OpenMed/multicare-articles huggingface dataset:
Hypertrophic obstructive cardiomyopathy masked by tako-tsubo syndrome: a case report
Authors: Y Daralammori, M El Garhy, M R Gayed, A Farah, B Lauer, M A Secknus
Journal: Case Rep Cardiol (2012)
MeSH terms: Case Reports

Introduction. Left ventricular outflow obstruction might be part of the pathophysiological mechanism of Tako-tsubo cardiomyopathy. This obstruction can be masked by Tako-tsubo cardiomyopathy and diagnosed only by followup. Case Presentation. A 70-year-old female presented with Tako-tsubo cardiomyopathy and masked obstructive hypertrophic cardiomyopathy at presentation. Conclusion. Tako-tsubo cardiomyopathy typically presents like an acute MI and is characterized by severe, but transient, regional left ventricular systolic dysfunction. Prompt evaluation of the coronary status is, therefore, mandatory. The prognosis under medical treatment of heart failure symptoms and watchful waiting is favourable. Previous studies showed that LVOT obstruction might be part of the pathophysiological mechanism of TCM. This paper supports this theory. However, TCM may also mask any preexisting LVOT obstruction.
Port site recurrence, an unintended consequence of laparoscopic resection of ovarian cancer. A case report
Authors: Paul H Sugarbaker
Journal: Int J Surg Case Rep (2019)
Keywords: chemotherapy, hipec, high grade serous cancer, intraperitoneal, metastatic efficiency, peritoneal metastases, tumor cell entrapment

Background:
Cancer surgery has as its goal complete clearance and absolute containment of the malignant disease as it is being resected. Any aspect of the procedure which allows the escapes of malignant cells may result in disease recurrence.
Methods:
The patient presented to an emergency room with left-sided abdominal pain. Pelvic sonogram suggested the diagnosis of a ruptured left ovarian cyst. A uterine biopsy showed high grade serous carcinoma. Definitive treatment of the primary ovarian cancer wasen bloc laparoscopic resection of her uterus, Fallopian tube and ovaries.
Results:
CT showed port site recurrence in both right and left upper abdominal trochar sites. The right-sided port site recurrence was through the fascia just lateral to the right rectus muscle and was small. A much larger port site metastases was present at the right trochar site that was through the left rectus muscle.
Conclusion:
The incidence of midline and lateral port site recurrence after laparoscopy for diagnosis or resection of ovarian cancer has not been determined. Limitation of trochar sites to the midline may reduce the extent of abdominal wall disease spread.
A Case Report of Suspected Malignant Hyperthermia: How Will the Diagnosis Affect a Patient's Insurability?
Authors: Brian M Osman, Isabela C Saba, William A Watson
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

The purpose of this case report is to increase awareness that a diagnosis of malignant hyperthermia may have long-lasting or permanent effects on a patient's insurance eligibility or premiums despite legislation providing varying levels of protection from preexisting conditions or genetic discrimination. We present a case of severe rigors, unexplained severe metabolic acidosis, and severe hyperthermia in a patient after general anesthesia for extensive head and neck surgery. The patient was treated for malignant hyperthermia and demonstrated a significant clinical improvement with the administration of dantrolene. Even with an "almost certain" diagnosis of malignant hyperthermia by clinical presentation, genetic testing was negative and the gold-standard caffeine-halothane contracture test has yet to be performed. Laboratory results, clinical grading scales, and genetic testing support a diagnosis of malignant hyperthermia but the gold standard is a live muscle biopsy and caffeine-halothane contracture test. A clinical diagnosis of MH or a positive caffeine-halothane contracture test could result in exclusion from genetic discrimination legislature due to the fact that diagnosis can be confirmed without genetic testing. The fate of the Affordable Care Act may also affect how insurance companies scrutinize this disease. Improving accuracy of MH diagnosis in hospital discharge records will be crucial.
Clozapine-Induced Myocarditis: A Case Report of an Adolescent Boy with Intellectual Disability
Authors: Lila Aboueid, Nitin Toteja
Journal: Case Rep Psychiatry (2015)

