OpenMed/multicare-articles huggingface dataset:
A case of reinfection with a different variant of SARS-CoV-2: case report
Authors: Nagashige Shimada, Masahiro Shinoda, Hiroaki Takei, Yuto Yoshida, Masashi Nishimura, Mio Kousaka, Miwa Morikawa, Takashi Sato, Hiroto Matsuse, Masaharu Shinkai
Journal: Egypt J Intern Med (2023)
Keywords: alpha variant, e484k, n501y, reinfection, sars-cov-2, variant
MeSH terms: Case Reports

Background:
Coronavirus disease 2019 (COVID-19) was previously thought to have a low reinfection rate, but there are concerns that the reinfection rate will increase with the emergence and spread of mutant variants. This report describes the case of a 36-year-old, non-immunosuppressed man who was infected twice by two different variants of COVID-19 within a relatively short period.
Case presentation:
A 36-year-old Japanese man with no comorbidities was infected with the E484K variant (R.1 lineage) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms were mild and improved with symptomatic treatment alone. About four months later he presented to another outpatient department with high fever and headache. We diagnosed him as infected with the Alpha variant (B.1.1.7) of SARS-CoV-2 based on SARS-CoV-2 real-time reverse transcription polymerase chain reaction testing (RT-PCR). The patient was hospitalized with high fever. The patient received treatment in the form of anti-inflammatory therapy with corticosteroid and antibacterial chemotherapy. The patient improved without developing severe disease.
Conclusion:
Concerns have been raised that the reinfection rate of COVID-19 will increase with the emergence of mutant variants. Particularly in mild cases, adequate amounts of neutralizing antibodies may not be produced, and reinfection may thus occur. Continued attention to sufficient infection control is thus essential.
Plasmacytoid Urothelial Carcinoma of the Bladder That Manifests Disseminated Carcinomatosis of the Bone Marrow: A Case Report of Extremely Rapid Progression
Authors: Nobuhiko Shimizu, Yoshinobu Moritoki, Nao Katsumi, Takahiro Yanase, Teruaki Sugino, Kazuhiro Kanemoto, Hidetoshi Akita, Takahiro Yasui
Journal: Case Rep Urol (2022)
MeSH terms: Case Reports

Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare variant of invasive urothelial carcinoma (UC) with aggressive behavior. Despite its prognosis being poorer than that of conventional UC, a median overall survival of approximately 2 years is ensured when it is treated with radical cystectomy (RC), and few patients die within a few months of RC. In this paper, we report the case of a patient with PUC who developed widespread bone metastasis only 6 weeks after RC, which resulted in death within 2 months postoperatively.
Case Report: A Case Series Using Natural Anatomical Gaps-Posterior Cervical Approach to Skull Base and Upper Craniocervical Meningiomas Without Bone Removal
Authors: Nadine Lilla, Almuth F Kessler, Judith Weiland, Ralf-Ingo Ernestus, Thomas Westermaier
Journal: Front Surg (2021)
Keywords: cervical spine, craniovertebral junction, meningioma, minimally invasive, spinal tumor operation
MeSH terms: Case Reports

Background: Removal of anteriorly located tumors of the upper cervical spine and craniovertebral junction (CVJ) is a particular surgical challenge. Extensive approaches are associated with pain, restricted mobility of neck and head and, in case of foramen magnum and clivus tumors, with retraction of brainstem and cerebellum. Methods: Four symptomatic patients underwent resection of anteriorly located upper cervical and lower clivus meningiomas without laminotomy or craniotomy using a minimally invasive posterior approach. Distances of natural gaps between C0/C1, C1/C2, and C2/C3 were measured using preoperative CT scans and intraoperative lateral x-rays. Results: In all patients, safe and complete resection was conducted by the opening of the dura between C0/C1, C1/C2, and C2/C3, respectively. There were no surgical complications. Local pain was reported as very moderate by all patients and postoperative recovery was extremely fast. All tumors had a rather soft consistency, allowing mass reduction prior to removal of the tumor capsule and were well separable from lower cranial nerves and vascular structures. Conclusion: If tumor consistency is appropriate for careful mass reduction before removal of the tumor capsule and if tumor margins are not firmly attached to crucial structures, then upper cervical, foramen magnum, and lower clivus meningiomas can be safely and completely removed through natural gaps in the CVJ region. Both prerequisites usually become clear early during surgery. Thus, this tumor entity may be planned using this minimally invasive approach and may be extended if tumor consistency turns out to be less unfavorable for resection or if crucial structures cannot be easily separated from the tumor.
Hemophagocytic Lymphohistiocytosis and Clostridium difficile Infection: A Diagnostic Dilemma
Authors: Kimberly Boldig, Amy Kiamos, Avni Agrawal, Pramod Reddy
Journal: Cureus (2023)
Keywords: clostridium difficle infection, hemophagocytic lymphohistiocytosis (hlh), hyperferritinemia, immune system dysregulation, septicemia
MeSH terms: Case Reports

