OpenMed/multicare-articles huggingface dataset:
Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess
Authors: Ryan K Dahlberg, Mary Elizabeth Lyvers, Thomas K Dahlberg
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture. The patient's pain continued to increase in severity over the next several weeks, and he was evaluated by multiple healthcare professionals with no discovered pathology. Approximately 5 weeks following the fall, repeat CT scan and MRI were conducted which then revealed extensive findings of discitis/osteomyelitis at L5-S1 as well as an epidural abscess resulting in severe narrowing of the central spinal canal. Patient underwent emergent decompression laminectomy and discectomy at L5-S1 with evacuation of the epidural abscess. Intraoperative tissue and wound cultures revealed Salmonella enterica serovar Agbeni. The patient recovered well and was discharged on an eight-week regimen of IV ceftriaxone. He has since recovered appropriately with no neurologic deficits. Important takeaways from this case include continuing to work up patients whose pain or condition is not consistent with radiographic findings and the importance of clinical intuition. This case also highlights the use of intraoperative cultures and sensitivities to correctly direct antibiotic management. Lastly, this report adds to the paucity of literature surrounding Salmonella Agbeni-related discitis and epidural abscesses and makes the suggestion that traumatic incidents such as a fall may instigate these infections.
Motor cortical functional connectivity changes due to short-term immobilization of upper limb: an fNIRS case report
Authors: Arun Karumattu Manattu, Jordan A Borrell, Christopher Copeland, Kaitlin Fraser, Jorge M Zuniga
Journal: Front Rehabil Sci (2023)
Keywords: fnirs (functional near infrared spectroscopy), functional reorganization, immobilization, plasticity, resting state connectivity
MeSH terms: Case Reports

Introduction:
A short-term immobilization of one hand affects musculoskeletal functions, and the associated brain network adapts to the alterations happening to the body due to injuries. It was hypothesized that the injury-associated temporary disuse of the upper limb would alter the functional interactions of the motor cortical processes and will produce long-term changes throughout the immobilization and post-immobilization period.
Methods:
The case participant (male, 12 years old, right arm immobilized for clavicle fracture) was scanned using optical imaging technology of fNIRS over immobilization and post-immobilization. Pre-task data was collected for 3 min for RSFC analysis, processed, and analyzed using the Brain AnalyzIR toolbox. Connectivity was measured using Pearson correlation coefficients (R) from NIRS Toolbox's connectivity module.
Results:
The non-affected hand task presented an increased ipsilateral response during the immobilization period, which then decreased over the follow-up visits. The right-hand task showed a bilateral activation pattern following immobilization, but the contralateral activation pattern was restored during the 1-year follow-up visit. Significant differences in the average connection strength over the study period were observed. The average Connection strength decreased from the third week of immobilization and continued to be lower than the baseline value. Global network efficiency decreased in weeks two and three, while the network settled into a higher efficient state during the follow-up periods after post-immobilization.
Discussion:
Short-term immobilization of the upper limb is shown to have cortical changes in terms of activations of brain regions as well as connectivity. The short-term dis-use of the upper limb has shifted the unilateral activation pattern to the bilateral coactivation of the motor cortex from both hemispheres. Resting-state data reveals a disruption in the motor cortical network during the immobilization phase, and the network is reorganized into an efficient network over 1 year after the injury. Understanding such cortical reorganization could be informative for studying the recovery from neurological disorders affecting motor control in the future.
Erosive Vulvovaginitis Associated With Borrelia burgdorferi Infection
Authors: Melissa C Fesler, Marianne J Middelveen, Jennie M Burke, Raphael B Stricker
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: lyme disease, lichen planus, lichen sclerosus, spirochetes, vulvovaginitis
MeSH terms: Borrelia burgdorferi / isolation & purification, Lyme Disease / complications, Vulvovaginitis / etiology, Vulvovaginitis / microbiology, Case Reports, Biopsy, DNA, Bacterial / analysis, Female, Humans, Lyme Disease / pathology, Middle Aged, Polymerase Chain Reaction, Vulvovaginitis / pathology, DNA, Bacterial