Background. Although known for its efficacy in treatment-resistant schizophrenia, the usage of clozapine has been limited due to concerns over potential adverse effects. Myocarditis, one potential fatal complication, can develop at any point during treatment but has been most commonly observed 2-3 weeks after clozapine initiation. Objective. A case of acute clozapine-induced myocarditis is described, highlighting the history, onset, and treatment course of presentation. There is a need to raise awareness of this potential complication, especially in the pediatric population. Results. 17-year-old Puerto Rican boy, with history of schizophrenia, disorganized type (treatment resistant), and intellectual disability, developed myocarditis on the thirteenth day following clozapine commencement. Initial presenting symptoms included tachycardia, lethargy, and vague gastrointestinal distress. Patient fully recovered after supportive medical care and clozapine discontinuation. Conclusions. Myocarditis is a known potential complication of clozapine initiation; however, due to its limited usage in the pediatric population, reported cases are limited. There is a need to establish evidence-based monitoring guidelines for clozapine usage, particularly in the pediatric population where the presentation may be atypical and clinical suspicion may be overlooked.
Schmidt's syndrome presenting as a generalised anxiety disorder: a case report
Authors: D Anyfantakis, E K Symvoulakis, I Vourliotaki, S Kastanakis
Journal: J Med Life (2013)
Keywords: schmidt’s syndrome, autoimmune polyglandurar syndrome type 2, autoimmune thyroiditis, generalized anxiety disorder
MeSH terms: Anxiety Disorders / diagnosis, Polyendocrinopathies, Autoimmune / diagnosis, Case Reports, Female, Humans, Middle Aged, Thyroiditis, Autoimmune / diagnosis

Schmidt's syndrome or autoimmune polyglandurar syndrome type 2 represents an uncommon endocrine disorder composed by Addison's disease with autoimmune thyroid disease and/or type 1 diabetes mellitus. The syndrome usually affects women in the fourth decade of their lives. Prompt diagnosis and treatment can prevent serious complications. We present the case of a 64-year-old woman with generalised anxiety, facing socio-economic problems. Her symptoms attributed to stress led to a late diagnosis. Physicians involved have to be aware about endocrine disorders of which first manifestations may have atypical components mimicking mental health problems.
Peritoneal-cutaneous fistula successfully treated at home: A case report and literature review
Authors: Mirosław Kiedrowski, Eliza Mokrosz
Journal: Open Med (Wars) (2020)
Keywords: ascites, cancer, fistula, paracentesis, quality of life
MeSH terms: Case Reports

We present the first case of peritoneal-cutaneous fistula (PCF) within ovarian carcinoma neoplastic infiltrates located inside a large abdominal hernia in a home hospice patient with massive ascites. It is an instructive case featuring a rapid diagnosis and efficient treatment of the PCF at home. As the patient refused hospitalization, she had successful paracentesis performed at home. Subsequent hydrocolloid dressing application, diuretics, and oral protein supplementation were recommended. Our intervention led to PCF closure, improved quality of life, and deepened the trust between the patient and the home hospice team. Our case demonstrates that in some instances, PCF may be efficiently treated at home, which may require paracentesis, appropriate dressings, and identification of all factors affecting healing. It also provides further support for the safety of paracentesis in home settings.
Early-onset neonatal sepsis due to Streptococcus salivarius: A case report
Authors: Sakviseth Bin, Sethikar Im
Journal: Clin Case Rep (2023)
Keywords: streptococcus salivarius, multi‐drug resistance, neonatal sepsis, newborn
MeSH terms: Case Reports

