OpenMed/multicare-articles huggingface dataset:
Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus
Authors: Anne Kirstine Høyer-Nielsen, Shahin Gaini, Anne Kjerulf, Rudi Kollslíð, Torkil Á Steig, Marc Stegger, Jan Jóanesarson
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) is mostly known as an opportunistic pathogen found in horses and as a rare human zoonosis. An 82-year-old male, who had daily contact with horses, was admitted in a septic condition. The patient presented with dyspnea, hemoptysis, impaired general condition, and severe pain in a swollen left shoulder. Synovial fluid from the affected joint and blood cultures showed growth of S. equi subsp. zooepidemicus. Transesophageal echocardiography showed a vegetation on the aortic valve consistent with endocarditis. Arthroscopic revision revealed synovitis and erosion of the rotator cuff. Technetium-99m scintigraphy showed intense increased activity in the left shoulder, suspicious of osteitis. The infection was treated with intravenous antibiotics over a period of five weeks, followed by oral antibiotics for another two months. The patient recovered without permanent sequelae.
Spontaneous Thyroid Hemorrhage Caused by Langerhans Cell Histiocytosis: A Case Report and Literature Review
Authors: Jingying Zhang, Chengchen Wang, Chuanshuai Lin, Binglong Bai, Mao Ye, Dapeng Xiang, Zhiyu Li
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: langerhans cell histiocytosis, chemotherapy, spontaneous thyroid hemorrhage, thyroid, thyroidectomy
MeSH terms: Hemorrhage / etiology, Histiocytosis, Langerhans-Cell / complications, Thyroid Diseases / etiology, Case Reports, Research Support, Non-U.S. Gov't, Review, Female, Hemorrhage / diagnosis, Hemorrhage / surgery, Histiocytosis, Langerhans-Cell / diagnosis, Histiocytosis, Langerhans-Cell / pathology, Histiocytosis, Langerhans-Cell / surgery, Humans, Middle Aged, Thyroid Diseases / diagnosis, Thyroid Diseases / surgery

Purpose:
Langerhans cell histiocytosis (LCH) is a rare clonal disorder of Langerhans antigen-presenting cells. However, thyroid LCH involvement is relatively rare. We present the first case of spontaneous thyroid hemorrhage due to LCH progression and discuss the clinical features, diagnosis, and treatments of thyroid LCH in a literature review.
Methods:
Clinical data were collected. Previously published articles on thyroid LCH involvement were reviewed to assess the clinical features, diagnosis, and treatments for thyroid LCH.
Results:
A 54-year-old female presented with a multi-system LCH, affecting the uterus, liver, pituitary gland, and thyroid gland. Clinical stability was achieved after systemic chemotherapy. After 7 years of regular follow up, the patient complained of a sudden painful neck swelling and progressive dyspnea. Computed Tomography revealed bilateral goiter with hematoma, and the patient was diagnosed with spontaneous thyroid bleeding based on her clinical symptoms and radiological findings. The patient was incubated to relieve airway compromise and partial thyroidectomy was performed for definitive treatment. Pathological evaluation further confirmed the diagnosis of thyroid LCH. The patient recovered well after surgery.
Conclusion:
Spontaneous thyroid bleeding due to thyroid LCH progression is extremely rare. Treatments for LCH vary depending on the severity of the disease. We suggest that, for patients with multi-system LCH with thyroid lesion, long-term active surveillance of thyroid hormone concentrations, and thyroid gland volume is required. Physicians should be alert of the potentially life-threatening spontaneous thyroid hemorrhage when aggravated diffuse goiter and hypothyroidism appear. Further investigation is required to establish the guidelines for thyroid LCH treatment.
Grey Matter Heterotopia and Criminal Responsibility in a Case of Personal Injury Defense
Authors: Antonietta Curci, Antonio Rampino
Journal: Front Psychiatry (2020)
Keywords: grey matter heterotopia, epilepsy, impulsivity, inhibitory control, neurodevelopmental disorder
MeSH terms: Case Reports

