OpenMed/multicare-articles huggingface dataset:
Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma
Authors: Kevin Moerenhout, Georgios Gkagkalis, Rayan Baalbaki, Xavier Crevoisier
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Introduction:
A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture.
Case report:
We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation. At one year postoperative, the patient developed an invalidating tibiotalar and subtalar arthrosis that eventually required an ankle-hindfoot arthrodesis. A Bosworth injury is an infrequent entity and is even rarer when associated with other fractures. Careful preoperative planning is necessary, as the combination of these fractures is a surgical challenge. Special care must be taken to preserve the neurovascular bundle.
Discussion:
The present case highlights a Bosworth injury involving a severity that has never been described before and suggests adding an eighth stage to the classification presented by Perry et al.
Investigation of anti-Toxocara antibodies in epileptic patients and comparison of two methods: ELISA and Western blotting
Authors: Mohammad Zibaei, Farzaneh Firoozeh, Parviz Bahrami, Seyed Mahmoud Sadjjadi
Journal: Epilepsy Res Treat (2013)

The relationship between Toxocara infection and epilepsy was previously demonstrated by several case-control studies and case reports. These previous studies were often based on the enzyme-linked immunosorbent assay (ELISA) using Toxocara excretory-secretory antigens, which are not specific due to cross-reactivity with other parasitic infections such as ascariasis, trichuriasis, and anisakiasis. An immunoblot analysis is highly specific and can detect low levels of Toxocara antibodies. Therefore, this assay may be useful in the identification of toxocariasis in epileptic patients. We examined patients who had epilepsy and healthy subjects for seropositivity for Toxocara infection by ELISA and Western blotting. Out of 85 epileptic patients, 10 (11.8%) and 3 (3.5%) persons exhibited Toxocara immunoglobulin G (IgG) antibodies responses by ELISA and by both techniques, respectively. Moreover, in the healthy group (n = 85), 3 (3.5%) persons were positive by ELISA, but none was detected by Western blotting. This study indicates that Toxocara infection is a risk factor for epilepsy in Iran. These findings strongly suggest the need to perform Western blotting immunodiagnosis, as well as the ELISA using Toxocara excretory-secretory antigens, to improve diagnosis of human toxocariasis in patients with epilepsy.
Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity
Authors: S P Carr, F T MacNamara, K M Muhammed, E Boyle, S M McHugh, P Naughton, A Leahy
Journal: Case Rep Surg (2015)

Introduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation. An 88-year-old man presented to the emergency department with abdominal pain and distension. Clinical exam revealed signs of peritonism. Computed tomography (CT) revealed GSI of the transverse colon with a closed-loop large bowel obstruction (LBO) and caecal perforation. The patient underwent emergency laparotomy. A right hemicolectomy was performed, the gallstone was removed, and a primary bowel anastomosis was undertaken. A Foley catheter was sutured into the residual gallbladder bed to create a controlled biliary fistula. The patient recovered well postoperatively with no complications. He was discharged home with the Foley catheter in situ. Discussion. Gallstone ileus is a difficult diagnosis both clinically and radiologically with only 50% of cases being diagnosed preoperatively. Most commonly it is associated with impaction at the ileocaecal valve and small bowel obstruction. Gallstone ileus should also be considered as a rare but potential cause of LBO. This is the first reported case of caecal perforation secondary to gallstone ileus of the transverse colon. Successful operative management consisted of a one-stage procedure with right hemicolectomy and formation of a controlled biliary fistula.
Acquired Epiblepharon Treated by Lateral Orbital and fat Decompression
Authors: Radwan Almousa, Gangadhara Sundar
Journal: Middle East Afr J Ophthalmol (2011)
Keywords: decompression, epiblepharon, eyelids, orbit

Conventional lid surgery of acquired epiblepharon secondary to increased orbital volume can be result of under correction of the epiblepharon, because the increased orbital volume remains unaddressed. In this case report, we present a case of acquired epiblepharon, secondary to increased orbital volume, treated with orbital decompression.
Laser Resection of Fibroepithelial Polyps with Digital Ureteroscopy
Authors: Scott G Hubosky, Demetrius H Bagley
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