Streptococcus salivarius, the most predominant human oral microbiota, is rarely associated with neonatal sepsis. This report aims to describe a rare culture-proven case of early-onset sepsis in a 3-day-old boy with isolated high-grade fever. Streptococcus salivarius was isolated in two consecutive hemocultures and unexpectedly resistant to the conventional empirical antibiotics.
Diffuse Bone Marrow Metastasis as the Initial Presentation of an Occult Breast Cancer
Authors: Frank S Fan, Chung-Fan Yang, Yi-Fen Wang
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Introduction:
Breast cancer is one of the malignancies which tend to involve the bone marrow, but initial presentation with diffuse bone marrow metastasis from an occult breast cancer is very rare. Prognosis is generally very poor for marrow metastasis from solid tumors except that breast cancer is a treatable disease even in such a dismal condition.
Case:
A 64-year-old woman's headache was found to result from diffuse adenocarcinoma metastasis in the bone marrow from an unknown primary site. Intensive immunohistochemistry study of bone marrow biopsy specimen confirmed the disease nature to be an estrogen receptor-positive/human epidermal growth factor receptor 2-negative breast cancer. Mammography and magnetic resonance imaging of breasts revealed a suspicious primary lesion in the right breast. Treatment with tamoxifen alone achieved a sustained response.
Discussion:
Mucin 1 (MUC1), also known as cancer antigen 15-3 (CA 15-3), facilitates motility and metastatic potential of breast cancer cells. Interleukin-1β (IL-1β) drives breast cancer cell growth and colonization in bone marrow adipose tissue niche. Receptor activator of nuclear factor kappa-B (RANK) and its ligand (RANKL) activate osteoclasts to make a favorable bone marrow microenvironment for tumor cells. Agents against MUC1, IL-1β, and RANKL might be of therapeutic effect for patients like ours.
Production of thyrotropin receptor antibodies in acute phase of infectious mononucleosis due to Epstein-Barr virus primary infection: a case report of a child
Authors: Keiko Nagata, Keisuke Okuno, Marika Ochi, Keisuke Kumata, Hitoshi Sano, Naohiro Yoneda, Jun-Ichi Ueyama, Michiko Matsushita, Satoshi Kuwamoto, Masako Kato, Ichiro Murakami, Susumu Kanzaki, Kazuhiko Hayashi
Journal: Springerplus (2015)
Keywords: autoantibody, epstein–barr virus (ebv), graves’ disease, infectious mononucleosis, lytic infection, reactivation, thyrotropin receptor antibody (trab)

Various autoantibodies have been reported to be detected during the progression of infectious mononucleosis. We observed a case of infectious mononucleosis due to Epstein-Barr virus primary infection for 2 months, and noticed the transiently increased titer of thyrotropin receptor autoantibodies detected at the acute phase on the 3rd day after admission. At that time, real-time quantitative PCR also revealed the mRNA expressions of an immediate early lytic gene, BZLF1, and a latent gene, EBNA2. The expression of BZLF1 mRNA means that Epstein-Barr virus infects lytically, and EBNA2 protein has an important role in antibody production as well as the establishment of Epstein-Barr virus latency. These results suggest that Epstein-Barr virus lytic infection is relevant to thyrotropin receptor autoantibody production. Thyrotropin receptor autoantibodies stimulate thyroid follicular cells to produce excessive thyroid hormones and cause Graves' disease. Recently, we reported the thyrotropin receptor autoantibody production from thyrotropin receptor autoantibody-predisposed Epstein-Barr virus-infected B cells by the induction of Epstein-Barr virus lytic infection in vitro. This case showed in vivo findings consistent with our previous reports, and is important to consider the pathophysiology of Graves' disease and one of the mechanisms of autoimmunity.
Immune Thrombocytopenia Induced by Immune Checkpoint Inhibitors in Solid Cancer: Case Report and Literature Review
Authors: Xiaolin Liu, Xiuju Liang, Jing Liang, Yan Li, Jun Wang
Journal: Front Oncol (2020)
Keywords: durvalumab, immune checkpoint inhibitor, immune thrombocytopenia, immune-related adverse event, programmed cell death 1 inhibitor, programmed cell death ligand 1
MeSH terms: Case Reports