We describe a case of acute erosive vulvovaginitis accompanying Borrelia burgdorferi infection. The patient is a 57-year-old woman previously diagnosed with Lyme disease who presented with a painful erosive genital lesion. At the time of the outbreak, she was being treated with oral antibiotics, and she tested serologically positive for B burgdorferi and serologically negative for syphilis. Histological examination of biopsy tissue from the lesion was not characteristic of dermatopathological patterns typical of erosive vulvar conditions. Dieterle-stained biopsy sections revealed visible spirochetes throughout the stratum spinosum and stratum basale, and anti- B burgdorferi immunostaining was positive. Motile spirochetes were observed by darkfield microscopy and cultured in Barbour-Stoner-Kelly-complete medium inoculated with skin scrapings from the lesion. Cultured spirochetes were identified genetically as B burgdorferi sensu stricto by polymerase chain reaction, while polymerase chain reaction amplification of treponemal gene targets was negative. The condition resolved after treatment with additional systemic antibiotic therapy and topical antibiotics. In cases of genital ulceration that have no identifiable etiology, the possibility of B burgdorferi spirochetal infection should be considered.
Allograft and prostatic involvement in a renal transplant recipient with disseminated tuberculosis
Authors: P Sreejith, V Jha, H S Kohli, M Rathi, K L Gupta, V Sakhuja
Journal: Indian J Nephrol (2010)
Keywords: genitourinary tuberculosis, renal transplantation
MeSH terms: Case Reports

Tuberculosis is a serious opportunistic infection in renal transplant recipients and is disseminated in nature in one-third of patients. Genito urinary tuberculosis is rare in renal transplant recipients. We report a patient presenting 5 years after renal transplantation with disseminated tuberculosis and allograft and prostatic involvement.
Metastatic Colorectal Cancer Patient With Microsatellite Stability and BRAFV600E Mutation Showed a Complete Metabolic Response to PD-1 Blockade and Bevacizumab: A Case Report
Authors: Chongkai Fang, Jietao Lin, Tao Zhang, Jiajun Luo, Duorui Nie, Meng Li, Xue Hu, Yating Zheng, Xuewu Huang, Zhiwei Xiao
Journal: Front Oncol (2021)
Keywords: braf mutation, pd-1 inhibitor, anti-angiogenesis, colon cancer, microsatellite stability
MeSH terms: Case Reports

A vast majority of colorectal cancer (CRC) patients with microsatellite stability (MSS) or proficient mismatch repair (pMMR) are refractory to immunotherapeutic strategies. The current research focusses on the combined treatment strategies for identification and optimization in order to improve the efficacy of immunotherapy among patients with microsatellite stability (MSS), who account for the majority of metastatic colorectal cancer (mCRC) cases. mCRC patients harboring MSS and the BRAFV600E mutation show a worse prognosis and barely benefit from immunotherapy. In this report, we discuss the case of a mCRC patient with MSS and BRAFV600E mutation, who exhibited significant response to the combined treatment with nivolumab and bevacizumab, and has been exhibiting a progression-free survival (PFS) of more than 17 months. Our findings indicate that combined anti-angiogenic therapy can improve the efficacy of immunotherapy, which results in the prolong survival of the patient. This is a case report on MSS and BRAFV600E colorectal cancer which presents with a response to immunotherapy and anti-angiogenic therapy.
Myeloid Sarcoma of Orbits: Effectiveness of a Low-Dose Radiation Regimen
Authors: Shyam Ravisankar, Yair Levy, Maya Shah
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Acute myeloid leukemia (AML) can present with extramedullary involvement known as myeloid sarcoma (MS). We present the case of a young woman who was diagnosed with AML and MS in bilateral orbits, brain, omentum, and retroperitoneum. She was treated with induction chemotherapy. Low-dose radiation was given to the orbits due to visual symptoms which resulted in complete response. The use of radiation therapy in orbital MS has not been studied extensively, and low dose may be adequate to achieve complete remission (CR) in selected patients.
A Rare Case of Pheohyphomycotic Lumbar Spondylodiscitis Mistreated as Koch's Spine
Authors: Shakti A Goel, Hitesh N Modi, Yatin J Desai, Harshal P Thaker
Journal: Case Rep Orthop (2016)
MeSH terms: Case Reports