Fibroepithelial polyps (FEPs) are rare benign upper urinary-tract neoplasms originating from mesodermal components of the ureteral wall covered in normal urothelial epithelium. Historically, these lesions have been treated with endoscopic, laparoscopic, or open means depending on the size, number, and morphology of the polyps. Digital ureteroscopy (DURS) offers many advantages over fiber-optic endoscopy, including superior resolution and potential ergonomic benefits, given the absence of external cameras and light cords. We describe a case involving multiple proximal ureteral FEPs treated with flexible DURS and the holmium (Ho) laser, in which the digital ureteroscope offered exceptional visualization of the FEP stalks allowing for straightforward resection and endoscopic removal.
Septic pelvic thrombophlebitis: diagnosis and management
Authors: Javier Garcia, Ramzi Aboujaoude, Joseph Apuzzio, Jesus R Alvarez
Journal: Infect Dis Obstet Gynecol (2006)
MeSH terms: Pelvis / blood supply, Pelvis / diagnostic imaging, Sepsis / diagnosis, Sepsis / diagnostic imaging, Sepsis / drug therapy, Sepsis / microbiology, Thrombophlebitis / diagnosis, Thrombophlebitis / diagnostic imaging, Thrombophlebitis / drug therapy, Thrombophlebitis / therapy, Case Reports, Review, Adult, Anti-Bacterial Agents / therapeutic use, Anticoagulants / therapeutic use, Female, Humans, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Anti-Bacterial Agents, Anticoagulants

Septic pelvic thrombophlebitis (SPT) was initially diagnosed and described in the late 1800's. The entity had a high incidence and mortality during this period of time, and a surgical therapeutic approach was the treatment of choice. Since then, the diagnosis, incidence, and management of the entity evolved. This evolution followed the development of newer diagnostic tools such as computed tomography (CT), magnetic resonance imaging (MRI), and a better understanding of the pathophysiology of the disease. The treatment of SPT has had significant changes as well, from a surgical approach at the end of the 19th century to a medical approach after the 1960's. By using an adequate broad-spectrum antibiotic therapy, mortality has decreased. However, controversy in the management of this entity remains even till today.
A pregnant woman with a giant bilateral parietal hemangiopericytoma underwent multiple surgeries and radiotherapy: a case report and literature review
Authors: Yingxi Wu, Yafei Xue, Xinqi Wang, Junting Li, Yan Qu, Tianzhi Zhao
Journal: Front Oncol (2023)
Keywords: gamma knife radiosurgery, histopathology, intracranial hemangiopericytoma, malignant transformation, pregnant woman, surgical resection
MeSH terms: Case Reports

Intracranial hemangiopericytoma is a rare invasive tumor originating from mesenchymal fibroblasts and is prone to local recurrence and distant metastasis. This study reports a case of a 27-year-old woman who presented with severe headache, nausea and vomiting for two weeks at thirty-three weeks of gestation. Cranial magnetic resonance imaging (MRI) demonstrated a giant lesion in the bilateral parietal lobe with a size of 5.12x9.19x6.03 cm and severe edema in the surrounding brain tissue. The patient underwent four operations and 3 gamma knife radiosurgery procedures and is recovering well now. The histopathology findings showed hemangiopericytoma and STAT6 and CD34 positivity after the first and second surgeries. Because of tumor progression, the patient received gamma knife radiosurgery at 1, 3, and 4 years after the first operation. Total tumor resection was achieved in the fourth surgery. Nevertheless, the patient showed malignant transformation to from low-grade to high-grade hemangiopericytoma.
Retinal vasculitis in Toxocara canis neuroretinitis
Authors: Cagri G Besirli, Susan G Elner
Journal: J Ophthalmic Inflamm Infect (2013)

