OpenMed/multicare-articles huggingface dataset:
Unforeseen Hodgkin Lymphoma Hidden behind Hypercalcemia
Authors: Moutaz Ghrewati, Balraj Singh, Parminder Kaur, Michael Maroules
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

As one of the leading causes of hypercalcemia, malignancy is an essential consideration when patients present with such symptomology. While certain tumors are more known to cause hypercalcemia, it can occur with almost any type of cancer. Hodgkin lymphoma is an infrequent cause of hypercalcemia. Only a few case reports have been published in the literature to date. We report an unusual case of a 61-year-old female who presented with altered mental status, nausea, vomiting, and dizziness and was found to have multiple enlarged lymph nodes, and blood work showed hypercalcemia. Biopsy of the cervical lymph node showed Hodgkin lymphoma of the nodular sclerosis subtype. Our case aims to raise awareness of this rare but significant presentation of hypercalcemia and how timely treatment of calcium levels can facilitate the employment of available chemotherapeutic options.
Efficient and cost-effective alternative treatment for recurrent urinary tract infections and interstitial cystitis in women: a two-case report
Authors: Anthony Mansour, Essa Hariri, Samar Shelh, Ralph Irani, Mohamad Mroueh
Journal: Case Rep Med (2014)

Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance.
Human Nasal Myiasis Caused by Oestrus ovis in the Highlands of Cusco, Peru: Report of a Case and Review of the Literature
Authors: P Hoyer, R R Williams, M Lopez, M M Cabada
Journal: Case Rep Infect Dis (2016)
MeSH terms: Case Reports

Myiasis is the infestation by dipterous larvae. The larvae can infect intact or decaying tissue including the skin or epithelial surfaces of the orbits, nose, and genitourinary and gastrointestinal tracts. We report a case of primary obligatory nasal myiasis by Oestrus ovis in a 56-year-old man from Cusco in Peru. He presented with nasal pruritus, congestion, and sneezing white "cottony" material. The material was identified as O. ovis larvae. A literature review of publications reporting nasal myiasis caused by O. ovis is presented.
A 26-year-old male with mesothelioma due to asbestos exposure
Authors: P Zarogoulidis, M Orfanidis, T C Constadinidis, E Eleutheriadou, T Kontakiotis, T Kerenidi, L Sakkas, N Courcoutsakis, K Zarogoulidis
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Mesothelioma is a malignancy with poor prognosis, with an average 5-year survival rate being less than 9%. This type of cancer is almost exclusively caused by exposure to asbestos. A long exposure can cause mesothelioma and so can short ones, as each exposure is cumulative. We report a case of a 26-year-old male who was exposed to asbestos during his primary school years from the age of 6 to 12. Although the tumor mainly affects older men who in their youth were occupationally exposed to asbestos, malignant mesothelioma can also occur in young adults. A medical history was carefully taken and asbestos exposure was immediately mentioned by the patient. We conducted biopsy on the right supraclavicular lymph node. The patient was not a candidate for surgery, and chemotherapy treatment was initiated. While patient's chemotherapy is still ongoing, no other similar cases of students or teachers have been traced up to date from his school. The school building was demolished in January 2009.
Extra-articular lateral tenodesis for anterior cruciate ligament deficient knee: a case report
Authors: Diego García-Germán, Pablo Menéndez, Samuel González, Pablo de la Cuadra, Ricardo Rodríguez-Arozena
Journal: Case Rep Orthop (2013)

We present the case of an extra-articular lateral tenodesis for an anterior cruciate ligament (ACL) deficient knee. A 46-year-old male patient sustained an ACL graft rupture after a motorcycle accident. He complained of rotational instability and giving-way episodes. His previous graft was fixed by an intra-articular femoral staple that was not possible to remove at the time of the ACL revision. A modified Lemaire procedure was then performed. He gained rotational stability and was able to resume his sporting activities. We believe that isolated extra-articular reconstructions may still have a role in selected indications including moderate-demand patients complaining of rotational instability after ACL graft failure.
Case Report: New-Onset Rheumatoid Arthritis Following COVID-19 Vaccination
Authors: Tomohiro Watanabe, Kosuke Minaga, Akane Hara, Tomoe Yoshikawa, Ken Kamata, Masatoshi Kudo
Journal: Front Immunol (2022)
Keywords: covid-19 vaccination, il-6, tnf-alpha, rheumatoid arthritis, type i ifn
MeSH terms: Arthritis, Rheumatoid, Autoimmune Diseases, COVID-19, Case Reports, Research Support, Non-U.S. Gov't, COVID-19 Vaccines / adverse effects, Cytokines / therapeutic use, Humans, Interleukin-6, RNA, Messenger / therapeutic use, SARS-CoV-2, Tumor Necrosis Factor-alpha, Vaccination / adverse effects, COVID-19 Vaccines, Cytokines, Interleukin-6, RNA, Messenger, Tumor Necrosis Factor-alpha