Pheohyphomycosis is an uncommon infection and its association in spondylodiscitis has not yet been reported. The purpose of this case report is to describe a rare case of Pheohyphomycotic spondylodiscitis and methods to diagnose and manage the patient with less invasive techniques. A 29-year-old male patient presented to the outpatient department with complaints of gradually increasing low back pain with bilateral lower limbs radicular pain since one and a half years. He had associated fever, weight loss, voice changes, and dry, scaly, erythematous skin with elevated ESR. The patient had been taking anti-Koch's therapy since 1 year with little relief in pain and no radiological improvement. Percutaneous pedicle biopsy of L4 vertebra was taken under local anaesthesia and confirmed Pheohyphomycosis which was treated with antifungal medications. The patient showed sequential improvement with long term antifungal treatment. He was eventually able to walk independently without support.
Intermittent brugada syndrome presenting with syncope in an adult female
Authors: Patricia Chavez, Daniel Bamira, Abel Casso Dominguez, Akshai Bhandary, Eyal Herzog
Journal: Case Rep Emerg Med (2014)

Background. Brugada syndrome accounts for 4-12% of all sudden deaths worldwide and at least 20% of sudden deaths in patients with structurally normal hearts. Case Report. A 48-year-old female presented to the emergency department after two witnessed syncopal episodes. While awaiting discharge had a third collapse followed by cardiac arrest with shockable rhythm. Initial electrocardiogram showed wide QRS complex with left axis deviation, ST-segment elevation of <1 mm in V1 and V2, and flattening of T waves in V1. The angiogram did not demonstrate obstructive coronary disease. The electrocardiogram obtained two days after these events showed a right bundle branch block with ST-segment elevation of >2 mm followed by a negative T wave with no isoelectric separation, suggestive of spontaneous intermittent Brugada type 1 pattern. Cardiac magnetic resonance imaging demonstrated neither structural heart disease nor abnormal myocardium. After placement of an implantable cardioverter defibrillator the patient was discharged. Why should an emergency physician be aware of this? Brugada syndrome is an infrequently encountered clinical entity which may have a fatal outcome. This syndrome primarily presents with syncope. It should be considered as a component of differential diagnosis in patients with family history of syncope and sudden cardiac death.
Scalp Melanoma Diagnosed by Fine Needle Aspiration Cytology in a Tertiary Health Center
Authors: A B Zarami, N A Satumari, M Ahmed
Journal: Case Rep Oncol Med (2015)

Melanoma is one of the most aggressive malignant skin neoplasms worldwide with more than 20% of world melanoma seen in black Africa and Asia. Late presentation due to ignorance, poverty, and lack of adequate health facility in Nigeria is always the norms. We present this case report because of precision in diagnosis, using fine needle aspiration cytology (FNAC) to reemphasize that the technique is cheap, cost effective, and quick that can reduce the burden of incisional biopsy before definitive surgery and improve early detection of the disease especially in developing countries.
Effect of High Selective Serotonin-Reuptake Inhibitor Doses on the Development and Treatment of Sarcoid-Like Reaction
Authors: Badr Rashed Al-Ghamdi
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Sarcoidosis is a systemic disorder characterized by the presence of noncaseating granulomas that are most commonly observed in the lungs. Sarcoid-like reaction has been reported to develop in response to several immune modulator agents and antidepressants. In this report, a case of pulmonary sarcoidosis that was strongly related to the use of more than the average recommended dose of selective serotonin-reuptake inhibitor (SSRI) medications has been described. The patient, a 37-year-old, single, Caucasian woman, who suffered from severe depression and who presented to the emergency department with shortness of breath, low-grade fever, a dry cough, fatigue, and the loss of appetite, was diagnosed with this condition, and she failed to respond to the administered sarcoidosis treatment until the SSRI medications that she was using were discontinued; furthermore, she relapsed when one of these medications was reintroduced. Based on these observations, we were able to show a possible relationship between sarcoid-like reaction and SSRIs, and therefore, in the case of patients with interstitial lung diseases who are using SSRIs, we recommend that meticulous precautions be taken while planning their treatment and careful follow-ups be implemented to monitor their progress.
Massive Submandibular Sialolith: Complete Radiographic Registration and Biochemical Analysis through X-Ray Diffraction
Authors: Ademir Franco, Mayara Jessica de Carvalho Mattos, Francine Ferrari, José Manoel Dos Reis Neto, Luiz Carlos Carta Gambus, Paulo Henrique Couto Souza, Soraya de Azambuja Berti-Couto
Journal: Case Rep Surg (2014)

