, radiology, and histopathology, and might have the same etiology. This may explain why the two diseases are tangled together in the reported cases, and suggests the role that the fungi may play in the development of these ENKTL-NT/ROCM diseases. The reason why ENKTL-NT and ROCM are sometimes confused is that the main pathogens of ROCM, Mucor irregularis and Rhizopus arrhizus, are the fungal causative agents of ENKTL-NT.
Threat of a Cycle Proof: Vertebral Artery Dissection Associated with Posterior Inferior Cerebellar Artery Infarction
Authors: Francisco Monteiro, Pedro Oliveira, Artur Condé
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

This paper presents a case of a perfectly healthy 36-year-old male, who went to the emergency department with a clinical picture of diffuse headache, dizziness, and asthenia with 3 days of evolution, after a long cycling race. He was admitted to the ENT Department with suspected diagnosis of peripheral vertigo. The patient developed hypoesthesia of the face, diplopia, right lateropulsion, and Romberg with preferential rightward fall, and imaging studies demonstrated an extracranial vertebral artery dissection concomitant with PICA territory infarction. This is a rare described case of a vertebral artery dissection concomitant with an infarction of the PICA territory. This case demonstrates the importance of maintaining a high degree of suspicion of stroke in patients with signs/symptoms of nystagmus/vertigo and the relevance of magnetic resonance imaging instead of tomography in the detection of these serious clinic conditions.
Evolution of Cerebral Atrophy in a Patient with Super Refractory Status Epilepticus Treated with Barbiturate Coma
Authors: Christopher R Newey, Pravin George, Premkumar Nattanmai, Christine Ahrens, Stephen Hantus, Aarti Sarwal
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion weighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive generalized cerebral atrophy from status epilepticus is underrecognized and may be related to neuronal death. We present here a case of diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged barbiturate coma. Methods. Case report and review of the literature. Case. A 19-year-old male with a prior history of epilepsy presented with focal clonic seizures. His seizures were refractory to multiple anticonvulsants and eventually required pentobarbital coma for 62 days and midazolam coma for 33 days. Serial brain magnetic resonance imaging (MRI) showed development of cerebral atrophy at 31 days after admission to our facility and progression of the atrophy at 136 days after admission. Conclusion. This case highlights the development and progression of generalized cerebral atrophy in super refractory status epilepticus. The cerebral atrophy was noticeable at 31 days after admission at our facility which emphasizes the urgency of definitive treatment in patients who present with super refractory status epilepticus. Further research into direct effects of therapeutic coma is warranted.
Uncommon presentation of potential medication-related osteonecrosis of the jaw
Authors: Seong-Gon Kim, HaeYong Kweon, Suk-Keun Lee
Journal: Springerplus (2016)
Keywords: anti-angiogenic drug, inflammation, macrophage, medication-related osteonecrosis of the jaw

Background:
This article presents a patient with potential atypical medication-related osteonecrosis of the jaw and reviews related literatures.
Case presentation:
A 52-year-old male showed pain in the left buccal area and had numbness on the left lower lip area. He received medications having anti-angiogenic effect for 4 years. He did not receive irradiation of the jaw regions. In histological view, most of the adipocytes were destroyed and disappeared in the scanty vascular marrow tissue, resulting in the replacement of the fatty necrosis with variable sized vacuolated empty spaces. In the immunohistochemistry analysis, the infiltrated macrophages into the marrow stromal tissue were strongly positive for lysozymes. These findings demonstrate that the presented osteonecrosis underwent a chronic and persistent granulomatous inflammatory reaction.
Conclusions:
We conclude that the present case might have been caused by anti-angiogenic drug abuse, affecting the reduction of the mandibular marrow vascularity and subsequently inducing fatty necrosis and an extensive osteolytic change of the mandible.
Primary acantholytic squamous cell carcinoma of the cecum: a case report
Authors: Zoran Jukić, Iva Ledinsky, Monika Ulamec, Mario Ledinsky, Božo Krušlin, Davor Tomas
Journal: Diagn Pathol (2011)
MeSH terms: Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / pathology, Cecal Neoplasms / diagnosis, Cecal Neoplasms / pathology, Case Reports, Carcinoma, Squamous Cell / surgery, Cecal Neoplasms / surgery, Colectomy, Female, Humans, Keratins / metabolism, Middle Aged, Mucin-1 / metabolism, Syndecans / metabolism, Treatment Outcome, Mucin-1, Syndecans, Keratins