Efficient protection against coronavirus disease 2019 (COVID-19) has been achieved by immunization with mRNA-based vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, efficient immune responses against this novel virus by vaccination are accompanied by a wide variety of side effects. Indeed, flares or new-onset of autoimmune disorders have been reported soon after the COVID-19 vaccination. Although pro-inflammatory cytokine responses play pathogenic roles in the development of autoimmunity, cytokines charactering COVID-19 vaccination-related autoimmune responses have been poorly understood. Given that mRNA derived from COVID-19 vaccine is a potent inducer for pro-inflammatory cytokine responses, these cytokines might mediate autoimmune responses after COVID-19 vaccination. Here we report a case with new-onset rheumatoid arthritis (RA) following COVID-19 vaccination. Serum concentrations not only of arthrogenic cytokines, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), but also of type I interferon (IFN) were elevated at the active phase in this case. Induction of remission by methotrexate and tocilizumab was accompanied by a marked reduction in serum concentrations of type I IFN, IL-6, and TNF-α. These results suggest that production of type I IFN, IL-6, and TNF-α induced by COVID-19 vaccination might be involved in this case with new-onset RA.
Hyperammonemic Coma in an Adult due to Ornithine Transcarbamylase Deficiency
Authors: Daniel L Roberts, David A Galbreath, Bhavesh M Patel, Timothy J Ingall, Amer Khatib, Daniel J Johnson
Journal: Case Rep Crit Care (2013)

Objective. To report an unusual cause of coma in an adult. Design. Case report. Setting. University teaching hospital. Patient. A previously healthy 53-year-old man initially presented with altered mental status and progressed to coma. He was found to be substantially hyperammonemic and did not improve with lactulose therapy and continuous venovenous hemodialysis. Results. Biochemical testing revealed previously undiagnosed ornithine transcarbamylase deficiency, and the patient responded to arginine, sodium phenylacetate, and sodium benzoate. Conclusion. Even in adult patients with no known history, inborn errors of metabolism must be considered in the differential diagnosis of unexplained coma. Defects of the urea cycle can present with an unprovoked hyperammonemic coma.
Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report
Authors: Xiaoyan Gai, Xiaoyan Sun, Xiang Zhu, Qingtao Zhou, Yongchang Sun
Journal: Front Med (Lausanne) (2023)
Keywords: acute respiratory distress syndrome, bronchoalveolar lavage (bal), fat grafting, liposuction, pulmonary fat embolism
MeSH terms: Case Reports

Background:
Pulmonary fat embolism usually occurs after fracture, yet rarely observed after liposuction and fat grafting.
Case presentation:
We describe a 19-year-old female patient who presented with acute respiratory failure and diffuse pulmonary opacities on chest radiographic image shortly after liposuction and fat grafting. Bronchoalveolar lavage was performed and lipid content in alveolar cells contribute to the diagnosis of the fat embolism syndrome. The patient was successfully treated with noninvasive mechanical ventilation and a short course of glucocorticoids.
Conclusions:
Early recognition and appropriate treatment are very important to improve the outcome of pulmonary fat embolism. Considering that liposuction and fat grafting are increasingly common cosmetic surgeries, our aim is to raise awareness for this rare adverse event.
Hypersensitivity pneumonitis among wind musicians - an overlooked disease?
Authors: Janne Møller, Charlotte Hyldgaard, Sissel Brix Kronborg-White, Finn Rasmussen, Elisabeth Bendstrup
Journal: Eur Clin Respir J (2017)
Keywords: hypersensitivity pneumonitis, molds, mycobacteria, wind instruments
MeSH terms: Case Reports

Hypersensitivity pneumonitis (HP) is a complex pulmonary disorder mediated by the immune system and caused by various inhaled antigens against which the subject has previously been sensitized. In about 50% of the cases, the antigen is not identified. Identification and removal of the eliciting antigen is important for the prognosis. We report two cases of HP caused by molds and atypical mycobacteria isolated from wind instruments. We present the first case of HP caused by bassoon playing and another case of HP caused by molds in a trombone. HP caused by fungi and bacteria in wind instruments may be much more common than previously thought. HP caused by fungi and bacteria in wind instruments is probably underdiagnosed; this calls for more clinical attention when HP is suspected.
Rare Anal Canal Cancer with Secondary Extramammary Paget's Disease (Pagetoid Spread) Complicated by Squamous Cell Carcinoma of the Skin
Authors: Tatsuki Kusuhara, Takashi Ito, Hiroki Matsuoka, Teruhiro Chohno, Masataka Zozumi, Takamasa Ohnishi
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

