OpenMed/multicare-articles huggingface dataset:
Case Report: Diagnostic Value of Metagenomics Next Generation Sequencing in Intracranial Infection Caused by Mucor
Authors: YuChen Liu, Jun Zhang, Bing Han, LiJuan Du, ZhaoYang Shi, ChunCheng Wang, Min Xu, YongGang Luo
Journal: Front Med (Lausanne) (2021)
Keywords: lichtheimia ramosa, intracranial infection, metagenomics next generation sequencing, mucormycosis, precision treatment
MeSH terms: Case Reports

mNGS(metagenomics Next Generation Sequencing), as a novel culture-independent approach, demonstrated the capability of rapid, sensitive, and accurate pathogen identification. At present, there have been many case reports about the use of mNGS to assist in the diagnosis of bacterial, fungal, viral and parasitic infections and to guide clinicians to determine appropriate treatment. However, the clinical understanding of this technique is not comprehensive, and the experience of using it is relatively limited. We reported a 53-year-old man who was admitted to hospital with a high fever and headache. His inflammatory biomarkers were markedly elevated. Based on the clinical presentation, He was initially diagnosed as having an intracranial infection of unknown etiology and received empirical antibiotics and systemic supportive treatment. But these did not relieve his symptoms. Both the blood and CSF specimens were examined using traditional culture, serological testing, and mNGS. Traditional culture and serological testing produced negative results, while the mNGS revealed the presence of a potential pathogen, mucor, in the CSF specimen. Then targeted antifungal treatment was selected quickly and his temperature gradually returned to normal. Thus, we report the case in which mNGS was an auxiliary method to diagnose mucormycosis, and discuss this case in combination with relevant literature, in order to improve the clinical cognition of this technology.
Retroperitoneal kaposiform hemangioendothelioma with kasabach-merritt phenomenon in children: A case report and review of the literature
Authors: Junming Huo, Song Chen, Jing Li, Chengjun Liu
Journal: Front Pediatr (2023)
Keywords: kaposiform hemangioendothelioma, kasabach-merritt phenomenon, literature review, pediatric, retroperitoneal
MeSH terms: Case Reports

Objective:
To investigate the clinical features, diagnosis and treatment methods and prognosis of retroperitoneal Kaposiform hemangioendothelioma (R-KHE) in children.
Methods:
The clinical data of an infant with R-KHE was retrospectively analyzed. Literature on R-KHE in pediatrics were retrieved in databases including Wanfang, CNKI and PubMed as of April 2022.
Results:
A 1 month and 6 days female infant with R-KHE was reported. After the diagnosis was confirmed by biopsy and pathological examination, the patient was treated by interventional embolization, and a combined therapy with glucocorticoid, vincristine, sirolimus and propranolol. The patient has been followed up for 1 year and 2 months, and is still alive with tumor. Through literature search, a total of 15 children, together with the case in our report, were included. The main manifestations were diversity among those patients. 14 cases have combined Kasabach-Merritt phenomenon (KMP). 6 cases accepted surgery plus drug therapy. 4 cases accepted only surgery, and 4 cases only accepted drug therapy. While drug therapy plus radiotherapy were employed to 1 case. Improvement was observed in 11 cases, with significantly reduced tumor and survival with tumor. Tumor disappeared completely in 2 cases. While 2 cases suffered death.
Conclusion:
R-KHE has diverse clinical presentations and non-specificity in symptoms and imaging examinations, and most cases accompanied with KMP. Methods for R-KHE treatment include surgical resection, interventional embolization and drug therapy. Close attention needs to be paid to the adverse reactions of the drug during the course of treatment.
An interesting finding of multiple calcified pulmonary nodules in a patient with rheumatoid arthritis
Authors: Aws Alfahad, Paul Jennings, Simmon Smith, Nikta Niktash, John Curtin
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Calcified pulmonary (lung parenchymal) densities can occur in a number of conditions. A patient with rheumatoid arthritis presented with new right lung base nodules and left long base soft-tissue densities on his chest X-ray. These findings did not exist on his chest X-ray performed 2 years earlier. A subsequent thoracic CT scan showed multiple pleural-based irregular nodules of soft-tissue density that were partially calcified. There was also mediastinal and hilar lymphadenopathy. Following a discussion at the respiratory multidisciplinary team meeting, a CT-guided nodal biopsy was performed that showed necrotic lung tissue with palisaded histiocytes and fibrosis with chronic inflammation. No vasculitis or granulomata were seen and no there was evidence of malignancy. Appearances were consistent with a rheumatoid nodule. No mycobacteria or fungi were seen on Ziehl-Neelsen, Wade-Fite or periodic acid-Schiff stains. We concluded that this patient had unusual calcified rheumatoid lung nodules. Previously, calcified pulmonary nodules have been reported in the setting of Caplan's syndrome in miners.
A case of endogenous trichosporon endophthalmitis treated with micafungin and voriconazole
Authors: Harpreet Walia, Veronica T Tucci, John N Greene, Jennifer Tordilla-Wadia, Patrick Kelty, Sandeep Walia
Journal: J Glob Infect Dis (2009)
Keywords: endophthalmitis, micafungin, voriconazole
MeSH terms: Case Reports