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition that often goes underdiagnosed because of broad and non-specific symptomatology, usually consisting of fever, hepatosplenomegaly, and multiorgan failure. This disorder can be driven by genetic components (primary) or acquired (secondary) causes related to infectious, autoimmune, or malignant processes. HLH pathogenesis derives from overactive and dysregulated immune system responses. This disorder often goes misdiagnosed because of similar clinical and laboratory findings to septicemia. Cases of HLH most commonly coexist with Epstein-Barr virus (EBV). Clostridium difficile (C. difficile) infection causing HLH has also rarely been described in the literature. A firm knowledge of HLH association with clostridial infection is essential to recognize. A presumed diagnosis of HLH in a decompensating patient may prompt the initiation of appropriate treatment earlier and improve clinical outcomes. We discuss the diagnostic and management difficulties associated with these concurrent conditions.
Computational fluid dynamics analysis of the upper airway after rapid maxillary expansion: a case report
Authors: Ahmed Ghoneima, Sahar AlBarakati, Feifei Jiang, Katherine Kula, Tamer Wasfy
Journal: Prog Orthod (2015)
MeSH terms: Finite Element Analysis, Nasal Cavity / physiology, Palatal Expansion Technique / instrumentation, Pharynx / physiology, Pulmonary Ventilation / physiology, Case Reports, Comparative Study, Research Support, Non-U.S. Gov't, Airway Resistance / physiology, Anatomy, Cross-Sectional, Child, Computer Simulation, Follow-Up Studies, Humans, Hydrodynamics, Hypopharynx / physiology, Imaging, Three-Dimensional / methods, Inhalation / physiology, Male, Models, Biological, Nasopharynx / physiology, Oropharynx / physiology, Orthodontic Appliance Design, Respiratory Mechanics / physiology, Tomography, Spiral Computed / methods

Background:
Assessment of the upper airway volume, morphology, and mechanics is of great importance for the orthodontic patient. We hypothesize that upper airway dimensions have significant effects on the dynamics of the airway flow and that both the dimensions and mechanics of the upper airway are greatly affected by orthodontic and orthopedic procedures such as rapid maxillary expansion (RME). The aim of the current study was to assess the effect of RME on the airway flow rate and pattern by comparing the fluid dynamics results of pre- and post-treatment finite element models.
Methods:
Customized pre- and post-treatment computational fluid dynamics models of the patient's upper airway were built for comparison based on three-dimensional computed tomogram. The inhalation process was simulated using a constant volume flow rate for both models, and the wall was set to be rigid and stationary. Laminar and turbulent analyses were applied.
Results:
Comparisons between before and after RME airway volume measurements showed that increases were only detected in nasal cavity volume, nasopharynx volume, and the most constricted area of the airway. Pressure, velocity, and turbulent kinetic energy decreased after dental expansion for laminar and turbulent flow. Turbulent flow shows relatively larger velocity and pressure than laminar flow.
Conclusions:
RME showed positive effects that may help understand the key reasons behind relieving the symptom of breathing disorders in this patient. Turbulence occurs at both nasal and oropharynx areas, and it showed relatively larger pressure and velocity compared to laminar flow.
The primary fallopian tube carcinoma: a rare association with pelvic nodal tuberculosis
Authors: Nisrine Mamouni, Hanane Saadi, Hinde Belfatemi, Sanaa Erraghay, Chahrazade Bouchikhi, Abdelaziz Banani
Journal: Pan Afr Med J (2017)
MeSH terms: Adenocarcinoma / diagnosis, Fallopian Tube Neoplasms / diagnosis, Peritonitis, Tuberculous / diagnosis, Case Reports, Adenocarcinoma / pathology, Adult, Fallopian Tube Neoplasms / pathology, Female, Humans, Peritonitis, Tuberculous / pathology