Background:
The purpose of this case report is to describe clinical and angiographic findings of retinal vasculitis in acute Toxocara canis neuroretinitis associated with systemic infection.
Findings:
A 16-year-old male presented with a 1 week history of left eye pain, floaters, and decreased visual acuity. Ocular examination was consistent with neuroretinitis and retinal vasculitis. Fluorescein angiography demonstrated leakage of fluorescein from the optic nerve and the retinal veins. Clinical and laboratory evaluation were consistent with systemic Toxocara canis infection.
Conclusions:
Ocular T. canis may present with retinal vasculitis in young patients in the setting of acute systemic infection.
Ulcerative Colitis in Hematological Malignancies: Paraneoplastic Manifestation or Coincidental Bystander?
Authors: Gregorios Christodoulidis, Konstantinos Perivoliotis, Anastasios Manolakis, Alexandros Diamantis, Apostolos Koffas, Dimitrios Magouliotis, Vasiliki Pappi, Dimitrios Zacharoulis
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Evidence of coexistence of diverse hematological malignancies-lymphoma, leukemia, multiple myeloma, and myelodysplastic syndromes-and either ulcerative colitis or Crohn's disease can be found in the literature. However, a more "systemic" effort to reach further and examine the potential of either one as paraneoplastic manifestation has not been performed. Based on these, three cases of ulcerative colitis manifesting before, simultaneously, and after the onset of different hematological malignancies are presented and critically evaluated.
Evaluation of Venous Congestion Using Beside Ultrasonography by the Nephrology Consultant: The VExUS Nexus
Authors: Abhilash Koratala
Journal: POCUS J (2022)
Keywords: pocus, vexus, heart failure, point of care ultrasound, venous doppler
MeSH terms: Case Reports

In patients with heart failure and cardiorenal syndrome, lingering congestion is associated with worse outcomes. As such, titrating diuretic or ultrafiltration therapy based on objective assessment of volume status plays a crucial role in the management of these patients. Conventional physical examination findings and parameters such as daily weight measurement are not always reliable in this setting. Recently, point of care ultrasonography (POCUS) has emerged as an attractive enhancement to bedside clinical examination in assessing fluid volume status. Specifically, Doppler ultrasound of the major abdominal veins gives additional information about end-organ congestion when used in conjunction with inferior vena cava ultrasound. Moreover, these Doppler waveforms can be monitored in real time to gauge the efficacy of decongestive therapy. Herein, we present a case that illustrates the utility of POCUS in the management of a patient with heart failure exacerbation.
Transient Complete Recovery of Chronic Refractory Idiopathic Thrombocytopenic Purpura after Treatment with Monoclonal Antibody Targeting SARS-CoV-2 Spike Protein
Authors: Pooja Gogia, Yiqing Xu
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Idiopathic thrombocytopenic purpura (ITP), also known as immune thrombocytopenic purpura, is an immune-mediated acquired disease characterized by transient or persistent decrease of the platelet count due to autoimmune-related destruction of platelets. Therapy for ITP relies on competing and inhibiting the autoantibody binding and destruction (intravenous immunoglobulin and anti-D immunoglobulin and spleen tyrosine kinase (Syk) inhibitor fostamatinib), augmenting platelet production (thrombopoietin receptor agonists), immunosuppression to reduce the autoantibody production, as well as splenectomy. Studies on autoantigens on the platelets suggested epitopes to be located predominantly on the GP IIb/IIIa receptor or integrin αIIbβ3, though the trigger for the development of ITP is unclear. We report a case here of a 37-year-old gentleman who has chronic ITP managed on eltrombopag, who after receiving monoclonal antibody against SARS-CoV-2 (mAb) i.e. casirivimab and imdevimab for his COVID-19 infection, demonstrated complete recovery of his platelet count for a short period of time. We discuss a few potential mechanisms of action and propose further studies to elucidate the therapeutic effect of COVID-19 mAb in ITP.
A Case of Unresolved and Worsening Retroperitoneal Abscess
Authors: Raghav Bansal, Mohamed Barakat, Soohwan Chun, Sonam Rosberger, Joel Baum, Melik Tiba
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset. Herein, we present a case of retroperitoneal abscess secondary to a perforation that occurred during an ERCP. A 54-year-old female patient was admitted to an outside hospital with gallstone pancreatitis and underwent ERCP with sphincterotomy followed by laparoscopic cholecystectomy. An abdominal CT scan was performed at the outside hospital 10 days later for worsening abdominal pain which showed multiple loculated pockets in the right upper and lower quadrant. Her condition improved after IV antibiotics and percutaneous drainage. Her symptoms recurred a month later and she presented to our hospital. Repeat abdominal CT scan at our hospital revealed recurrence of her abscesses. Multiple drains were placed and the abscess cavity was washed out without much improvement. EGD revealed a small mucosal defect in the distal portion of the duodenal bulb which was closed successfully using an over-the-scope clip. Repeat CT scan after 8 weeks from the endoscopic closure showed near complete resolution of the abscess. ERCP-associated perforation is a rare complication and can be challenging to diagnose and treat; prompt recognition is mandatory for favorable prognosis. Our patient was managed successfully via nonsurgical approach.
Operating Endoscopically with "Two Hands" to Remove Calcified Permanent Suture After Pyeloplasty
Authors: Sean McAdams, Robert M Sweet, James Kyle Anderson
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