The abnormal allocation of nodules of grey matter in areas of the brain or spinal cord that should physiologically be occupied by white matter characterizes a neural defect called Grey Matter Heterotopia (GMH). The improvement of MRI techniques has enabled a deeper understanding of the neuropathological bases and epidemiology of such a condition. Among its major manifestations, there is the onset of epileptic seizures, mild intellectual disability, impairments in executive functioning, neurodevelopmental disorders; less frequently GMH has been found associated with depression, anxiety, and schizophrenia. Despite the clinical interest in GMH, no studies have considered the possible forensic and criminological implications of this condition. In the current study, we present a case of GMH in a young male defendant accused of having seriously injured a schoolmate as a reaction to bullying behavior. Neuropsychological and instrumental evidence converge in showing prevalence for the defendant's adoption of repressive responses to stressors, and difficulties to inhibit undesirable behavior at the long run. In the case at hand, the massive stress induced by the exposition to bullying behavior undermined inhibitory control, hence an impulsive and disproportionate reaction took place. Without appropriate therapeutic control, this reactive behavior might take place again. As a consequence, the forensic assessment recommended that the defendant was held partially liable only but that there was likelihood of recidivism. We discuss this single-case evidence for a possible role of GMH in the adoption of dyscontrolled responses to stressors, and the relevance of GMH diagnosis in forensic proceedings.
Case report: Endoscopic Hemoclip treatment for massive hematemesis caused by a Dieulafoy's lesion on duodenal papilla caused acute pancreatitis
Authors: Zhi-Wei He, Hui Xu, Hua Shi, Yang-Mei Wang, Han Zhong, Xiao-Cong Liu
Journal: Front Med (Lausanne) (2023)
Keywords: dieulafoy’s lesion, duodenal papilla, endoscopic hemoclips, hematemesis, pancreatitis
MeSH terms: Case Reports

Background:
Dieulafoy's lesion is an uncommon cause of hemorrhage of the digestive tract. It often presents with urgent and massive bleeding usually leading to shock, even death. Dieulafoy's lesions have been reported throughout the digestive tract but which occurred on duodenal papilla were particularly rare and presented challenges in the choice of hemostasis.
Case presentation:
A 66-year-old man with melena for 2 days was admitted. Gastrointestinal endoscopy revealed blood clots covering the duodenal papilla with oozing blood. During the procedure of trying to place a plastic stent into the duodenal papilla first, the hemorrhage began to present pulsating bleeding. The patient went into shock. With consent, two titanium clips were inserted to clamp the bleeding site to stop the bleeding. The patient complained of epigastric pain 14 h after the endoscopy. An abdominal CT scan showed signs of acute pancreatitis. Endoscopy was performed to remove the titanium clips and showed a vessel stump on the duodenal papilla. The patient was discharged from the hospital on the 14th day and followed for 6 months with no recurrence.
Conclusion:
This case was diagnosed with a Dieulafoy's lesion on the duodenal papilla, which has rarely been reported. Hematemesis was stopped by clamping the vessel stump with titanium clips but caused acute pancreatitis. Reviewing the treatment, electrocoagulation might be a better choice, and life support treatment, including central vena catheterization and an adequate supply of blood products, should be prepared in advance to provide extra time for the stent placement or vascular intervention treatment.
Retroperitoneal myolipoma
Authors: Kasim A Behranwala, Krissen Chettiar, Mona El-Bahrawy, Gordon Stamp, Ajay K Kakkar
Journal: World J Surg Oncol (2005)