The primary carcinoma of fallopian tube is a rare entity. It represents 0.14 to 1.81% of genital cancers in women. It is a cancer of older women. Its association with tuberculosis is exceptional. We report a rare case of bilateral serous adenocarcinoma of the fallopian tube in a patient aged 42 years, multiparous, whose characteristic is the unexpected association with peritoneal tuberculosis.
Hepatic Artery Pseudoaneurysm in the Liver Transplant Recipient: A Case Series
Authors: David P St Michel, Naeem Goussous, Nathalie L Orr, Rolf N Barth, Stephen H Gray, John C LaMattina, David A Bruno
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Introduction:
Hepatic artery pseudoaneurysm is a rare and potentially fatal complication of liver transplantation with a reported incidence of 0.3-2.6% and associated mortality approaching 75%. Clinical presentation typically includes sudden hypotension, gastrointestinal bleed or abnormal liver function tests within two months of transplantation. We report a series of four cases of hepatic artery pseudoaneurysm in adult liver transplant recipients with the goal of identifying factors that may aid in early diagnosis, prior to the development of life threatening complications.
Methods:
A retrospective chart review at a high volume transplant center revealed 4 cases of hepatic artery pseudoaneurysm among 553 liver transplants (Incidence 0.72%) between March 2013 and March 2017.
Results:
Two of the four patients died immediately after intervention, one patient survived an additional 151 days prior to death from an unrelated condition and one patient survived at two years follow up. All cases utilized multiple imaging modalities that failed to identify the pseudoaneurysm prior to diagnosis with computed tomography angiography (CTA). Two cases had culture proven preoperative intrabdominal infections, while the remaining two cases manifested a perioperative course highly suspicious for infection (retransplant for hepatic necrosis after hepatic artery thrombosis and infected appearing vessel at reoperation, respectively). Three of the four cases either had a delayed biliary anastomosis or development of a bile leak, leading to contamination of the abdomen with bile. Additionally, three of the four cases demonstrated at least one episode of hypotension with acute anemia at least 5 days prior to diagnosis of the hepatic artery pseudoaneurysm.
Conclusions:
Recognition of several clinical features may increase the early identification of hepatic artery pseudoaneurysm in liver transplant recipients. These include culture proven intrabdominal infection or high clinical suspicion for infection, complicated surgical course resulting either in delayed performance of biliary anastomosis or a biliary leak, and an episode of hypotension with acute anemia. In combination, the presence of these characteristics can lead the clinician to investigate with appropriate imaging prior to the onset of life threatening complications requiring emergent intervention. This may lead to increased survival in patients with this life threatening complication.
Reduction of an Unusual Salter-Harris Type IV Fracture of the Ulna
Authors: Stephanie Marrannes, Delphine Lambrecht, Arne Decramer
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

We report the case of a 14-year-old boy with an isolated Salter-Harris type IV physeal fracture of the distal ulna. Following failed closed reduction, transition to open reduction and pin fixation was required. Six-month follow-up showed a favourable clinical evolution. Evidence suggests that long-term follow-up is needed because of the increased risk of premature physeal closure and subsequent growth disturbances associated with this type of injury.
Open and Arthroscopic with Mini-Open Surgical Hip Approaches for Treatment of Pigmented Villonodular Synovitis and Concomitant Hip Pathology
Authors: Bridget Ellsworth, Atul F Kamath
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Background. Pigmented villonodular synovitis (PVNS) is a rare benign tumor affecting large joints and prompts excision to prevent local destruction of the joint. The purpose of this case report is to describe two differing surgical approaches for management of PVNS of the hip in patients requiring concomitant treatment for additional hip pathology. Methods. This report discusses the presentation, clinical and radiographic findings, and operative management of two contrasting cases of PVNS of the hip. Case 1 describes a 31-year-old female with localized PVNS in addition to a labral tear treated with arthroscopic labral repair followed by tumor excision via a mini-open incision. Case 2 describes a 29-year-old male with more diffuse PVNS in addition to a cam deformity managed with open surgical dislocation of the hip, tumor excision, and restoration of the femoral head/neck junction. Results. This report demonstrates two cases of successful excision of PVNS of the hip in addition to addressing concomitant hip pathology in both cases. Conclusions. Open surgical dislocation of the hip or arthroscopic surgery with a mini-open incision may be used in appropriately selected patients to successfully excise PVNS lesions in addition to addressing concomitant hip pathology.
Use of Elamipretide in patients assigned treatment in the compassionate use program: Case series in pediatric patients with rare orphan diseases
Authors: Mary Kay Koenig, Sam Nick Russo, Kim L McBride, Hans Tomas Bjornsson, Brynja Bjork Gunnarsdottir, Amy Goldstein, Scott A Falk
Journal: JIMD Rep (2022)
Keywords: barth syndrome, cardiolipin, elamipretide, megdel, sengers syndrome, mitochondrial disease