A 91-year-old man had a node and erythema in the anal area resistant to treatment. A biopsy of the node in the anus showed atypical cells developing as Paget's disease, and staining revealed that the cells were CK7-positive, CK20-positive, and GCDFP15-negative. Therefore, tumor invasion with pagetoid spread (PS) from the anus to the skin was suspected, and the patient was referred to our department for a close examination and surgical treatment. Lower gastrointestinal endoscopy showed edematous, hemorrhagic mucosa in the anal canal, and he was diagnosed with adenocarcinoma via a biopsy. Additionally, redness and swelling with white moss were observed on the skin around the anus. Biopsy showed that Paget cells were diffusely present in the epithelium, and an image of squamous cell carcinoma directly under the epithelium was obtained. Taken together, the patient was diagnosed with the invasion of anal canal cancer with PS to the skin, and we performed laparoscopic abdominoperineal resection and skin carcinoma resection in the perineum. The histopathological analysis showed adenocarcinoma invading the external anal sphincter and subcutaneous adipose tissue in the vicinity of the pectinate line of the anal canal. Pagetoid spread of the adenocarcinoma was observed in the epidermis, and the open portion was slightly invaded up to the rectal mucosa. The anal skin region of the adenocarcinoma partially continued to the hair follicles, and it was complicated by squamous cell carcinoma invading the dermis. There are a few reports of anal canal cancer with PS, and the coexistence of adenocarcinoma and squamous cell carcinoma, as seen in the present case, is rare. We report our case together with relevant literature.
Pericarditis complicating COVID-19 infection: a report of two cases
Authors: Zainab El Mir, Hammam Rasras, Falmata Laouan Brem, Zakaria Bazid, Nabila Ismaili, Noha El Ouafi
Journal: Pan Afr Med J (2022)
Keywords: covid-19, pericarditis, case report, myocarditis, pericardial effusion
MeSH terms: COVID-19 / complications, COVID-19 / diagnosis, Pericarditis / diagnosis, Pericarditis / etiology, Case Reports, Colchicine, Humans, SARS-CoV-2, Colchicine

COVID-19 infection is responsible for many complications, which can lead to a high risk of mortality. Respiratory manifestations are the most encountered, while that cardiovascular complications are classified as the most severe. We report two cases of COVID-19 infection complicated by pericarditis. In the absence of other etiology of pericarditis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was considered as the behind cause. The treatment in these two cases was corticosteroids with colchicine, with good outcomes. In the presence of any cardiovascular symptoms, pericarditis related to COVID-19 should be suspected, in order to act swiftly and avoid complications as well as contamination.
Primary cranial mediastinal hemangiosarcoma in a young dog
Authors: Hun-Young Yoon, Hye-Mi Kang, Mi-Young Lee
Journal: Ir Vet J (2014)
Keywords: blunt dissection, debridement, primary cranial mediastinal hemangiosarcoma, young dog

