OpenMed/multicare-articles huggingface dataset:
Two cases of multinodular and vacuolating neuronal tumour
Authors: Istvan Bodi, Olimpia Curran, Richard Selway, Robert Elwes, Juan Burrone, Ross Laxton, Safa Al-Sarraj, Mrinalini Honavar
Journal: Acta Neuropathol Commun (2014)
MeSH terms: Brain Neoplasms / pathology, Frontal Lobe / pathology, Neoplasms, Neuroepithelial / pathology, Case Reports, Research Support, Non-U.S. Gov't, Adult, Aged, Brain Neoplasms / complications, Female, Frontal Lobe / metabolism, Frontal Lobe / ultrastructure, Humans, Magnetic Resonance Imaging, Microscopy, Electron, Motor Neuron Disease / etiology, Neoplasms, Neuroepithelial / complications, Nerve Tissue Proteins / metabolism, Seizures / etiology, Nerve Tissue Proteins

An unusual multinodular and vacuolating neuronal tumour (MVNT) has been described in the cerebral hemispheres of ten patients with adult-onset seizures. We report the findings in two cases with similar features, a surgical resection and the other an autopsy specimen.Case 1, a 34-year-old female, underwent surgical resection for a multinodular non-enhancing frontal white matter lesion causing intractable epilepsy. Case 2, presented with motor neurone disease (MND) at the age of 71 and MRI scanning revealed extensive multinodular non-enhancing white matter lesions in the temporal lobe. There was no history of epilepsy and post mortem histology confirmed MND.Macroscopically multiple small grey well-formed, discrete and coalescent nodules were seen in the deep cortex and subcortical white matter. On histology, mature-looking neurons with large cytoplasmic vacuoles were distributed in a fibrillary background, where vacuoles were also noted. In the resected tumour scattered oligodendroglia-like cells were present. No ganglion cells were seen. The vacuolated cells exhibited immunopositivity for synaptophysin, HuC/HuD and p62 but were negative for NeuN, neurofilament, GFAP, IDH1, nestin and CD34. Electron microscopy showed non-membrane bound cytoplasmic vacuoles in the neurons and in some neuronal processes. The seizures recurred in Case 1.Some clinicopathological features of this lesion suggest a possible relationship with dysembryoplastic neuroepithelial tumour (DNT) although the morphological features are not typical of DNT. Case 2 demonstrates that MVNT may remain asymptomatic.
Esophageal Perforation due to Anterior Cervical Spine Hardware Placement: Case Series
Authors: Thomas S Lee, Eric N Appelbaum, Derek Sheen, Reintine Han, Benjamin Wie
Journal: Int J Otolaryngol (2019)

Context. This case series discusses surgical management of esophageal perforations that occurred following cervical spine hardware placement. Purpose. (1) Determine presenting symptoms of esophageal perforation after anterior cervical spine hardware placement. (2) Discuss surgical management of these resulting esophageal perforation complications. Design/Setting. Case series of six patients at a tertiary-care, academic medical center. Patient Sample. Six patients with pharyngoesophageal perforations following anterior cervical spine surgery (ACSS). Outcome Measures. Date of ACSS, indication for ACSS, level of hardware, location of esophageal or pharyngeal injury, symptoms at presentation, surgical intervention, type of reconstruction flap, wound culture flora, and antibiotic choice. Methods. A retrospective review of patients with an esophageal or hypopharyngeal injury in the setting of prior ACSS managed by the otolaryngology service at a tertiary, academic center between January 2015 and January 2019. Results. Six patients who experienced pharyngoesophageal perforation following ACSS are included in this study. Range of presentation was two weeks to eight years following initial hardware placement. Five patients presented with an abscess and all had evidence of perforation on initial CT or esophagram. All patients underwent repair with a sternocleidomastoid flap with two patients eventually requiring an additional pectoralis myofascial flap for a persistent esophageal leak. Five patients eventually attained ability to tolerate oral nutrition. An algorithm detailing surgical reconstructive management is proposed. Conclusions. Esophageal perforations in the setting of prior ACSS are challenging clinical problems faced by otolaryngologists. Consideration should be given to early drainage of abscesses and spine surgery evaluation. Spinal hardware removal is recommended whenever possible. Utilization of a pedicled muscle flap reinforces primary closure and allows coverage of the vertebral bony defect. Nutrition, thyroid repletion, and culture-directed IV antibiotics are necessary to optimize esophageal perforation repair.
Fever associated with gastrointestinal shigellosis unmasks probable brugada syndrome
Authors: John N Makaryus, Jennifer Verbsky, Scott Schwartz, David Slotwiner
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Since it was first described approximately 15 years ago, the Brugada Syndrome has spurred a significant quantity of interest in its underlying mechanism and physiology. The Brugada electrocardiographic pattern is characterized by right bundle branch block morphology and ST segment elevations in the right precordial leads with an absence of identifiable underlying structural heart disease. The syndrome is clinically significant since these patients are at a higher risk of developing malignant ventricular arrhythmias. One of the mechanisms behind the disorder involves mutations in specific myocardial sodium channels. Furthermore, these electrocardiographic changes appear to be temperature dependent. We present the case of a 35-year-old male who presented with intestinal Shigellosis and was also found to have Brugada-type electrocardiographic changes on ECG. The electrocardiographic changes that were present when the patient was admitted and febrile resolved following antibiotic therapy and defervescence.
An enemy in shadows-Mycoplasma hominis septic arthritis and iliopsoas abscess: Case report and review of the literature
Authors: Gawahir A Ali, Wael Goravey, Abdulrahman Hamad, Emad B Ibrahim, Mohamed R Hasan, Muna Al Maslamani, Hussam Al Soub
Journal: IDCases (2021)
Keywords: mycoplasma hominis, pcr, doxycycline, rituximab, septic arthritis
MeSH terms: Case Reports