Background:
Myolipoma is a benign tumour in which smooth muscle cells are mixed with adipocytes.
Case presentation:
A 34-year old lady presented with a mass in the right iliac fossa detected on computerised tomographic (CT) scan. Wide excision of the retroperitoneal mass was done. Histopathology showed features of myolipoma. There was no recurrence or metastasis at three years.
Conclusion:
Myolipoma is a rare benign entity; hence a benign course and good prognosis are expected.
Factitious disorders and cardiothoracic surgery: the ongoing multidisciplinary challenges of a complex case
Authors: Michael S Firstenberg, John H Sirak, Benjamin Sun, David P Kasick
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Chronic factitious disorder, Munchausen's syndrome, can be challenging to manage-particularly when complaints and symptoms suggest medical or surgical emergencies. We present a patient whose problems have spanned many years and a great distance. Hopefully, with a greater awareness of this disease, as this patient continues to seek health care in many different hospitals, the implications of timely access to information, good histories and physical exams, and an index of suspicion can assist in potentially avoiding unnecessary, expensive, and invasive evaluations.
Complete resolution of obstructive colonic amebic pseudotumor with conservative treatment: A case report and literature review
Authors: Elias Chahine, Ramez Baghdady, Claude Chahine, Ghassan Doghman, Nader El Kary, Lionel El Khoury, Kassem Safa, Marc-Anthony Chouillard, Elie Chouillard
Journal: Int J Surg Case Rep (2019)
Keywords: amoebic colitis, amoeboma, case report, entamoeba histolytica, infectious colitis, tumor

Introduction:
Entamoeba histolytica is a well-known cause of infectious colitis, it has a worldwide distribution. Presentation ranges from mild diarrhea to occasionally frank dysentery and may spread to involve extra intestinal sites such as the liver, lung, and other organs, in the form of amebic abscesses.
Case presentation:
Herein, we report a case of amebic pseudotumor wherein the diagnosis was revealed after 2 months of diarrhea.
Discussion:
Colonic amebiasis, may rarely form a segmental mass called amebic pseudotumor in patient untreated or inadequately treated during the course of proven amebic colitis. Due to the rarity of colonic amoebic pseudo tumor it is usually discovered incidentally during surgical interventions. However if discovered earlier it responds well to medical treatment and usually resolves within few weeks.
Conclusion:
So surgical intervention is reserved for complications of this entity manifested by fulminant colitis or colonic perforation.
Case report: Uncommon immune-mediated skin disease involving systemic disorders in dogs
Authors: Soomin Kim, Yoonji Kim, Ha-Jung Kim
Journal: Front Vet Sci (2022)
Keywords: pemphigus foliaceus, adverse drug reaction, dog, immune mediated skin diseases, immune suppressive agents
MeSH terms: Case Reports

Case 1, a 6-year-old, spayed female Pug, presented with severe systemic urticaria, edema, and erythema. The dog had received a famotidine injection as a treatment for repeated vomiting in another hospital. On physical examination, hyperthermia was observed. Moderate pancytopenia, hypoalbuminemia, and increased CRP and D-dimer were also observed in blood tests. Hyposthenuric proteinuria, pulmonary interstitial infiltration, and hepatomegaly were found in other tests. In the histology of the skin, dermal edema and infiltration of inflammatory cells were observed. Therefore, she was diagnosed with acute systemic hypersensitivity. Case 2, a 13-month-old, neutered male Pembroke welsh corgi, presented with severe and patchy systemic ulcerative skin lesions. The dog had a history of soft feces and pain around the anus 2 days before. Thrombocytopenia, and increased CRP and D-dimer were observed in blood tests. In histology, epidermal necrolysis, separation of the epidermis and dermis, and infiltration of inflammatory cells were observed. Therefore, he was diagnosed with an immune-mediated disease with necrolysis dermatitis. Case 3, a 12-year-old, spayed female Pomeranian, presented with severe systemic alopecia, pustule, and crust on the skin. The dog had received an infection treatment from a local hospital. Severe regenerative anemia (hematocrit 15.3%, negative saline agglutination test, negative slide agglutination test, negative Coomb's test, prominent spherocytes) elevated liver enzymes, and increased CRP and D-dimer were observed in blood tests. On histopathology of the skin, pustules, acantholytic cells, and inflammatory cells were observed in the keratin layer of the epithelium. Therefore, she was diagnosed with Pemphigus foliaceus concurrent with immune-mediated hemolytic anemia. The 3 cases were diagnosed with fatal immune-mediated skin disease concurrently with hematological and systemic abnormalities. All the cases were treated with immune-suppressive drugs, prednisolone, and cyclosporine. In cases 2 and 3, the dogs also received human intravenous immunoglobulin as an immune modulator. The treatment was successful with significant improvements in all the 3 cases.
Wound infection caused by Photobacterium damselae in a 32-year-old woman: case report and review of the literature
Authors: Percy Schröttner, Eric Tille, Christian Lück, Boyke Bunk
Journal: GMS Infect Dis (2020)
Keywords: maldi tof ms, photobacterium damselae, antimicrobial profile, whole genome data, wound infection
MeSH terms: Case Reports