Sialolithiasis is a pathologic condition that affects 60 million people per year, which is caused by the presence of calcified structures, named sialoliths, inside the salivary glands and their salivary ducts. Despite the large incidence of sialolithiasis, its etiology is still unknown. In the present case report, a 47-year-old female patient, presenting with local pain and hampered mouth opening, underwent a surgical approach for the removal of a 20 mm sialolith, which was further analyzed through X-ray diffraction. In parallel, a radiographic registration of 8 years, covering all the period for sialolith formation, is presented along the case report.
Case Report: Potential Role of Corticosteroids in the Management of Post-COVID-19 Pneumonia
Authors: Houari Aissaoui, Anaïs Eskenazi, Valentin Suteau, Antoine Adenis, Kinan Drak Alsibai
Journal: Front Med (Lausanne) (2021)
Keywords: ards, corticosteroid, interstitial lung diseases, organizing pneumonia, post-covid-19 infection, severe covid-19 pneumonia
MeSH terms: Case Reports

Certain patients who recover from severe pneumonia due to coronavirus disease 2019 (COVID-19) remain symptomatic in the post-infectious period, either clinically, radiologically, or respiratory. The post-COVID-19 period is characterized by clinical symptoms of varying duration from one subject to another and does not seem to depend on the severity of initial pneumonia. The persisting inflammatory and/or immune reactions in the post-COVID-19 period may play a role in the development of pulmonary lesions. Here, we report the case of a 61-year-old man with severe COVID-19 pneumonia, complicated by acute respiratory distress syndrome and pulmonary embolism, which required the patient's admission to the intensive care unit and high-flow oxygen therapy. The patient was hospitalized for 23 days for the management of his severe COVID-19 pneumonia. Afterwards, he was discharged home following a negative SARS-CoV-2 PCR test. The post-COVID-19 period was characterized by a complex respiratory symptomatology associating cough, resting dyspnea, and exertional dyspnea requiring oxygen therapy for several weeks. Surprisingly, the follow-up chest CT scan performed 4 weeks after discharge revealed bilateral interstitial lung lesions. After ruling out pulmonary superinfection, the patient was treated with oral corticosteroid for 3 months at a digressive dose. In our case, the use of corticosteroid therapy in the post-COVID19 phase had improved the outcome of the lung disease. These benefits are characterized by a rapid symptomatic improvement, accelerated repair of pulmonary images, rapid oxygen withdrawal, and rapid return to daily activities.
Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis
Authors: Tihomir Vukšić, Pejana Rastović, Vedran Dragišić
Journal: Case Rep Surg (2016)

Endometriosis is presence of functional endometrium outside of uterine cavum. As a pluripotent tissue, endometrium has the possibility of implanting itself almost everywhere; even implantation in abdominal wall was described, but it is not common site. This case report presents implantation of functional endometrium in abdominal wall, inside scar tissue, and after insertion of a laparoscopic trocar port. Final diagnosis was confirmed by pathohistological examination.
Catheter ablation of para-hisian premature ventricular contractions using electroanatomical mapping: Approaches and pitfalls
Authors: Gokhan Aksan, Osman Can Yontar, Ahmet Yanik, Guney Erdogan, Ugur Arslan
Journal: North Clin Istanb (2022)
Keywords: para-hisian, premature ventricular contraction, radiofrequency ablation
MeSH terms: Case Reports

