OpenMed/multicare-articles huggingface dataset:
Drug Reaction With Eosinophilia and Systemic Symptoms: A Diagnostic Dilemma
Authors: Nicole M Vecin, Mohamed Elsheshtawi, Mohamed Abdul Qader, Stefanie Furlan, Daniel M Lichtstein
Journal: Cureus (2023)
Keywords: atypical presentation, cutaneous adverse drug reaction, delayed diagnosis, drug reaction with eosinophilia and systemic symptoms, drug reaction with eosinophilia and systemic symptoms (dress)
MeSH terms: Case Reports

Drug reaction with eosinophilia and systemic symptoms (DRESS) is an adverse reaction to medications such as sulfonamide-containing antibiotics, anticonvulsants, vancomycin, and non-steroidal anti-inflammatory drugs (NSAIDs). It typically presents with a characteristic rash, eosinophilia, and visceral organ failure. Patients who do not present with characteristic features of DRESS are at risk for delayed diagnosis and treatment. Early diagnosis of DRESS is imperative in preventing unfavorable outcomes such as multi-organ involvement and death. This case report presents the case of a patient who was diagnosed with DRESS but did not display a classic presentation.
Acute Bacterial Meningitis and Systemic Abscesses due to Streptococcus dysgalactiae subsp. equisimilis Infection
Authors: M Jourani, T Duprez, V Roelants, H Rodriguez-Villalobos, P Hantson
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Disseminated abscesses due to group G β-hemolytic Streptococcus dysgalactiae were observed in a 57-year-old cirrhotic patient with the skin being the putative way of entry for the pathogen. S. dysgalactiae is a rare agent in human infections responsible for acute pyogenic meningitis. The mortality rate associated with S. dysgalactiae bacteraemia and meningitis may be as high as 50%, particularly in the presence of endocarditis or brain abscesses. In our patient, main sites of infections were meningitis and ventriculitis, spondylodiscitis, septic arthritis, and soft-tissue infections. In contrast, no endocarditis was evidenced. Cirrhosis-related immune suppression was considered as a pathophysiological cofactor for the condition. Fortunately, clinical status improved after long-term (3 months) antimicrobial therapy.
Dramatic Response of Leptomeningeal Carcinomatosis to Nivolumab in PD-L1 Highly Expressive Non-small Cell Lung Cancer: A Case Report
Authors: David Arias Ron, Carmen M Labandeira, María Carmen Areses Manrique, Paula Sampedro Domarco, Ihab Abdulkader, Jesús García-Mata, Christian Rolfo, Diego González-Rivas, Jose Luis Fírvida
Journal: Front Oncol (2019)
Keywords: pd-l1, complete response, leptomeningeal carcinomatosis, nivolumab, squamous lung cancer
MeSH terms: Case Reports

In a patient who had been diagnosed of located squamous cell lung carcinoma, pneumonectomy, and adjuvant chemotherapy were performed. Brain recurrence and subsequent lung metastatic disease were uncontrolled by neurosurgery, holocranial radiotherapy, and first-line chemotherapy. In August 2015, appearance of leptomeningeal carcinomatosis triggered severe clinical deterioration and threatened the patient's life. Anti-PD1 immune checkpoint inhibitor Nivolumab was initiated in an attempt to stop tumor growth, achieving a spectacular brain and pulmonary complete response and clinical improvement, without serious adverse effects. High expression PD-L1 level (100%) was found in the pathological tissue sample. Nivolumab was maintained for more than 2 years and stopped in December 2017 after 28 months of treatment, with no disease evidence. More than 3 years after its onset, the patient maintains an outstanding PS with complete tumor response and no evidence of disease in last surveillance CT scan and brain MRI.
Polatuzumab Vedotin in a Patient with Refractory Burkitt Lymphoma, a Case Report
Authors: Meshaal Alanzi, Mohammad Abu-Tineh, Lajos Szabados, M Z Sharaf Eldean, Sali Alatasi, Ruba Y Taha, Sarah A Elkourashy
Journal: Onco Targets Ther (2023)
Keywords: burkitt’s lymphoma, lymphoma, anti cd79b, polatuzumab, resistant lymphoma
MeSH terms: Case Reports

Although Burkitt lymphoma is considered a curable disease due to the progress made in choosing the most effective first-line therapy, relapsed or refractory Burkitt lymphoma (BL) has a very poor outcome. There is a lack of data supporting the treatment regimens. We report a 48-year-old male with stage II Burkitt's lymphoma with no response to the first line of high-intensity chemotherapy. However, treatment with polatuzumab vedotin led to complete clinical remission for more than one year.
Unusually Large Extent of Pagetic Vertebral Ankylosis in a Patient with Ankylosing Spondylitis
Authors: Iness Tirraf, Pierre-Antoine Poncelet
Journal: J Belg Soc Radiol (2021)
Keywords: paget’s disease, ankylosing spondylitis, pagetic vertebral ankylosis
MeSH terms: Case Reports