The case of a 32-year-old woman is reported, who was affected by a persisting wound infection caused by Photobacterium damselae after an accident in the Mediterranean Sea. Besides the clinical case, microbiological characteristics based on the phenotypic and genotypic description of the isolate (including whole genome data) are presented and discussed.
Case Report: Globus Pallidus Internus (GPi) Deep Brain Stimulation Induced Keyboard Typing Dysfunction
Authors: Joshua K Wong, Melissa J Armstrong, Leonardo Almeida, Aparna Wagle Shukla, Addie Patterson, Michael S Okun, Irene A Malaty
Journal: Front Hum Neurosci (2020)
Keywords: connectomics, deep brain stimulation, dystonia, dystypia, stimulation induced side effect

Introduction:Typing on a keyboard requires complex collaboration between visuospatial/procedural memory, language, and motor function. The impaired ability to type, independent of motor deficits, apraxia, or aphasia has been coined "dystypia." Case Presentation: A 68-year-old woman with a history of blepharospasm, oromandibular, and segmental dystonia underwent bilateral pallidal deep brain stimulation (DBS) because of a waning response to botulinum toxin therapy. Following DBS, she discovered she no longer "remembered" how to type fluidly and had to "hunt and peck" for letters on the keyboard. This issue persisted at a 2-year follow-up. The patient underwent serial typing tests with the DBS ON vs. OFF. Post-operative lead reconstruction was performed using Lead-DBS. The volume of tissue activation (VTA) modeling was combined with whole-brain tractography. Results: Typing improved when the device was switched to the DBS OFF state. Cortical mapping revealed strong modulation of the right angular gyrus, left calcarine fissure, and left cuneus. There was also activation of bilateral supplemental motor areas and superior parietal gyri. Discussion: Shared lesion topography analysis of dystypia cases in the literature has suggested the involvement of the superior longitudinal fasciculus (SLF). The SLF involves the superior parietal lobe, angular gyrus, supramarginal gyrus, and arcuate fasciculus. Our patient's connectivity pattern suggested SLF involvement. The improvement in OFF state typing and her imaging together suggested that the dystypia in her case was a stimulation-induced side effect. Conclusion: Dystypia is a rare side effect of Globus Pallidus Internus (GPi) DBS therapy and may be associated with SLF involvement.
A Case of Cachexia Secondary to Obsessive-Compulsive Disorder
Authors: Hailey L Gosnell, Anita S Kablinger
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Obsessive-compulsive disorder (OCD), a relatively common psychiatric illness, is diagnosed using DSM-V criteria. Its severity is assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Symptoms are broken down into five categories of obsessive-compulsive (O-C) manifestations: contamination/cleaning, symmetry/ordering, taboo thoughts, doubt about harm/checking, and worry about throwing away items that could prove useful or valuable/hoarding. CBT in the form of exposure response therapy (ERP) and/or SSRI/clomipramine administration is the mainstay of treatment. We present a unique OCD case in the nature of obsessions and compulsions, cachexia presentation without anorexia, and history of multiple inpatient psychiatric admissions. Our patient's obsessions focus on eating at specific times, prompting compulsive eating patterns that often result in starvation due to missing timeframes that the patient deems acceptable for eating. His resulting cachexia and eventual worsening of depression to the point of suicidality necessitated multiple inpatient stays and placement at a long-term mental health care facility.
Atypical presentation and transabdominal treatment of chylothorax complicating esophagectomy for cancer
Authors: Matteo Rottoli, Iris S Russo, Daniele Bernardi, Luigi Bonavina
Journal: J Cardiothorac Surg (2012)
MeSH terms: Carcinoma, Squamous Cell / surgery, Chylothorax / diagnosis, Chylothorax / therapy, Esophageal Neoplasms / surgery, Esophagectomy / adverse effects, Case Reports, Chylothorax / etiology, Humans, Male, Middle Aged