We describe a combined percutaneous and endoscopic approach to remove encrusted permanent suture in the renal pelvis that was placed during pyeloplasty repair. Our index patient had a laparoscopic dismembered pyeloplasty at an outside institution 10 years before presenting with flank pain and nondependent nephrolithiasis. This proved to be an encrusted permanent suture material. There is limited data on incidence of nephrolithiasis after ureteropelvic junction repair, but it is well documented that nonabsorbable suture lines should be avoided in the urinary tract as they may serve as a nidus for stone formation.
Dermatosparaxis in two Limousin calves
Authors: Catherine I Carty, Alison M Lee, Nathan A E Wienandt, Edward L Stevens, Derron A Alves, John A Browne, Jill Bryan, Eoin G Ryan, Joseph P Cassidy
Journal: Ir Vet J (2016)
Keywords: bovine, dermatosparaxis, genetic, limousin, skin

Background:
An unusual presentation of skin disease was identified in two related neonatal Pedigree Limousin calves presented to University Veterinary Hospital, University College Dublin, following detailed post mortem examination a diagnosis of dermatosparaxis was made. Dermatosparaxis in animals or Ehlers Danlos Syndrome, which is the analogous condition seen in humans, is a connective tissue disorder characterised by extreme skin fragility. To the authors' knowledge this is the first report of such a diagnosis in the Limousin breed and the features of this lethal phenotype were severe in comparison to previous reports of the condition.
Case presentation:
Two calves, which were full siblings, a pedigree Limousin bull (Calf A) and pedigree Limousin heifer (Calf B) were examined clinically after presenting collapsed since birth, both had grossly abnormal skin with multiple skin fissures visible and both calves were subsequently euthanised. Both calves underwent gross post mortem examination, after which histological samples were reviewed and electron microscopical examination of selected skin samples was carried out. Histological features of dysplastic dermal collagen were identified. The diagnosis of dermatosparaxis in the Limousin breed was confirmed. Genetic testing was conducted to determine if the current cases had the same mutation as has previously been described in Belgian Blue cattle. Some common parentage was traced but genetic testing did not show a similar mutation to that previously described in cattle. The specific genetic cause in this case is unknown.
Conclusions:
This is the first report of dermatosparaxis in the Limousin and the presentation of the dermatosparaxis phenotype has some noteworthy features thus further genetic testing is required to pinpoint the causative mutation or other genetic defect. Given the popularity of the breed and the lethal nature of the phenotype in this case it is important to raise awareness of the condition.
Pyomyositis in Nodding Syndrome (NS) patient--a case report
Authors: David Lagoro Kitara, Amos Deogratius Mwaka, Henry R Wabinga, Paul Okot Bwangamoi
Journal: Pan Afr Med J (2013)
Keywords: nodding syndrome, pyomyositis, uganda
MeSH terms: Nodding Syndrome / complications, Nodding Syndrome / diagnosis, Pyomyositis / complications, Pyomyositis / diagnosis, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Adolescent, Humans, Male, Staphylococcal Infections / complications, Staphylococcal Infections / diagnosis, Staphylococcus aureus