Mycoplasma hominis (M. hominis) is fastidious and difficult to grow bacteria with the ability to colonize the genitourinary and respiratory tracts. Infrequently can cause a variety of genitourinary tract infections, pregnancy complications, and neonatal diseases. M. hominis rarely reported to cause extragenital infections and seldomly native joint septic arthritis particularly in immunocompromised hosts, raising diagnostic challenges and is often associated with delayed diagnosis and high morbidity and mortality. We report the case of a 30-year-old patient who developed M. hominis native left hip septic arthritis with iliopsoas abscess after receiving rituximab for newly diagnosed thrombotic thrombocytopenic purpura (TTP). The diagnosis of M. hominis hip septic arthritis with iliopsoas involvement was confirmed following repeated joint and abscess aspiration and identification of the organism with the aid of culture and specific Polymerase chain reaction (PCR). The patient was subsequently treated with a prolonged course of antibiotics targeting the organism with a favorable outcome. The clinical presentations, assessment, and management of this rare entity of M. hominis related extragenital infections are outlined. In addition, the literature on similar cases was reviewed to raise awareness and avoid devastating consequences.
A Rare Cutaneous Manifestation: Leukocytoclastic Vasculitis after Pfizer-BioNTech COVID-19 Vaccination
Authors: Yaritza Serrano Gomez, Brittney Grella, Hongbei Wang
Journal: Case Rep Dermatol Med (2022)
MeSH terms: Case Reports

There is growing evidence that vaccines against SARS-CoV-2 can cause various skin reactions, many of which have autoimmune origins. These specific vaccine-induced autoimmune conditions with cutaneous manifestations include lupus erythematosus, bullous pemphigoid, vitiligo, alopecia areata, and leukocytoclastic vasculitis (LCV). In particular, LCV, which is also called hypersensitivity vasculitis, is an inflammation of small blood vessels. We present a case of an 81-year-old male evaluated in the emergency department for a bilateral purpuric non-blanching rash that appeared ten days after receiving the Pfizer-BioNTech booster vaccine against SARS-CoV-2. Results of a skin biopsy indicated LCV, and the rash completely resolved three weeks after clinical presentation.
Case Report: Canakinumab for the Treatment of a Patient With COVID-19 Acute Respiratory Distress Syndrome
Authors: Massimo Caracciolo, Sebastiano Macheda, Demetrio Labate, Marco Tescione, Stefano La Scala, Eugenio Vadalà, Rosalba Squillaci, Francesco D'Aleo, Antonella Morabito, Cristina Garreffa, Maria Concetta Marciano, Esther N Oliva
Journal: Front Immunol (2020)
Keywords: covid-19, il-1, il-6, sars-cov-2, acute respiratory distress syndrome, canakinumab, cytokine storm, natural killer
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Betacoronavirus, Coronavirus Infections / drug therapy, Pneumonia, Viral / drug therapy, Respiratory Distress Syndrome / drug therapy, Case Reports, Aged, 80 and over, Antibodies, Monoclonal, Humanized / administration & dosage, Antibodies, Monoclonal, Humanized / pharmacology, CD56 Antigen / metabolism, COVID-19, COVID-19 Drug Treatment, Coronavirus Infections / virology, Fatal Outcome, Humans, Interleukin-1beta / antagonists & inhibitors, Interleukin-6 / blood, Killer Cells, Natural / immunology, Male, Pandemics, Pneumonia, Viral / virology, Respiratory Distress Syndrome / virology, SARS-CoV-2, Severity of Illness Index, Antibodies, Monoclonal, Humanized, CD56 Antigen, IL1B protein, human, IL6 protein, human, Interleukin-1beta, Interleukin-6, NCAM1 protein, human, canakinumab