Chylotorax is a relatively uncommon and difficult to treat complication after esophagectomy for cancer. We report a case of a young adult male who underwent neoadjuvant chemoradiationtherapy followed by Ivor-Lewis esophagectomy for a squamous-cell carcinoma of the distal esophagus. During the postoperative course the patient presented recurrent episodes of hemodynamic instability mimicking cardiac tamponade, secondary to compression of the left pulmonary vein and the left atrium by a mediastinal chylocele. Mediastinal drainage and ligation of the cisterna chyli and the thoracic duct was successfully performed through a transhiatal approach.
Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1
Authors: Baris Gundogdu, Servet Yolbas, Ahmet Yildirim, Murat Gonen, Suleyman Serdar Koca
Journal: Case Rep Rheumatol (2016)

Ankylosing spondylitis (AS) is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1) is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS and NF1.
A Novel Approach to Repair of Tracheal Occlusion Secondary to Percutaneous Tracheostomy Creation
Authors: Ali Syed, Mohammed A Kamalia, Alison Messina, Shahriyour Andaz, Joshua Melamed, Vanessa Gibson
Journal: Cureus (2023)
Keywords: airway obstruction, central airway obstruction, nd
MeSH terms: Case Reports

The number of endotracheal intubations increased in the United States during the COVID-19 pandemic with an associated rise in laryngotracheal injury. Our patient had a complete laryngeal occlusion just proximal to the first tracheal ring. The Neodymium-doped Yttrium Aluminum Garnet (Nd-YAG) laser is often used to resolve sub-laryngeal occlusions, and without access to the Nd-YAG laser, we had to find an alternative solution. Few centers have the access to an Nd-YAG laser, the optimal choice for sub-laryngeal occlusion and our novel approach allowed us to reestablish tracheal continuity and the patient's ability to speak.
Schizophrenia or Atypical Lupus Erythematosus with Predominant Psychiatric Manifestations over 25 Years: Case Analysis and Review
Authors: Axel Mack, Christiane Pfeiffer, E Marion Schneider, Karl Bechter
Journal: Front Psychiatry (2017)
Keywords: autoimmune diseases, autoimmune encephalitis, chronic schizophrenia, lupus erythematosus, mild encephalitis, neuroinflammation, neuropsychiatric lupus erythematosus, systemic
MeSH terms: Case Reports

We observed a case over 25 years of relapsing-remitting schizophrenic spectrum disorder, varying regarding the main symptomatology between more depressive or more schizoaffective or rather typical schizophrenic syndrome. Diseased phases were repeatedly accompanied by minor skin lesions, which were initially classified as mixed tissue disorder. Psychotic phases were waxing-waning over years. During one later relapse, skin involvement was severe, classified to likely represent an allergic reaction to psychopharmaca; this generalized exanthema remitted rapidly with cortisone treatment and azathioprine. Under continued azathioprine and low dose neuroleptics, the patient remitted completely, appearing psychiatrically healthy for 16 years. When azathioprine was set off due to pregnancy, an extraordinary severe relapse of schizophrenia like psychosis accompanied by most severe skin lesions developed within a few weeks, then requiring 2 years of psychiatric inpatient treatment. Finally, a diagnosis of systemic lupus erythematodes plus neuropsychiatric lupus was made. A single CSF sample in 2013 showed suspicious biomarkers, matching with CSF cytokine profiling in schizophrenic and affective spectrum disorder patients and indicated mild neuroinflammation. Complex immune suppressive treatment was reinitiated short after relapse, but was only partially successful. However, surprisingly the psychosis and skin lesions remitted (in parallel) when belimumab was given (add-on). The very details of this complicated, long-term disease course are discussed also with regard to general ideas, in particular with respect to the question if this case of seemingly comorbid schizophrenia with minor autoimmunity signs represented a case of one emerging autoimmune disorder with variant manifestations systemically and within the CNS, though atypically with predominant appearance as a schizophrenia spectrum disorder.