Background:
Acantholytic squamous cell carcinoma (ASCC) is an uncommon histopathologic variant of SCC, characterized by marked acantholysis, wherein the tumor cells demonstrate defective cohesion to one another in the cancer nest leading to a pseudoglandular or pseudovascular appearance. The most common site of ASCC is the sun-exposed areas of the skin. Sporadic cases of ASCC have also been reported in various mucosal membranes and organs but to our knowledge this is the first case of primary ASCC of the large bowel.
Case presentation:
A 59-year-old woman underwent right hemicolectomy due to large tumor in cecum and initial part of the ascending colon. Microscopically, the tumor consisted of nests of focally keratinizing large, atypical, squamous epithelial cells. Approximately 70% of the tumor showed acantholytic changes and acantholysis was equally distributed through the entire tumor. Immunohistochemically tumor cells were diffusely positive for cytokeratin (CK) AE1/AE3 and focally positive for epithelial membrane antigen and syndecan 1. All other tested antibodies (CK7, CK 20, CK MNF116, E-cadherin, beta-catenin, p63, p16, CD31, CD34, CEA, estrogen, progesterone) showed negative reaction. Periodic acid Schiff and alcian blue staining showed no intracellular or extracellular mucinous material in the tumor. The diagnosis of acantholytic squamous cell carcinoma of the cecum was suspected and additional examination was recommended to exclude possibility of metastatic carcinoma. Extensive clinical examination which also included whole-body PET/CT scan showed no additional tumors. After the exclusion of possible metastatic disease the diagnosis of primary acantholytic squamous cell carcinoma of the cecum was confirmed. Six months after surgery the metastasis in small intestine and recurrence in the abdominal cavity at the site of surgery appeared and had the same morphological characteristic as the primary tumor in the cecum.
Conclusion:
We report a unique case of ASCC arising in cecum and on this way expands the range of tumors originating in colon. Reports of more cases of colonic ASCC would possibly help to elucidate origin, clinical behavior and therapy of these tumors.
Delayed Treatment of Traumatized Primary Teeth with Distinct Pulp Response: Follow-Up until Permanent Successors Eruption
Authors: Gabriela Cristina de Oliveira, Juliana Calistro da Silva, Franciny Querobim Ionta, Catarina Ribeiro Barros de Alencar, Priscilla Santana Pinto Gonçalves, Thaís Marchini de Oliveira, Thiago Cruvinel, Daniela Rios
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51) and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61), which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61) due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA) of the tooth (51), because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth's exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11) was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.
Multiple Prostatic Abscesses Caused by Staphylococcus aureus Without Physical Findings in an Immunosuppressed Older Patient
Authors: Junji Uchiyama, Yudai Tanaka, Yasuo Kurita, Chiaki Sano, Ryuichi Ohta
Journal: Cureus (2023)
Keywords: antibacterial drug, diabetes mellitus, gangrenous cholecystitis, general medicine, prostatic abscess, rural hospital, staphylococcus aureus bacteremia
MeSH terms: Case Reports

Staphylococcus aureus is endemic to human and animal skin and the gastrointestinal tract and is highly tissue-destructive. Staphylococcus aureus bacteremia has a high mortality rate of 20%-30%. A prostatic abscess is a rare complication of acute bacterial prostatitis. The focus of S. aureus infection is elsewhere in the body, and bacteremia causes the abscess, hence difficult to diagnose. Here, we report a case of prostatic abscesses, followed by a diagnosis of S. aureus bacteremia without specific physical findings. The patient was a 72-year-old male with independent activities of daily living who developed prostate and perifemoral abscesses with multiple vague symptoms due to diabetes-related methicillin-susceptible S. aureus bacteremia. It is important to comprehensively evaluate multiple vague symptoms considering the immunological conditions of patients and investigate any suspicion of bacteremia and abscess in deep parts of the body. General physicians should be system-specific specialists to deal with multiple symptoms among older immunocompromised patients.
Case Report: Cognitive Assessment Before an Amnesic Seizure in Transient Epileptic Amnesia Syndrome
Authors: Coline Bouyer, Bertrand de Toffol
Journal: Front Neurol (2022)
Keywords: amnesic seizure, epilepsy, memory, neuropsychology, transient epileptic amnesia (tea)
MeSH terms: Case Reports