Teaching point: When the joints between bones are ankylosed, such as in ankylosing spondylitis, Paget's disease can involve multiple contiguous bones leading to pagetic vertebral ankylosis.
Metastatic HPV-related oropharyngeal carcinoma cured with chemoradiotherapy: importance of pretherapy biomolecular assessment
Authors: Francesco Perri, Francesco Longo, Giuseppina Della Vittoria Scarpati, Salvatore Pisconti, Vito Longo, Raffaele Addeo, Fabio Carducci, Carlo Buonerba, Franco Fulciniti, Raffaele Solla
Journal: Clin Case Rep (2017)
Keywords: cyclin d1, p16, human papillomavirus, oropharyngeal carcinoma, p53
MeSH terms: Case Reports

Pretherapy assessment has a crucial role in the management of advanced oropharyngeal carcinoma. The case report represents an example of how translational research may help to optimize the therapeutic options and to choose a well-shaped therapy adapted to the tumor and the patient.
Head and Neck Schwannomas: A Surgical Challenge-A Series of 5 Cases
Authors: Ishtyaque Ansari, Ashfaque Ansari, Arjun Antony Graison, Anuradha J Patil, Hitendra Joshi
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Background:
Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. They originate from any nerve covered with schwann cell sheath. Schwannomas constitute 25-45% of tumors of the head and neck. About 4% of head and neck schwannomas present as a sinonasal schwannoma. Brachial plexus schwannoma constitute only about 5% of schwannomas. Cervical vagal schwannomas constitute about 2-5% of neurogenic tumors.
Methods:
We present a case series of 5 patients of schwannomas, one arising from the maxillary branch of trigeminal nerve in the maxillary sinus, second arising from the brachial plexus, third arising from the cervical vagus, and two arising from cervical spinal nerves.
Result:
Complete extracapsular excision of the tumors was achieved by microneurosurgical technique with preservation of nerve of origin in all except one.
Conclusion:
Head and neck schwannoma though rare should be considered as a differential diagnosis of a unilateral slow growing mass in the head and neck region, particularly in an adult. Schwannomas are always a diagnostic dilemma as they are asymptomatic for long time, and histopathology is the gold standard for diagnosis. As a rule, treatment is surgical and dictated by the location of the tumor and nerve of origin. Due to its rarity, complex anatomical location and morbidity risk postexcision, they can pose a formidable challenge to surgeons. This study aims to describe the presentation, workup, surgical technique, and outcome.
Successful Liver Transplantation After Neurologically Determined Death Donation Following Sodium Nitrite Poisoning
Authors: Umasankar Mathuram Thiyagarajan, A M James Shapiro
Journal: Cureus (2023)
Keywords: acute poisoning, decompensated liver disease, liver failure, liver transplantation, sodium nitrite poisoining
MeSH terms: Case Reports

Sodium nitrite poisoning has been reported with increasing frequency since 2017 and popularized on social media as an effective means to commit suicide. Though accidental, non-intentional consumption has been reported, it is uncommon. Sodium nitrite is a colorless, odorless, yellowish-white crystalline material that resembles table salt, is easily ingested for self-harm, and is readily accessible through purchase from online portals at low cost. The chemical is used industrially as a curing agent for meat, fish, and cheese, as it inhibits Clostridium botulinum and prevents botulism. We herein report a successful case of liver transplantation from an organ donor who suffered brain death after intentional sodium nitrite consumption. Despite conflicting evidence on sodium nitrite's toxic versus protective effects on the liver, our transplant recipient showed normal graft function in the four months following liver transplantation. It would have been helpful and reassuring to have had access to similar positive case reports when deciding to use such a donor.
Concurrent ruptured spontaneous heterotopic pregnancy and ruptured appendix with delayed presentation in the first trimester: a case report
Authors: Grant Murewanhema, Simbarashe Madombi, Lynette Hlathswayo, Ndabaningi Simango
Journal: Pan Afr Med J (2020)
Keywords: case report, acute appendicitis, heterotopic pregnancy, ruptured appendix
MeSH terms: Abdominal Pain / etiology, Appendicitis / diagnosis, Pregnancy Complications / diagnosis, Pregnancy, Heterotopic / diagnosis, Case Reports, Adult, Female, Humans, Laparotomy, Pregnancy, Pregnancy Trimester, First, Rupture, Spontaneous / diagnosis, Salpingectomy