Primary cranial mediastinal hemangiosarcomas are uncommon tumors. A 30-kg, 2-year-old, intact female German shepherd was presented for evaluation of cachexia and respiratory distress of a few days' duration. Lateral radiographic projection of the thorax revealed significant pleural effusion. Computed tomography revealed a cranial mediastinal mass effect adjacent to the heart. On surgical exploration, a pedunculated mass attached to the esophagus, trachea, brachiocephalic trunk, left subclavian artery and cranial vena cava without attachment to the right atrium and auricular appendage was removed and debrided by use of blunt dissection and dry gauzes, respectively. Histopathology results described the cranial mediastinal mass as hemangiosarcoma. At 8 months and 5 days post-operatively, the patient died. Primary cranial mediastinal hemangiosarcomas, although a seemingly rare cause of thoracic pathology in young dogs, should be considered in the differential diagnosis for pleural effusion and soft tissue mass effect in the cranial mediastinum. This is the first case report in a dog to describe primary cranial mediastinal hemangiosarcoma.
Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review
Authors: Samantha Zwiebel, Alejandro G Villasante-Tejanos, Jose de Leon
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Kahlbaum first described catatonia; later Kraepelin, Gjessing, and Leonhard each defined periodic catatonia differently. A 48-year-old female with catatonia, whose grandmother probably died from it, was prospectively followed for >4 years in a US psychiatric state hospital. Through 4 catatonic episodes (one lasting 17 months) there were menstrual exacerbations of catatonia and increases in 4 biological variables: (1) creatine kinase (CK) up to 4,920 U/L, (2) lactate dehydrogenase (LDH) up to 424 U/L, (3) late afternoon cortisol levels up to 28.0 mcg/dL, and (4) white blood cell (WBC) counts up to 24,200/mm3 with neutrophilia without infections. Records from 17 prior admissions documented elevations of WBC and LDH and included an abnormal dexamethasone suppression test (DST) which normalized with electroconvulsive therapy. Two later admissions showed CK and WBC elevations. We propose that these abnormalities reflect different aspects of catatonic biology: (1) the serum CK, the severity of muscle damage probably exacerbated by the menses; (2) the hypercortisolemia, the associated fear; (3) the leukocytosis with neutrophilia, the hypercortisolemia; and (4) the LDH elevations, which appear to be influenced by other biological abnormalities. Twentieth-century literature was reviewed for (1) menstrual exacerbations of catatonia, (2) biological abnormalities related to periodic catatonia, and (3) familial periodic catatonia.
Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review
Authors: Marco Aurélio Knippel Galletta, Vera Lucia Carvalho Tess, Isabela Marangon Pasotti, Luiza Fior Pelegrini, Nicole Kemberly Ribeiro Rocha, Carolina Burgarelli Testa, Rossana Pulcineli Vieira Francisco
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Hyperemesis gravidarum (HG) is a rare condition (1.1%) characterized by excessive vomiting, malnutrition, dehydration, and laboratorial alterations. Herein, we describe the even rarer and serious presentation of refractoriness to the usual treatment of antiemetics and parenteral nutrition, with improvement only after the use of olanzapine and mirtazapine. Two subsequent pregnancies of the same woman with HG are described, which were associated with severe weight loss, anemia, hyponatremia, hypokalemia, and mild dysfunction of liver enzymes. In the third pregnancy, the usual treatment for HG was not successful, requiring enteral nutrition and the introduction of olanzapine. In the fourth pregnancy, the patient refused to use enteral nutrition for refractory HG. Hence, the patient was started on mirtazapine at an initial dose of 15 mg/day, which was gradually increased to 30 mg/day. The patient responded well to the new regimen, as demonstrated by the decrease in symptoms, the gain of 10 kg in the pregnancy, and delivering a healthy newborn. A systematic review of literature showed 11 articles and 30 cases that successfully used mirtazapine in HG. Good clinical outcomes were seen with 4 days of the treatment and at an initial dose of 15 mg/day. However, most of these reports were from psychiatric profiles, with a predominance of depression and anxiety symptoms, and a poor description of the obstetric conditions and the disease progression itself. Pulmonary hypertension was described in one case and neonatal hyperexcitability in another. The case described in this paper reinforces the idea that mirtazapine and olanzapine can be considered in refractory HG, with good results. In the world literature, this is the second case of HG that has been successfully treated with olanzapine and the first in Latin America treated with mirtazapine.
Pneumocephalus after the Treatment of an Inoperable Superior Sulcus Tumor with Chemoradiation
Authors: Ashley Albert, Robert Allbright, Todd Nichols, Edward Farley, Srinivasan Vijayakumar
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Background:
Pneumocephalus is a rare phenomenon that can occur as a complication after operations involving the thoracic discs, following thoracotomy for tumor resection, and after an intracranial operation or cranial trauma. This complication frequently occurs when a tumor is located in the costovertebral angle and an operative intervention creates a tear in the dura resulting in a pleural-dural fistula.
Case presentation:
We describe the case of a 58-year-old man with an inoperable superior sulcus tumor who developed pneumocephalus after the initiation of chemoradiation secondary to a pleural-dural fistula.
Conclusions:
Although a rare occurrence, pneumocephalus should be considered when patients with tumors in the superior sulcus treated with radiation develop neurologic symptoms characteristic of increased intracranial pressure.
Recurrent Pneumothorax with CPAP Therapy for Obstructive Sleep Apnea
Authors: Kartikeya Rajdev, Pretty Sara Idiculla, Shubham Sharma, Susanna G Von Essen, Peter J Murphy, Sabin Bista
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

Pulmonary barotrauma such as pneumothorax (PTX) is a known complication of invasive mechanical ventilation. However, it is uncommonly reported with the use of noninvasive positive pressure ventilation (NPPV) and CPAP (continuous positive airway pressure) therapy. We present a case of a 66-year-old female who presented with chronic dyspnea on exertion secondary to right-sided diaphragmatic hernia. The patient also underwent a home sleep study which suggested obstructive sleep apnea (OSA) for which she was initiated on CPAP. She then underwent surgical repair of her right diaphragmatic hernia. The patient developed pneumothorax three times over the course of the following several months, once on the right side and twice on the left side. The patient's incidences of PTX had a temporal association with the CPAP initiation. Her CPAP therapy was discontinued permanently after the third occurrence of PTX. With this case report, we highlight the risk of barotrauma with the use of CPAP for OSA. There are very few reported cases of PTX in association with NPPV therapy for OSA. The lung-protective ventilation strategies and limiting the positive airway pressures can help reduce the risk of pulmonary barotrauma with CPAP.