We report a case of Pyomyositis in a 13-year-old boy diagnosed using WHO surveillance definition of Probable Nodding syndrome. Complete blood count showed Leukocytosis with immature granulocytes and atypical lymphocytes. Except for the liver enzymes which were high the renal functions and serum electrolytes were within normal range values. Culture of a pus-swab grew Staphylococcus aureus. Abdominal ultrasound scan showed a focal mass on the internal and external oblique muscles of the right abdominal wall. Incision and drainage was performed. Histology of the muscle showed non-specific inflammation of the external and internal oblique muscles. This finding may highlight some of the other tropical diseases that occur in children with Nodding syndrome.
Quantitative Assessment of Parenchymal Involvement Using 3D Lung Model in Adolescent With Covid-19 Interstitial Pneumonia
Authors: Luca Borro, Paolo Ciliberti, Teresa Pia Santangelo, Andrea Magistrelli, Andrea Campana, Francesca Calò Carducci, Marabotto Caterina, Paolo Tomà, Aurelio Secinaro
Journal: Front Pediatr (2020)
Keywords: 3d in covid19, 3d lung reconstructions, 3d modeling in pneumonia, 3d parenchima reconstruction, 3d quantify in pneumonia, 3d rendering in pneumonia

Background: Amount of parenchymal involvement in patients with interstitial pneumonia Covid-19 related, seems to be associated with a worse prognosis. Nowadays 3D reconstruction imaging is expanding its role in clinical medical practice. We aimed to use 3D lung reconstruction of a young lady affected by Sars-CoV2 infection and interstitial pneumonia, to better visualize, and quantitatively assess the parenchymal involvement. Methods: Volumetric Chest CT scan was performed in a 15 years old girl with interstitial lung pneumonia, Sars-CoV2 infection related. 3D modeling of the lungs, with differentiation of healthy and affected parenchymal area were obtained by using multiple software. Results: 3D reconstruction imaging allowed us to quantify the lung parenchyma involved, Self-explaining 3D images, useful for the understanding, and discussion of the clinical case were also obtained. Conclusions: Quantitative Assessment of Parenchymal Involvement Using 3D Lung Model in Covid-19 Infection is feasible and it provides information which could play a role in the management and risk stratification of these patients.
Case Report: Diabetic nephropathy aggravates the progression and prognosis of COVID-19-associated acute limb ischemia
Authors: Decsa Medika Hertanto, Henry Sutanto, Soebagijo Adi
Journal: F1000Res (2021)
Keywords: acute limb ischemia, covid-19, diabetes mellitus, diabetic nephropathy, limb amputation, hypercoagulability, vascular thrombosis, case report
MeSH terms: COVID-19, Diabetes Mellitus, Type 2 / complications, Diabetic Nephropathies, Case Reports, COVID-19 Testing, Female, Humans, Ischemia / etiology, Middle Aged, Prognosis, SARS-CoV-2

Hypercoagulation is a hallmark of both the novel coronavirus disease (COVID-19) and type 2 diabetes mellitus (T2DM). It increases the risk for vascular thrombosis, including peripheral artery diseases. Among others, acute limb ischemia (ALI) is one of most common complications that requires immediate and prompt treatments to reduce morbidity and mortality. However, the complex interplay between COVID-19, T2DM and its complications (e.g., diabetic nephropathy), and ALI creates a great challenge in the management of the disease. Here, we present a case of a 59-year-old diabetic female with progressive pain in her left leg in the last five years, which was significantly intensified following COVID-19 diagnosis. Bluish coloration, numbness and functional impairments were observed during examinations with no palpable pulsation on left posterior tibial and dorsalis pedis arteries. The patient also had diabetic nephropathy (stage III), hypoalbuminemia, anemia and a urinary tract infection that complicated the management of the disease. Due to the excruciating pain and the worsening of the limb conditions, right leg revascularization and left leg amputation were performed at day 14 after admission. Following the surgeries, no more pain was observed and patient was discharged for further follow-up at the outpatient clinic.
Epilepsy Caused by Neurocysticercosis: A Case Report
Authors: Mary G McGoldrick, Daniel Polvino, Grant Wei
Journal: J Educ Teach Emerg Med (2023)

Neurocysticercosis is one of the most common causes of acquired epilepsy worldwide. This diagnosis is rarely considered in patients presenting to the emergency department (ED) with recurrent seizures in the United States (U.S.). This is the case of a young adult male presenting with post-ictal confusion and recurrent seizures requiring intubation for agitation and airway protection. It illustrates the need to maintain a broad differential when considering etiology of seizures in a globalized patient population.
Topics:
Seizure, neurocysticercosis, epilepsy, parasitic infection.