Acute appendicitis is the commonest non-gynaecological surgical emergency in pregnancy. However, the concurrent occurrence of acute appendicitis with a heterotopic pregnancy is a rare event and presents diagnostic challenges to unsuspecting clinicians and sonographers. We present a case of a woman who had a heterotopic pregnancy and was noted to have a gangrenous appendicitis at laparotomy, illustrating how a diagnosis of acute appendicitis could easily be missed in pregnancy. We report the case of a 34-year-old woman in the first trimester of pregnancy who had a missed diagnosis of acute appendicitis after she had complained of vague abdominal symptoms for three weeks. She presented to a gynaecologist with vaginal bleeding for three days and was noted to have a heterotopic pregnancy on ultrasound scan. At laparotomy, she was noted to have a gangrenous appendicitis with pyoperitoneum concurrent with a ruptured left fimbrial ectopic pregnancy. Left salpingectomy and saline lavage were done and she had uneventful post-operative recovery. Unsuspecting clinicians, in patients without risk factors, can miss both heterotopic pregnancy and acute appendicitis. As assisted reproductive techniques become widespread, the possibility of heterotopic pregnancies must always be considered and any patient who presents with vague abdominal symptoms must be suspected to have the possibility of acute appendicitis. Because of the unreliability of laboratory investigations and clinical predictive scores in pregnancy, sonographers must be specifically asked to scan for heterotopic pregnancy and appendicitis in suspected cases.
Vascularized bone graft from the second metacarpal base for trapeziometacarpal joint arthrodesis
Authors: Akito Nakanishi, Kenji Kawamura, Shohei Omokawa, Takamasa Shimizu, Yasuhito Tanaka
Journal: Case Reports Plast Surg Hand Surg (2018)
Keywords: vascularized bone graft, non-union, osteoarthritis, the second metacarpal base, trapeziometacarpal joint
MeSH terms: Case Reports

Three female patients underwent TMC joint arthrodesis using a vascularized bone graft from the second metacarpal base. Surgical indications were nonunion after failed TMC joint arthrodesis and osteoarthritis and severe osteoporosis. All cases achieved early bone union, and marked postoperative improvement in the VAS and DASH scores.
Severe Metabolic Acidosis: A Case of Triple Hit with Ketogenic Diet, Vinegar, and Metformin in an Obese Patient
Authors: Abdul Mughees Rana, Kannan Mansoor, Salman Assad, Mahmoud Abouzid, Iheanyichukwu Ogu, Ghassan Salim Issa Bandak
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Obesity is an epidemic with high burden of disease. It is directly proportional to increased risk of morbidity and mortality. Ketogenic diet and herbal supplements have recently gained popularity amongst patients struggling with weight loss. There are limited data available for most of these supplements contrary to the claims laid by the mainstream media. Due to lack of awareness, this patient population is at high risk of adverse effects. We present a case of severe acidosis secondary to ketogenic diet and acetic acid (vinegar) ingestion. The use of dietary acetic acid is usually well tolerated; however, in this case, the large quantities and presence of acute renal injury may have worsened the acidosis. Severe ketosis in setting of ketogenic diets is a serious complication, which is infrequently reported in literature. Many of these diets and supplements may seem harmless, but as our case illustrates, when combined with other risk factors, patients can face adverse effects and even hospitalization. It is imperative that such dietary practices are physician supervised to avoid complications. With the recent surge of over-the-counter weight loss supplements and fat diets, physicians need to engage in dietary discussion with patients when attempting to lose weight.
Successful treatment of extensive-stage small cell lung cancer with concurrent pleural and pericardial effusions: Case report
Authors: Ayaka Kashima, Yosuke Fukuda, Miri Shimamura, Miharu Ijichi, Hironori Sagara
Journal: Front Oncol (2022)
Keywords: immune checkpoint inhibitor, pericardial effusion, pleural effusion, pleurodesis, small-cell lung cancer
MeSH terms: Case Reports