Invasive fungal infections are a significant cause of morbidity and mortality. Endogenous fungal endophthalmitis is a rare intraocular infection with potential vision threatening consequences. Our review of the literature revealed only one other case of Trichosporon endophthalmitis. Ocular fungal infections are difficult to eradicate because of the limited availability of systemic and intravitreal therapeutic agents and poor tissue penetration of current antifungals. Along with systemic antifungal agents, vitrectomy and intravitreal amphotericin B have been suggested as optimal treatments for fungal endophthalmitis. Other antifungals such as flucytosine and triazoles have recently received consideration. Although the current antifungal therapy is not highly successful, there remains a significant potential for more successful treatments in the future, based on the current studies. We report a case of endogenous trichosporon endophthalmitis that was successfully treated with micafungin and voriconazole. This combination has not been previously reported as a successful therapy in literature. More targeted research is required to uncover additional efficacious therapies to combat trichosporon.
Successful Treatment of Whole Coronary Artery Spasm after Off-Pump Coronary Artery Bypass Grafting
Authors: Akihiro Kobayashi, Yoshimori Araki, Takafumi Terada, Osamu Kawaguchi
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Coronary artery spasm after coronary artery bypass grafting is a rare but life-threatening condition. Herein, we report the case of a 77-year-old man who received off-pump coronary artery bypass grafting. An hour after surgery, there was a sudden hemodynamic compromise due to coronary artery spasm, prompting emergent coronary angiography with extracorporeal membrane oxygenation support. Because the angiography results showed diffuse severe spasm of the entire native coronary artery, the patient was treated with an intracoronary injection of vasodilators. The patient recovered in 7 days with mechanical support, catecholamines, and vasodilators, and he was discharged on postoperative day 30. Although coronary artery spasm after off-pump coronary artery bypass surgery is a rare condition, it must be suspected when sudden circulatory collapse occurs.
New insights in the management of antipsychotics in the treatment of schizophrenia in a patient with prolactinoma: a case report and review of the literature
Authors: Elvis Henrique Santos Andrade, Pedro Mario Pan, Paula F Ramalho da Silva, Ary Gadelha
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Prolactinomas are the commonest pituitary adenomas and the major pathological cause of hyperprolactinaemia. Symptomatic prolactinomas are treated mainly by dopamine agonists; surgery and radiotherapy are options for nonresponders. Schizophrenia treatment is based on antipsychotics, which acts mainly at serotonergic and dopaminergic systems. We report a case of a 39-year-old schizophrenic male patient that was diagnosed with a macroprolactinoma 8 years after his first psychotic episode. The association of Schizophrenia and prolactinoma represents a clinical challenge once the treatment of one disease can exacerbate the symptoms of the other.
Case report: Ewing sarcoma with EWSR-ERG fusion elevates procalcitonin extremely in the long term without infection
Authors: Ying Chen, Tao Qin, Yan Chen, Ming Gao
Journal: Front Oncol (2023)
Keywords: ewsr, ewing sarcoma, case report, infection, inflammatory marker, procalcitonin
MeSH terms: Case Reports