Several mitochondrial diseases are caused by pathogenic variants that impair membrane phospholipid remodeling, with no FDA-approved therapies. Elamipretide targets the inner mitochondrial membrane where it binds to cardiolipin, resulting in improved membrane stability, cellular respiration, and ATP production. In clinical trials, elamipretide produced clinical and functional improvements in adults and adolescents with mitochondrial disorders, such as primary mitochondrial myopathy and Barth syndrome; however, experience in younger patients is limited and to our knowledge, these are the first case reports on the safety and efficacy of elamipretide treatment in children under 12 years of age. We describe the use of elamipretide in patients with mitochondrial disorders to provide dosing parameters in patients aged <12 years.
A case of decompression illness not responding to hyperbaric oxygen
Authors: Asadullah Naqvi, Derrick Clarence
Journal: J Intensive Care (2018)
Keywords: arterial gas emboli, decompression sickness, diving syndrome, hyperbaric oxygen, nitrogen narcosis
MeSH terms: Case Reports

Background:
The case reinforces the importance of stepping back and looking at every possibility along with multiple co-existing pathologies. It takes into account the thought process of multiple systems and a multidisciplinary team approach. Learning points to take are that decompression illness can present atypically, but one must exclude other causes.
Case presentation:
We present the case of a 42-year-old male from the West Midlands, UK, who attended the emergency department post-scuba diving with confusion, light-headedness, left arm weakness, and bilateral paraesthesia of the hands. Post-diving, he displayed typical symptoms of decompression illness. He attended the hyperbaric decompression chamber before attending the emergency department but to no resolve. A computed tomography of the head showed no signs of intracranial pathology. He had another session in the hyperbaric oxygen chamber but to no success. Upon admission, his blood showed polycythaemia. His saturation had dropped to 91% on room air, and a computed tomography pulmonary angiogram revealed no obvious cause. A magnetic resonance imaging of his head revealed some deep periventricular ischaemic changes, old and new, however no signs of gas embolism or poor flow. A bubble echo confirmed a patent foramen ovale. A leptospirosis and a vasculitis screen were both negative. Symptoms had slowly improved but he was left with a left arm motor weakness, and the team was left puzzled as to what could have caused his signs and symptoms. Through a diagnosis of exclusion, decompression sickness was the conclusive diagnosis. The patient made a full recovery.
Conclusions:
Decompression illness results as a sudden decrease in pressures during underwater ascent; it is caused by nitrogen bubbles forming in tissue. Additionally, a patent foramen ovale allows arterial gas emboli to cause further harm. Type 2 decompression sickness is the more severe form and includes neurological, respiratory, and cardiovascular symptoms.
Primary non-Hodgkin's lymphoma of the bladder: case report and literature review
Authors: Tarik Mahfoud, Rachid Tanz, Mohamed Mesmoudi, Mohamed Réda Khmamouche, Basma El Khannoussi, Mohamed Ichou, Hassan Errihani
Journal: Pan Afr Med J (2013)
Keywords: bladder, chemotherapy, non-hodgkin's lymphoma, primary lymphoma
MeSH terms: Lymphoma, Non-Hodgkin / diagnosis, Urinary Bladder Neoplasms / diagnosis, Case Reports, Review, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Combined Chemotherapy Protocols, Cyclophosphamide, Diagnosis, Differential, Doxorubicin, Female, Hematuria / diagnosis, Hematuria / drug therapy, Humans, Lymphoma, Non-Hodgkin / drug therapy, Lymphoma, Non-Hodgkin / pathology, Middle Aged, Prednisone, Rituximab, Urinary Bladder Neoplasms / drug therapy, Urinary Bladder Neoplasms / pathology, Vincristine, Antibodies, Monoclonal, Murine-Derived, R-CHOP protocol, Rituximab, Vincristine, Doxorubicin, Cyclophosphamide, Prednisone