It is unclear whether pleural/pericardial drainage and pleurodesis/pericardiodesis should be performed before or after initiating chemotherapy in patients with chemotherapy-sensitive small-cell lung cancer. A 76-year-old woman presented to the emergency department with progressive dyspnea on exertion for a week. Chest computed tomography showed a mass shadow anterior to the left upper lobe, bilateral pleural effusions, and a circumferential pericardial effusion surrounding the heart. We diagnosed extensive-stage small-cell lung cancer based on the clinical course and pathological findings. We first performed pleurodesis and pericardial drainage and successfully initiated immune checkpoint inhibitor combined chemotherapy, with improved performance status. This case highlights the importance of aggressive drainage and pleurodesis/pericardiodesis, and suggests that drainage and pleurodesis/pericardiodesis should be considered before systemic chemotherapy in patients with concurrent pericardial or pleural effusions, even in patients with small-cell lung cancer that is sensitive to chemotherapy.
Spermatic cord metastasis presenting as strangulated inguinal hernia - first manifestation of a multifocal colon adenocarcinoma: a case report
Authors: Ioannis Galanis, Grigoris Chatzimavroudis, Alexandros Katsougiannopoulos, Nikiforos Galanis, John Makris, Konstantinos Atmatzidis
Journal: Cases J (2009)

Spermatic cord is a rare metastatic site of colorectal cancer. We herein report a case of spermatic cord metastasis of a previous undiagnosed multifocal colon adenocarcinoma, which was clinically presented as a strangulated groin hernia.
Malignant infantile osteopetrosis: case report with review of literature
Authors: Laila Essabar, Toufik Meskini, Said Ettair, Naima Erreimi, Nezha Mouane
Journal: Pan Afr Med J (2014)
Keywords: osteopetrosis, hepatomegaly, hydrocephalus, infant, rickets, splenomegaly
MeSH terms: Osteopetrosis / diagnosis, Case Reports, Review, Fatal Outcome, Humans, Hydrocephalus / complications, Hydrocephalus / diagnosis, Hydrocephalus / genetics, Infant, Male, Osteopetrosis / complications, Osteopetrosis / genetics, Respiratory Insufficiency / complications, Respiratory Insufficiency / diagnosis, Respiratory Insufficiency / genetics, Rickets / complications, Rickets / diagnosis, Rickets / genetics, Vacuolar Proton-Translocating ATPases / genetics, TCIRG1 protein, human, Vacuolar Proton-Translocating ATPases

Malignant Infantile Osteopetrosis (MIOP) is a rare genetic disorder due to osteoclast abnormal activity. We report a thirteen month-old male patient, diagnosed as MIOP while investigating the cause of hepatosplenomegaly associated with hydrocephalus. His medical history revealed non consanguineous parents and one brother's death at the same age of unknown etiology (similar symptoms). Systemic examination showed hepatosplenomegaly, growth failure, developmental milestones delay, and rickets features. Ophthalmic exam yielded bilateral optic atrophy. Skeleton radiographs detected generalized dense bone and rickets. Cerebral CT scan revealed hydrocephalus. Histological examination showed hypoplastic bone marrow and extra-medullary hematopoeisis. Diagnosis was confirmed by genetic testing that showed two heterozygote mutations within the TCIRG1 gene. The patient received supportive treatment. He died from an acute respiratory distress. MIOP should be kept in mind as a rare cause of hepatosplenomegaly. Early diagnosis and timely Hematopoietic stem cell transplantation are the only curative approach for an otherwise fatal disease.
Case report: Ventricular primary central nervous system lymphoma with partial hypointensity on diffusion-weighted imaging
Authors: Xintong Li, Hua Xiong
Journal: Front Neurol (2022)
Keywords: t2 blackout effect, case report, diffusion weighted imaging, primary central nervous system lymphoma, third ventricle, ventricular pcnsl
MeSH terms: Case Reports

Introduction:
Primary central nervous system lymphoma (PCNSL) is infrequent and represents 3. 1% of primary brain tumors. And the lesions that are restricted to the ventricular system, particularly the third ventricle, are even rarer. There are few pieces of literature or case reports to date. We report a case of PCNSL with partial hypointense on diffusion-weighted imaging (DWI) located in the lateral and third ventricles. Then we reviewed almost all case reports of ventricular PCNSLs in the last 20 years, discuss the imaging presentation, other ventricular tumors with similar imaging findings, and primary treatment measures.
Case presentation:
A 78-year-old man presented with memory loss and poor responsiveness for one week without obvious precipitating factors. Magnetic resonance imaging (MRI) showed lesions in the third ventricle and left lateral ventricles, which were slightly hypointense on T1-weighted imaging (T1WI), and isointense to slightly hypointense on T2-weighted imaging (T2WI). On DWI, the left lateral ventricular lesion was hyperintense, while the third ventricular lesion was hypointense. After the surgical procedure, the pathology and immunohistochemistry revealed diffuse large B-cell lymphoma (DLBCL).
Conclusions:
Ventricular PCNSL is quite rare, and may be confused with other tumors in the same position. However, PCNSL differs from other central nervous system tumors in that it is primarily treated with chemotherapy and/or radiation therapy. So, it is important to recognize PCNSL and differentiate it from other tumors, considering its implications for management planning.
Endoscopic treatment of a patient with duodenal major papilla adenoma and ansa pancreatica
Authors: Yan-Yan Wu, Yun-Lu Feng, Ai-Ming Yang
Journal: DEN Open (2023)
Keywords: ansa pancreatica, duodenal major papilla adenoma, endoscopic retrograde cholangiopancreatography, hybrid endoscopic mucosal resection, recurrent pancreatitis
MeSH terms: Case Reports