A patient with transient epileptic amnesia syndrome presented a clinically observable amnesic seizure immediately after a neuropsychological assessment. An hour and a half before the onset of the seizure, the patient progressively developed an isolated alteration of episodic memory. These data question the ictal/interictal distinction in this syndrome as well as the speed of propagation of an epileptic activity.
Florid Mesothelial Hyperplasia Associated with Abdominal Wall Endometriosis Mimicking Invasive Carcinoma
Authors: Edgar G Fischer, Shweta Agarwal
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Florid mesothelial hyperplasia typically occurs in the pelvis, abdomen, or chest associated with an underlying neoplastic or inflammatory process. These lesions are of clinical significance because they can mimic a neoplasm. Early reports were published in the 1970s, but only a few case series of such lesions have been published in the gynecologic pathology literature. Here, we report a case of florid mesothelial hyperplasia with an infiltrative growth pattern, mimicking an invasive carcinoma. The lesion was associated with endometriosis forming a mass lesion in the abdominal wall. Histologically, tubular arrangements and nests of mesothelial cells, some with artifactual slit-like spaces, formed a stellate lesion adjacent to endometrial glands and stroma. Cytologic atypia was mild and reactive, and positive immunostaining for calretinin, WT-1, and cytokeratin 5 identified the lesion as mesothelial and benign. We describe in detail the histologic findings in this case and review the pertinent literature. We discuss the clinically importance of this diagnostic pitfall and the path to arriving at the correct diagnosis.
The effect of antiviral therapy on hepatitis C virus-related thrombocytopenia: a case report
Authors: Rita Lebano, Valerio Rosato, Mario Masarone, Marco Romano, Marcello Persico
Journal: BMC Res Notes (2014)
MeSH terms: Antiviral Agents / therapeutic use, Hepatitis C, Chronic / complications, Purpura, Thrombocytopenic, Idiopathic / drug therapy, Case Reports, Alanine Transaminase / blood, Antiviral Agents / pharmacology, Aspartate Aminotransferases / blood, Drug Administration Schedule, Drug Therapy, Combination, Female, Hepatitis C, Chronic / blood, Hepatitis C, Chronic / drug therapy, Humans, Interferon-alpha / therapeutic use, Middle Aged, Platelet Count, Polyethylene Glycols / therapeutic use, Prednisone / administration & dosage, Prednisone / therapeutic use, Purpura, Thrombocytopenic, Idiopathic / etiology, Recombinant Proteins / therapeutic use, Remission Induction, Ribavirin / therapeutic use, Antiviral Agents, Interferon-alpha, Recombinant Proteins, Polyethylene Glycols, Ribavirin, Aspartate Aminotransferases, Alanine Transaminase, peginterferon alfa-2a, Prednisone

Background:
Autoimmune thrombocytopenic purpura is an immunological disorder characterized by increased platelet destruction due to presence of anti-platelet autoantibodies. Hepatitis C virus infection, which is one of the most common chronic viral infections worldwide, may cause secondary chronic immune thrombocytopenic purpura.
Case presentation:
We report a case of a 51-year-old Caucasian female with hepatitis C virus infection who developed a severe, reversible, immune thrombocytopenia. Platelet count was as low as 56.000/mm3, hepatitis C virus serology was positive, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase and gamma-glutamyltransferase serum levels were elevated. Disorders potentially associated with autoimmune thrombocytopenic purpura were ruled out. A corticosteroid treatment was started and led to an increase in platelet count. The patient was then treated with pegylated-interferon alpha 2a and ribavirin. After four weeks of treatment hepatitis C virus - ribonucleic acid became undetectable and steroid treatment was discontinued. Six months of antiviral therapy achieved a sustained biochemical and virological response together with persistence of normal platelet count.
Conclusion:
In our case report hepatitis C virus seemed to play a pathogenic role in autoimmune thrombocytopenic purpura. Moreover, the successful response (negative hepatitis C virus - ribonucleic acid) to tapered steroids and antiviral therapy was useful to revert thrombocytopenia.
Cytomegalovirus meningoencephalitis in a case of severe COVID-19 Pneumonia. A case report
Authors: Dore C Ananthegowda, Mohamad Y Khatib, Husain S Ali, Mohamed Al Wraidat, Yahia Imam
Journal: IDCases (2021)
Keywords: cmv, covid 19, case report, ganciclovir, immunosuppression, meningoencephalitis, opportunistic infections, steroids
MeSH terms: Case Reports