Immune checkpoint inhibitors, including antibodies targeting programmed cell death protein-1 (PD-1) and its receptor programmed cell death ligand-1 (PD-L1), represent promising therapeutic strategies for advanced human malignancies. However, a subgroup of patients experiences various autoimmune toxicities, termed immune-related adverse events (irAEs), that occur as a result of on-target and off-tumor autoimmune responses. Although irAEs are generally confirmed to be less severe than toxicities caused by conventional chemotherapy and targeted therapy, uncommon irAEs, such as immune thrombocytopenia, may occur with a very low incidence and sometimes be severe or fatal. This review focuses on the epidemiology, clinical presentation, and prognosis of immune thrombocytopenia occurring in advanced cancer patients induced by immune checkpoint inhibitors, especially in those with PD-1 or PD-L1 inhibitor treatment. We also first present one patient with non-small cell lung cancer who received the PD-L1 inhibitor durvalumab and developed severe thrombocytopenia.
Extrahepatic biliary papillomatosis in a child
Authors: A Singh, M Bajpai, N Sharma, M Jana
Journal: APSP J Case Rep (2013)
Keywords: common bile duct, extrahepatic biliary papillomatosis, polyp
MeSH terms: Case Reports

In children, benign neoplasms of extrahepatic biliary ducts are extremely rare. We report a case of 3 year old girl who presented with abdominal pain and jaundice for 6 months. The final diagnosis on histopathology was papillomatosis in lower common bile duct.
A Case of Kawasaki Disease Complicated With Cerebral Salt-Wasting Syndrome
Authors: Masanari Oshima, Junji Fukuhara, Takanori Noto, Teppei Noguchi, Masao Murabayashi, Mamoru Ayusawa, Ichiro Morioka
Journal: Front Pediatr (2020)
Keywords: kawasaki disease, cerebral salt-wasting syndrome (csws), fractional excretion of uric acid (feua), hyponatremia, syndrome of inappropriate antidiuretic hormone secretion (siadh)
MeSH terms: Case Reports

We report the case of a 3-years-old boy who developed severe hyponatremia and unconsciousness during an episode of Kawasaki disease (KD). He was diagnosed with cerebral salt-wasting syndrome (CSWS), which has not previously been reported as a complication of KD. He was diagnosed with KD with fever and four clinical signs and received intravenous immunoglobulin (IVIG) on the day after onset. Hyponatremia had been observed, and it worsened after IVIG. At first, syndrome of inappropriate antidiuretic hormone secretion (SIADH) was suspected, but his hyponatremia did not improve by restriction of water intake. The patient's consciousness level decreased along with the worsening hyponatremia. Electroencephalography revealed abnormal electrical discharge concordant with acute encephalopathy. Laboratory data showed hypouricemia with high fractional excretion of uric acid (FEUA), in addition to a negative balance of both Na and water. We diagnosed KD complicated with CSWS. The patient improved promptly with appropriate Na supplementation and water correction.
Isolated Fallopian Tube Torsion with Necrotic Hemorrhagic Cyst in an 11-Year-Old Girl Diagnosed by Laparoscopy
Authors: Atl Simon Arias Rivera, Luis Miguel Zamora Duarte, Samuel Shuchleib Chaba, Alberto Chousleb Kalach, Marcos Jalak Cababie, Ariel Shuchleib Cung
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Isolated fallopian tube torsion (IFTT) is a rare pathology that causes acute abdomen in women, it is even less common in pediatric patients. We present a case of an 11-year-old girl who presented with abdominal pain 24 hours of evolution, the diagnosis could not be specified with cabinet methods, so the definitive diagnosis was made using a diagnostic laparoscopy. A necrotic hemorrhagic tubal cyst was found. A left salpingectomy had to be performed due to necrosis. Early diagnosis can have a positive impact on the fertility of these patients.
Spontaneous Abdominal Bleeding from an Infundibulopelvic Ligament Tear in a Patient with Large Ovarian Fibroma
Authors: Justin To, Cui-Lan Li
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Ovarian fibromas are rare benign solid tumors of the ovary which are often difficult to differentiate from uterine leiomyomas preoperatively. The symptoms usually include abdominal discomfort and may have ascites and/or an elevation in CA-125 levels. There have been no publications of associated abdominal bleeding to date. The treatment is surgical removal via a laparoscopic or laparotomic approach. We present a case of a 19 cm unilateral ovarian fibroma with abdominal bleeding from a spontaneous right infundibulopelvic ligament (IPL) tear who underwent a laparoscopic and mini-laparotomic right salpingo-oophorectomy. Patients with large ovarian fibromas should be cautioned that abdominal bleeding and/or acute abdominal pain can occur and that a minimally invasive surgical approach is feasible.
Idiopathic portal hypertension complicating systemic sclerosis: a case report
Authors: John Moschos, Grigoris I Leontiadis, Clive Kelly, James Henry, Savvas Kadis
Journal: BMC Gastroenterol (2005)
MeSH terms: Hypertension, Portal / complications, Scleroderma, Systemic / complications, Case Reports, Aged, 80 and over, Esophageal and Gastric Varices / complications, Humans, Hypertension, Portal / physiopathology, Liver Circulation, Male, Melena / complications, Portal System / physiopathology