A 35-year-old female who suffered from recurrent pancreatitis was admitted to our hospital. Her magnetic resonance cholangiopancreatography revealed ansa pancreatica. And during endoscopic retrograde cholangiopancreatography, a major duodenal papilla adenoma was identified. Hybrid endoscopic mucosal resection of this lesion was performed with pancreatic stent placement through the minor papilla to prevent recurrent pancreatitis. To our knowledge, this is the first report of a major papilla adenoma associated with ansa pancreatica. These minimally invasive endoscopic treatments solved a difficult clinical problem and avoided traumatic surgery.
Distal-continual colon interposition for esophageal reconstruction after esophagectomy: Two case reports
Authors: Bin Guo, Ming He, Jidong Zhao, Minting Ma, Zhanjie Gao
Journal: Front Surg (2023)
Keywords: case reports, double primary carcinoma of esophagus and heart, esophagectomy, surgical anastomosis, transverse colon
MeSH terms: Case Reports

Background:
Colon interposition is a complex and time-consuming procedure requiring at least three or four digestive anastomoses. However, the long-term functional outcomes are promising, with an acceptable operative risk.
Case presentation:
Herein, two cases of esophageal carcinoma that received esophagus reconstruction using the distal continual colon interposition technique have been described. The transverse colon was lifted to the thoracic cavity for the end-to-side anastomosis with the esophagus, and a closure device was used to close the colon instead of severing and isolating the distal end. The duration of the operation was 140 and 150 min, respectively. The blood supply of the colon was maintained during the intervention. The tension-free anastomosis was performed without severe complications, and oral food intake was resumed on postoperative day 6. Neither anastomotic stenosis, antiacid or heartburn, dysphagia, or emptying obstacles nor complaints of diarrhea, bloating, or malodor were reported during the follow-up period.
Conclusions:
The modified distal-continual colon interposition technique may have the advantages of a short operation time and potential prevention of serious complications caused by the torsion of mesocolon vessels.
Case report: Persistent hypogammaglobulinemia in thymoma-associated myasthenia gravis: the impact of rituximab or Good's syndrome?
Authors: Jingru Ren, Jianchun Wang, Ran Liu, Jing Guo, Yan Yao, Jingjing Luo, Hongjun Hao, Feng Gao
Journal: Front Neurol (2023)
Keywords: good's syndrome (gs), hypogammaglobulinemia, infections, myasthenia gravis (mg), rituximab (rtx)
MeSH terms: Case Reports

Introduction:
Rituximab (RTX) showed good efficacy and safety for patients with myasthenia gravis. However, the percentage of peripheral CD20+ B cell may be absent for years after low dose of RTX treatment. Persistent hypogammaglobulinemia and opportunistic infection may occur in patients under treatment of RTX with thymoma relapse.
Case representation:
We report a case of refractory myasthenia gravis. After two doses of 100 mg rituximab, the patient developed transient neutropenia. The peripheral blood CD20+ B cell percentage was 0 more than 3 years. Eighteen months later, the patient's symptoms relapsed with thymoma recurred. She had persistent hypogammaglobulinemia and multiple opportunistic infections.
Conclusion:
In MG patient under B cell depletion therapy had thymoma relapse, Good's syndrome may induce prolonged B cell depletion, hypogammaglobulinemia and opportunistic infections.
Lipoma of Columella with septal extension in Pai syndrome: report of a rare case
Authors: Surendra B Patil, Shree Harsh
Journal: BMC Ear Nose Throat Disord (2017)
Keywords: case report, columella, lipoma, pai syndrome
MeSH terms: Case Reports

Background:
Lipoma in nasal region in a case of Pai syndrome is very rare. Very few cases of Pai syndrome with columellar lipoma with extension to septum and tip have been reported till date.
Case presentation:
We report a very rare form of nasal lipoma in a case of Pai syndrome with extension to septum and tip in a 4 year old female child.
Conclusions:
Pai syndrome with columellar lipoma with septal and tip extension should always be kept in mind when evaluating a swelling in the region of nasal tip, collumella and septum with notch in upper lip and corpus callosal lipoma.