Primary non-Hodgkin's lymphoma (NHL) of the bladder is a very rare entity. The clinical, radiological and endoscopic signs are not specifics. The diagnosis is exclusively histological. Chemotherapy, radiotherapy and surgery are the different therapeutic options used either alone or in combination. We report a 57 years old patient treated with chemotherapy (6 cycles of R-CHOP) for primary NHL of the bladder with a complete response while discussing the different specificities of this disease.
Mucosal Schwann cell hamartoma of the gallbladder
Authors: Farhan Ismael, Sidrah Khawar, Ameer Hamza
Journal: Autops Case Rep (2021)
Keywords: gallbladder, hamartoma, msch, neurofibroma, neuroma, schwann cells
MeSH terms: Case Reports

Mucosal Schwann cell hamartoma (MSCH) is a rare benign neurogenic tumor characterized by pure S100p positive spindle cell proliferation. Most cases occur in the distal colon. Involvement of the gall bladder is exceedingly rare. There have been no reports of recurrence or a syndromic association with MSCH. Herein, we describe a case of MSCH of the gallbladder in a 55-year-old female patient with prior history of gastrointestinal neurofibromas who presented with abdominal pain. MR imaging revealed choledocholithiasis, gallbladder thickening, and marked biliary and pancreatic ductal dilation. The patient subsequently underwent cholecystectomy with choledochoduodenostomy. Histologic evaluation of the gallbladder showed diffuse expansion of the mucosa with S100p positive cells with spindly nuclei and indistinct cytoplasmic borders and diagnosis of MSCH of the gallbladder was rendered.
COL1-Related Disorders: Case Report and Review of Overlapping Syndromes
Authors: Maria Gnoli, Evelise Brizola, Morena Tremosini, Elena Pedrini, Margherita Maioli, Massimiliano Mosca, Alessandra Bassotti, Paola Castronovo, Cecilia Giunta, Luca Sangiorgi
Journal: Front Genet (2021)
Keywords: col1, clinical signs, collagen, collagen type i, musculoskeletal diseases, overlap, rare diseases
MeSH terms: Case Reports

Collagen type I mutations are related to wide phenotypic expressions frequently causing an overlap of clinical manifestations, in particular between Osteogenesis Imperfecta (OI) and Ehlers-Danlos syndrome (EDS). Both disorders present inter- and intra-familial clinical variability and several clinical signs are present in both diseases. Recently, after the observation that some individuals first ascertained by a suspicion of EDS resulted then carriers of pathogenic variants of genes known to primarily cause OI, some authors proposed the term "COL1-related overlap disorder" to describe these cases. In this paper, we report clinical, molecular, and biochemical information about an individual with a diagnosis of EDS with severe joint hypermobility who carries a pathogenic heterozygous variant in COL1A2 gene, and a benign variant in COL1A1 gene. The pathogenic variant, commonly ascribed to OI, as well as the benign variant, has been inherited from the individual's mother, who presented only mild signs of OI and the diagnosis of OI was confirmed only after molecular testing. In addition, we reviewed the literature of similar cases of overlapping syndromes caused by COL1 gene mutations. The reported case and the literature review suggest that the COL1-related overlap disorders (OI, EDS and overlapping syndromes) represent a continuum of clinical phenotypes related to collagen type I mutations. The spectrum of COL1-related clinical manifestations, the pathophysiology and the underlying molecular mechanisms support the adoption of the updated proposed term "COL1-related overlap disorder" to describe the overlapping syndromes.
Primary Meningococcal Type C Arthritis: A Case Report and Literature Review
Authors: Maximiliano Barahona, Jaime Catalan, Yoshiro Sato, Jaime Hinzpeter
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Acute septic arthritis is a common clinical problem in emergency departments. Primary meningococcal arthritis (PMA) is very rare and few cases are reported in literature. D. B. M. consulted the emergency department for knee pain and fever; analysis showed that the cause was a Neisseria meningitidis type C infection. He received a treatment consisting of 2 arthroscopies and 5 weeks of antibiotics. At five weeks he returned to work and at 2 months he resumed sports (jogging and soccer) without complaints. Primary arthritis of the knee caused by Neisseria meningitidis is very rare. It has a very good response to antibiotics and arthroscopy procedure. Short-term follow-up and functional results are often good or excellent.