Severe cases of COVID-19 present with serious lung inflammation, acute respiratory distress syndrome and multiorgan damage. SARS-CoV-2 infection is associated with high cytokine levels, including interleukin-6 and certain subsets of immune cells, in particular, NK, distinguished according to the cell surface density of CD56. Cytokine levels are inversely correlated with lymphocyte count, therefore cytokine release syndrome may be an impediment to the adaptive immune response against SARS-CoV-2 infection. Canakinumab, a monoclonal antibody targeting IL-1β is under investigation for the treatment of severe SAR-CoV-2 infection. An 85 year old male presenting in our hospital with COVID-19, whose condition was complicated by acute respiratory distress syndrome and cardiac and renal failure (with oliguria) after 25 days of hospitalization, was intubated and received canakinumab for compassionate use. On the next day, diuresis recovered and conditions improved: high IL-6 levels and NK cells expressing CD56 bright (associated with cytokine relase) were significantly reduced giving rise to NK CD56 dim . Patient died on day 58 with pulmonary bacterial superinfection and persistent SARS-CoV-2 positivity. In conclusion, canakinumab rescued a high risk, very elderly patient, from multiorgan damage complicating COVID-19. It may represent an useful treatment in severe cases.
Synchronous multiple primary malignancies of clear cell renal cell carcinoma with sarcomatoid, thyroid carcinoma: a case report
Authors: Yaxian Tan, Xiaowen Chen, Mushi Ye, Xiaofang Li, Wenci Liu, Sihai Liao, Zhong Xie, Yufang Zuo
Journal: Front Oncol (2023)
Keywords: case report, clear cell renal cell carcinoma with sarcomatoid, multidisciplinary, multiple primary malignancies, papillary thyroid carcinoma
MeSH terms: Case Reports

Multiple primary malignant neoplasms (MPMNs) are defined as the presence of two or more malignancies with different histologies in the same patient. MPMNs are rare, accounting for fewer than 4% of all tumor cases. Depending on the time interval between the diagnosis of the different malignancies, they are classified as either simultaneous or metachronous MPMNs, with simultaneous being rarer in MPMNs. Here, we present a 63-year-old female patient presenting with multiple primary renal and thyroid carcinomas and discuss the risk factors, treatment options, and prognosis of rare dual carcinomas. We focus on managing multidisciplinary teams and selecting individualized treatment options to deliver valuable treatment strategies to patients.
Rheumatic heart disease in pregnancy: a report of 2 cases
Authors: Asaph Ziruma, Munyaradzi Innocent Nyakanda, Annie Fungai Muyotcha, Fungisai Nyarai Hove, Mugove Gerald Madziyire
Journal: Pan Afr Med J (2017)
Keywords: mitral stenosis, mechanical heart valve, pregnancy
MeSH terms: Mitral Valve Stenosis / complications, Pregnancy Complications, Cardiovascular / physiopathology, Rheumatic Heart Disease / complications, Warfarin / adverse effects, Case Reports, Adult, Anticoagulants / administration & dosage, Anticoagulants / adverse effects, Cesarean Section, Female, Heart Valve Prosthesis, Humans, Pregnancy, Pregnancy Outcome, Warfarin / administration & dosage, Anticoagulants, Warfarin