A 58-year-old female patient presented at cardiology outpatient clinic with palpitation. The 12-lead electrocardiography on admission revealed monomorphic bigeminy premature ventricular contractions (PVCs) showed a left bundle-branch block configuration, monophasic R wave in lead I and aVL and precordial transition in V3 lead. Cardiac electrophysiological study was performed to patient. Activation mapping guided by three-dimensional electroanatomic system was done. The earliest ventricular activation was observed in the para-hisian region with the largest His potential (0.6 mV) during PVC. Due to the risk of atrioventricular (AV) block, radiofrequency (RF) ablation was planned to the region, where the His potential amplitude was lower (0.2 mV), the AV ratio was <1, and ventricular activation preceded the QRS onset by 37 ms. Subsequently, irrigated RF current was delivered in the distal His region with power starting at 15 W after PVC was suppressed, RF delivery was applied for a total of 90 s with gradually increasing power to 25 W. After ablation, under isoproterenol infusion, burst pacing from the right ventricle no PVCs/VTs was observed. A gradual RF energy application, a detailed activation mapping, and the distance from the largest His potential increase the likelihood of success in para-hisian PVC ablation.
Case Report: Neonatal Massive Pneumothorax Resulting in Compression Atelectasis Treated by Ultrasound-Guided Pleural Puncture Therapy: A Typical Case Based on Lung Ultrasound Finding
Authors: Jing Liu, Ru-Xin Qiu, Ying Liu
Journal: Front Pediatr (2021)
Keywords: atelectasis, case report, imaging, lung ultrasound, neonate, pneumothorax
MeSH terms: Case Reports

Atelectasis is a complication of different pulmonary diseases; however, neonatal compression atelectasis due to pneumothorax is rarely reported in the literature. Recently, we encountered a typical case of atelectasis. A preterm infant was admitted to the neonatal intensive care unit owing to severe respiratory distress. Lung ultrasound examination confirmed severe pneumothorax and large area of atelectasis. Lung re-expansion occurred when the air was drained from the pleural cavity.
Successful treatment of hemoptysis caused by a type 2 endoleak after thoracic endovascular aortic repair
Authors: Eijun Sueyoshi, Hirofumi Koike, Ichiro Sakamoto, Masataka Uetani
Journal: CVIR Endovasc (2018)
Keywords: aortic aneurysm, embolization, endoleak, hemoptysis, rupture

Background:
Massive hemoptysis is a life-threatening condition and can arise as a complication of conditions. Conversely, hemoptysis rarely occurs as a complication of a ruptured thoracic aortic aneurysm (TAA).
Case presentation:
A 76-year-old male had a history of surgical replacement of the whole aortic arch due to a TAA. Three years after the surgery, severe hemoptysis occurred, which resulted in the patient's emergency hospitalization at our hospital. The patient was diagnosed with ruptured pseudoaneurysms of the aortic arch. Emergency thoracic endovascular aortic repair (TEVAR) was performed. .After that, the hemoptysis stopped, and the patient was discharged. Two months later, the hemoptysis reccurred so the patient was re-admitted to our hospital. CT showed a type 2 endoleak from the bronchial artery. The anastomotic pseudoaneurysms remained. As re-rupturing of the anastomotic aneurysms due to a type 2 endoleak was suspected, transcatheter arterial embolization was performed to treat the type 2 endoleak. The patient's hemoptysis stopped, and he was discharged.One year later, CT showed that the anastomotic pseudoaneurysms had disappeared, and the diameter of the aorta had also reduced.
Conclusion:
We present a case of hemoptysis caused by a type 2 endoleak that occurred after TEVAR for a ruptured TAA. The hemoptysis was secondary to aortobronchial fistulas caused by anastomotic aortic pseudoaneurysms. Transcatheter arterial embolization of the type 2 endoleak was very effective against the hemoptysis, and the pseudoaneurysms also disappeared. No such cases have been reported previously.
Intussusception in a premature neonate: a rare often misdiagnosed cause of intestinal obstruction
Authors: I Loukas, N Baltogiannis, C Plataras, A-V Skiathitou, S Siahanidou, G Geroulanos
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Intestinal obstruction in neonatal period is an emergency caused by many surgical causes. An extremely rare surgical cause in this group of age is intussusception which can be easily confused with other surgical entities. In several reports, a significant number of the infants who were included in the study population were believed to have necrotizing enterocolitis (NEC). We present a rare cause of small intestine obstruction in a preterm female infant that can be easily misdiagnosed and confused preoperatively with other clinical entities particular for this period.