The use of steroids and other immune modulatory therapies in the treatment of severe COVID-19 pneumonia predisposes patients to the reemergence of opportunistic infections. Cytomegalovirus (CMV) reactivation can be one of them. A 55-year-old gentleman with severe COVID-19 pneumonia and hypoxic respiratory failure who was ventilated and received steroids but no other immunomodulatory drugs; had altered sensorium and multiple episodes of seizures in the later course of his illness. Brain MRI showed leptomeningeal enhancement and encephalopathy changes, electroencephalography (EEG) was suggestive of diffuse encephalopathy and his cerebrospinal fluid (CSF) analysis revealed high Cytomegalovirus PCR DNA titers (103,614). The patient made a complete recovery after treatment with Ganciclovir. Altered sensorium in cases of COVID-19 can be multifactorial. High index of suspicion for reactivation of dormant infections is warranted. CMV meningoencephalitis is one of the differential diagnoses. We believe this is the first case reported of CMV meningoencephalitis in the setting of severe COVID-19 infection.
Clinical strategies for complete denture rehabilitation in a patient with Parkinson disease and reduced neuromuscular control
Authors: Satheesh B Haralur
Journal: Case Rep Dent (2015)

The dentist has a large role in geriatric health care for the ever increasing elder population with associated physical and neurological disorders. The Parkinson disease is progressive neurological disorder with resting tremor, bradykinesia, akinesia, and postural instability. The psychological components of disease include depression, anxiety, and cognitive deficiency. Poor oral hygiene, increased susceptibility for dental caries, and periodontal diseases predispose them to early edentulism. The number of Parkinson affected patients visiting dental clinic seeking complete denture is growing. This case report explains the steps involved in the complete denture rehabilitation of Parkinson patient. The effective prosthesis will help in alleviating functional, aesthetic, and psychological disabilities of the patient.
Lurbinectedin in Refractory Diffuse Malignant Peritoneal Mesothelioma: Report of Two Cases
Authors: Louis Gros, Petr Szturz, Antonella Diciolla, Volker Kirchner, Solange Peters, Niklaus Schaefer, Martin Hubner, Antonia Digklia
Journal: Front Oncol (2021)
Keywords: case report, durable response, lurbinectedin, palliative chemotherapy, peritoneal mesothelioma, peritoneal tumor

Mesothelioma is a malignancy of serosal membranes. Parietal pleura is the most common site, with peritoneum being the second most frequent location. Malignant peritoneal mesothelioma (MPM) is a rare and aggressive disease. The prognosis is often very poor with median overall survival ranging from 6 to 18 months in patients who are not candidates for cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) due to non-resectable disease or comorbid conditions. For patients with resectable disease, CRS and HIPEC have become the standard of care. However, for patients with unresectable malignant mesothelioma there is unfortunately no effective systemic treatment beyond the first line. Based on the results of a recent phase II trial, lurbinectedin has clinical activity and acceptable toxicity in the second- and third-line treatment of malignant pleural mesothelioma. However, until present, no data have been available for patients with MPM and for patients who become refractory after multiple treatment lines. We report on two patients with metastatic MPM who achieved durable disease control of 10+ and 8 months with lurbinectedin in the fourth and fifth treatment line, respectively.
Case report: The treatment for olfactory neuroblastoma combined with leptomeningeal carcinomatosis via an ommaya reservoir
Authors: Yichen Peng, Xun Kang, Bo Jiang, Feng Chen, Shoubo Yang, Zhuang Kang, Ce Wang, Yi Lin, Shenglan Li, Jiefei Han, Botao Zhang, Weichunbai Zhang, Wenbin Li
Journal: Front Oncol (2023)
Keywords: case report, intrathecal administration, leptomeningeal carcinomatosis, olfactory neuroblastoma, ommaya reservoir
MeSH terms: Case Reports

Olfactory neuroblastoma is a rare neoplasm that usually presents in the upper nasal cavity. Although its prognosis is highly unfavorable, effective treatment options are still lacking. Moreover, there is no standard treatment for patients with olfactory neuroblastoma that progressed to leptomeningeal carcinomatosis. Here we report an uncommon case of a 59-year-old woman who was diagnosed with olfactory neuroblastoma and leptomeningeal carcinomatosis. For a direct delivery of the drugs to the tumor, and to avoid the impact of lumbar puncture on the patient's quality of life, the intravenous chemotherapy plus intrathecal administration of MTX via an Ommaya reservoir was chosen. The results were striking, with the disappearance of tumor cells in the cerebrospinal fluid and the relief of the patient's symptoms with PR. Our result indicates that chemotherapy via an Ommaya reservoir offers a new potential therapy for patients with meningeal metastases.