Pregnant women with severe mitral stenosis tend to experience clinical decompensation with approximately 50% mortality and they may experience adverse effects of the medication they are taking, notably congenital malformations from warfarin exposure. Corrective heart surgery may increase the risk of pregnancy loss. We present 2 cases of RHD in pregnancy. The first case was a 27-year-old patient in her first pregnancy with severe mitral stenosis. Caesarean section was done for foetal distress and she delivered a small for gestational age baby. She was closely monitored postpartum and was stable on discharge. She presented with supraventricular tachycardia and died in the coronary care unit 4 weeks postpartum. The second case was a 28-year-old who was on warfarin for a mechanical mitral valve. A foetal anomaly scan done at 20 weeks showed severe congenital malformations which were not compatible with extra-uterine life. The pregnancy was terminated and she recovered well. The first case illustrates the significant mortality risk with uncorrected severe rheumatic heart disease. The second case highlights the risks of warfarin on the foetus and the need to avoid mechanical heart valves if possible in young women. RHD patients require preconception counselling so they can make informed reproductive choices.
Pimecrolimus 1% cream for anogenital lichen sclerosus in childhood
Authors: Stefanie Boms, Thilo Gambichler, Marcus Freitag, Peter Altmeyer, Alexander Kreuter
Journal: BMC Dermatol (2004)
MeSH terms: Anus Diseases / drug therapy, Calcineurin Inhibitors, Dermatologic Agents / administration & dosage, Immunosuppressive Agents / administration & dosage, Lichen Sclerosus et Atrophicus / drug therapy, Tacrolimus / analogs & derivatives, Vulvar Diseases / drug therapy, Administration, Cutaneous, Child, Female, Humans, Male, Ointments, Tacrolimus / administration & dosage, Treatment Outcome, Calcineurin Inhibitors, Dermatologic Agents, Immunosuppressive Agents, Ointments, pimecrolimus, Tacrolimus

Background:
Lichen sclerosus is a chronic inflammatory disease with a predilection of the anogenital region. Because of the potential side effects of repeated local application of potent glucocorticosteroids, equally-effective, safer therapeutic options are required, especially in the treatment of children.
Case presentations:
We report on the efficacy of twice-daily application of pimecrolimus 1% cream in four prepubertal girls (range of age: 4 to 9 years) who suffered from anogenital lichen sclerosus. After three to four-month treatment, all patients had almost complete clinical remission including relief from itch, pain and inflammation. Only minor improvement was observed for the white sclerotic lesions. No significant side effects have been observed.
Conclusions:
Topical pimecrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. The clinical benefits observed in the four patient presented particularly include relief of pruritus, pain and inflammation. Vehicle-controlled studies on a larger number of patients are now warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital lichen sclerosus.
Impella-Supported Optical Coherence Tomography-Guided Aggressive Rotational Atherectomy for Heavily Calcified Lesions in Left Main Trunk Bifurcation in a Patient with Severe Left Ventricular Systolic Dysfunction
Authors: Masahiro Koide, Kento Fukui, Hikaru Sugimoto, Yuki Takeda, Koji Sogabe, Yukinori Kato, Hiroki Kitajima, Satoshi Akabame
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

The Impella, a percutaneous left ventricular assist device, has been reported to minimize the risk of hemodynamic compromise and improve clinical outcomes during percutaneous coronary intervention (PCI) in complex high-risk indicated patients (CHIPs). Optical coherence tomography (OCT) provides information on calcified plaque thickness, which is helpful in determining the indication and endpoint of atherectomy during PCI for calcified lesions. However, there are few reports on OCT-guided aggressive rotational atherectomy with Impella assistance in CHIPs. A 71-year-old man on dialysis for end-stage renal failure was admitted for congestive heart failure. Transthoracic echocardiography revealed severe left ventricular systolic dysfunction, and coronary angiography performed after improvement of heart failure showed severe stenosis with heavily calcified lesions in the left main trunk (LMT) bifurcation and right coronary artery. The patient refused coronary artery bypass surgery and was revascularized using PCI. PCI was started with prophylactic Impella CP insertion because of the high risk of hemodynamic collapse. After OCT-guided rotational atherectomy with 1.5- and 2.0-mm burr toward the left anterior descending artery and left circumflex artery, respectively, double-kissing culotte stenting was performed in the LMT, and good dilation was obtained. Impella CP was removed immediately after PCI without hemodynamic compromise, and the procedure was completed.
Usefulness of intraoperative neuromonitoring for preservation of an extralaryngeal bifurcation of the recurrent laryngeal nerve: A case report
Authors: Masatsgu Yano, Yasufumi Saito, Makoto Yoshida, Takafumi Oshiro, Toshikatsu Fukda, Makoto Ochi, Yuzo Okamoto, Eiji Ono, Hideki Ohdan
Journal: Int J Surg Case Rep (2018)
Keywords: extralaryngeal bifurcation, neuromonitoring, recurrent laryngeal nerve, thyroid surgery