Background:
Patients with systemic sclerosis may develop mild abnormalities of liver function tests. More serious hepatic involvement has been well documented but is rare. Idiopathic portal hypertension had been reported only in a few female patients with systemic sclerosis.
Case presentation:
An 82-year-old man with known systemic sclerosis presented with melaena. Urgent gastroscopy revealed oesophageal varices, which re-started bleeding during the procedure and were treated ensocopically, with Sengstaken tube and glypressin. Liver function tests and coagulation were normal. Non-invasive liver screen (including hepatitis viral serology and autoantibodies) was negative. Ultrasound scan of the abdomen revealed a small liver with coarse texture and no focal lesion. Hepato-portal flow was demonstrated in the portal vein. The spleen was enlarged. A moderate amount of free peritoneal fluid was present. A CT scan confirmed the absence of portal vein thrombosis. One month following discharge the patient had a liver biopsy. Histological examination showed essentially normal liver tissue; there was no evidence of any excess inflammation and no features to suggest cirrhosis or drug-induced liver disease. Taking into account the above evaluation we concluded that the patient had idiopathic portal hypertension.
Conclusion:
Both male and female patients with systemic sclerosis may -- rarely -- develop idiopathic portal hypertension.
Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature
Authors: Shimon Edelstein, Inbar Ben Shachar, Hila Ben-Amram, Seema Biswas, Naama Marcus
Journal: Infect Dis Obstet Gynecol (2019)
MeSH terms: Coagulase / metabolism, Endometriosis / microbiology, Ovarian Cysts / microbiology, Reproductive Techniques, Assisted / adverse effects, Staphylococcal Infections / diagnosis, Staphylococcus lugdunensis / metabolism, Case Reports, Review, Adult, Anti-Bacterial Agents / administration & dosage, Anti-Bacterial Agents / therapeutic use, Cephalexin / administration & dosage, Cephalexin / therapeutic use, Clindamycin / administration & dosage, Clindamycin / therapeutic use, Endometriosis / surgery, Female, Humans, Leukocyte Count, Oocyte Retrieval / adverse effects, Ovarian Cysts / surgery, Pregnancy, Staphylococcal Infections / drug therapy, Staphylococcal Infections / microbiology, Staphylococcal Infections / surgery, Staphylococcus lugdunensis / isolation & purification, Treatment Outcome, Anti-Bacterial Agents, Coagulase, Clindamycin, Cephalexin

Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy-with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature include Escherichia coli (E. coli) and Group B streptococcus (GBS) but Staphylococcus lugdunensis (S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.
Electrocardiographic abnormalities of takotsubo cardiomyopathy in a patient with paced ventricular rhythm
Authors: Krati Chauhan, Siva P Sontineni, Venkata M Alla, Mark J Holmberg
Journal: Cardiol Res Pract (2010)
MeSH terms: Case Reports

Takotsubo cardiomyopathy (TCM) is a unique cardiomyopathy characterized by chest pain, ECG, and regional wall motion abnormalities closely mimicking acute myocardial infarction, in the absence of significant coronary artery disease. Classic ECG changes of TCM include ST elevation or T wave inversion. However, ECG abnormalities of TCM in patients with paced ventricular rhythms have not been well characterized. Herein, we report the case of an 85-year-old pacemaker dependant female who was diagnosed with TCM four weeks following the demise of her husband. Abnormal negative T wave concordance in precordial leads and QT interval prolongation were the only new ECG findings and these reverted back to baseline on followup.