Introduction:
Recurrent laryngeal nerve injury is a major complication of thyroid surgery. An endotracheal tube with electromyography electrodes attached to it was recently developed for intraoperative neuromonitoring during thyroid surgery. Here we describe the successful identification and preservation of an extralaryngeal bifurcation of the recurrent laryngeal nerve by intraoperative neuromonitoring in a patient undergoing thyroid surgery.
Presentation of case:
A 56-year-old woman presented for evaluation of a neck swelling found during a medical examination. Computed tomography (CT) revealed a tumor with a 5-cm diameter in the left thyroid lobe. Fine needle aspiration cytology revealed a Bethesda category III finding. Left thyroid lobe resection was scheduled. During surgery, the left recurrent laryngeal nerve was found to be adhered to the tumor. Careful exploration and intraoperative neuromonitoring allowed us to identify and preserve an extralaryngeal bifurcation of the recurrent laryngeal nerve.
Discussion:
The recurrent laryngeal nerve can demonstrate various anomalies and bifurcations. Failure to notice and correctly identify extralaryngeal bifurcation leads to recurrent laryngeal nerve injury. Motor branch injury has a particularly large effect. Intraoperative neuromonitoring has been reported to be useful for identifying and preserving the recurrent laryngeal nerve and its aberrations as well as the external branch of the superior laryngeal nerve during thyroid surgery.
Conclusion:
The findings from this case suggest that an extralaryngeal bifurcation of the recurrent laryngeal nerve can be identified and safely preserved by intraoperative neuromonitoring.
Austrian Syndrome in an Immunocompromised Patient-A Case Report
Authors: Carlos E Arias-Morales, Shorabh Sharma, Marjorie M Flores-Chang, Razia Rehmani, Venkata Sandeep Koripalli, Michelle Dahdouh
Journal: Front Med (Lausanne) (2020)
Keywords: streptococcus pneumoniae, endocarditis, invasive pneumococcal disease, meningitis, pneumonia
MeSH terms: Case Reports

Austrian syndrome consists of a triad of endocarditis, meningitis, and pneumonia caused by Streptococcus pneumoniae. With the arrival of many antibiotic therapies, the disease remains rare, however, it can be overlooked due to the lack of awareness. We present a case of Austrian syndrome in an immunocompromised patient complicated by multiorgan failure.
Dysgenetic Polycystic Disease of Minor Salivary Gland: A Rare Case Report and Review of the Literature
Authors: N Srikant, Shweta Yellapurkar, Karen Boaz, Mohan Baliga, Nidhi Manaktala, Ankita Sharma, Shakthi Dorai, Prajwal Pai
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Polycystic (dysgenetic) disease of the salivary glands is a rare entity that has only recently been described in the literature. The disease is more commonly seen in females and majority of the cases have presented as bilateral parotid gland swellings. This case presenting in a 21-year-old male is the first of this unusual entity involving solely the minor salivary gland on the lower lip. This case report highlights the importance for the clinician to be aware of this differential diagnosis, when treating an innocuous lesion like a mucocele.
Blue Rubber Bleb Nevus Syndrome With Multiple Cavernoma-Like Lesions on MRI: A Familial Case Report and Literature Review
Authors: García Anwár, Paredes-Aragón Elma, Jorge-de Saráchaga Adib, Meyer-Nava Ilse, Gutiérrez-Romero Alonso, Salinas Lara Ciltlaltepelt, Novelo Soto Alma, Vega Memije Maria Elisa, Arauz Antonio
Journal: Front Neurol (2020)
Keywords: brbns, bean's syndrome, blue rubber bleb angiomatosis, blue rubber bleb nevus syndrome, blue rubber-bleb nevus, cavernomas, central nervous system bleeding, central nervous system venous malformations
MeSH terms: Case Reports

Blue rubber bleb nevus syndrome (BRBNS), also called Bean's syndrome, is a rare disease associated with multiple venous malformations in the skin and gastrointestinal (GI) tract. Dermatological lesions, which are the first clinically visible manifestations, appear as skin-colored compressible protuberances or as dark-blue venous nodules, rubbery in consistency. Central nervous system (CNS) manifestations are rare, variable, non-specific, and tend to occur late in the disease, mainly reported as seizures and focal neurological deficits secondary to compression. Most cases occur sporadically, however, an autosomal dominant inheritance pattern has been reported. A 74-year-old male with history of focal epilepsy secondary to possible neurocysticercosis presented at the emergency department due to sudden onset of aphasia, left central facial paralysis, and dysphagia secondary to catastrophic intracerebral hemorrhage. Cerebral MRI showed multiple cerebral cavernous malformations (CCM)-like lesions and, on the general exploration, multiple dark-blue nodules, rubbery in consistency. One week later he died due to complicated pneumonia; a brain autopsy was performed showing multiple vascular malformations. His son had a history of focal epilepsy presumed to be related to neurocysticercosis. He had the same skin lesions and brain MRI pattern. Histological analysis of the skin lesions of the two cases showed venous vascular malformations. A non-systematic review was carried out, in which all case reports of blue nevus syndrome with neurological manifestations in adults were included.