Background:
Ewing sarcoma (ES) represents a rare, aggressive bone and soft-tissue cancer. Unlike breast, liver, pancreatic, and prostate cancers, Ewing sarcoma has had no representative tumor marker until now. The use of procalcitonin (PCT) as a tumor marker is also rarely reported. PCT is a clinically recognized and widely used inflammatory marker in recent years. In rare cases, PCT may also be falsely positive due to non-infectious factors. In the few previously reported papers regarding the correlation between tumors and PCT, we learned that abnormalities of PCT level can also be impacted by individual cancers.
Case presentation:
Here, we first reported a case of Ewing sarcoma with markedly elevated PCT without infection and carried out some literature review. The patient was a middle-aged man with extraskeletal Ewing sarcoma whose lesion was located in the distal abdominal ileum. He had a sudden and unprovoked onset of high fever during chemotherapy before surgery. After multiple examinations, the patient's blood routine, C-reactive protein, blood culture, and CT examination showed no signs of infection, and even the culture from the end of the central venous catheter showed no pathogen growth. Only PCT increased dramatically to more than 200 ng/ml. PCT remained at this level for several months until a single abdominal lumpectomy was performed before it dropped to near-normal levels.
Conclusion:
In our report, PCT is significantly elevated in Ewing sarcoma in the absence of infection. Not only that, but we particularly highlighted the precipitous drop in PCT following tumor resection.
Bardet-Biedl Syndrome with a Kidney Transplant, Esophageal Adenocarcinoma, and Postoperative Complications
Authors: Georgi Yankov, Teodora Mihalova, Rosen Petkov, Evgeni Mekov, Stefka Yankova, Danail Petrov
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

The authors present a rare clinical case of a patient with Bardet-Biedl syndrome and chronic kidney disease, who reached end-stage renal disease (ESRD) and underwent a long-term hemodialysis treatment, during which infections with Hepatitis C Virus (HCV) infection and Cytomegalovirus (CMV) infection were established. Kidney transplantation from an alive unrelated donor was performed. Later, an adenocarcinoma of the esophagus was diagnosed at an early stage, treated surgically with resection of the esophagus and gastroesophagoplasty afterward. Seven months later, a rare complication of the immunosuppressive therapy with Cyclosporin A occurred, which consisted of spontaneous bilateral pleural hemorrhage. The same, as well as the postoperative ventral hernia, was successfully resolved. Concomitant HCV was also treated. Rare autosomal recessive syndrome with severe complications, adenocarcinoma of the esophagus, spontaneous bilateral pleural hemorrhage after the operation, and successful treatment were discussed.
Influence of Internet Language Violence on Young Students' Mental Health and Intervention Countermeasures
Authors: Xiaoqin Shi, Chao Yu, Dongmei Wu
Journal: J Healthc Eng (2021)
MeSH terms: Language, Mental Health, Retracted Publication, Adolescent, Humans, Internet, Students, Violence / prevention & control

With the development of the Internet, it has increasingly become an indispensable product in people's lives, but many problems have arisen with it. Internet language violence is one of them. At present, the main Internet users in my country are young people, and online language violence brings extremely serious psychological problems to young students. In order to understand the current mental health of young students and the impact of online language violence on them, this article investigates the students in the city's no. 1 middle school, filters the data through decision tree analysis, and judges online language through the psychological symptoms self-rating scale. The mental health symptom self-rating scale has the characteristics of large capacity, abundant symptoms, and more accurate description of the subject's conscious symptoms. It contains a wide range of psychiatric symptoms, from feelings, emotions, thinking, consciousness, and behavior to life habits, interpersonal relationships, eating, and sleeping, and it uses 10 factors to reflect the psychological symptoms in 10 aspects. It has good distinguishing ability for people with psychological symptoms (that is, they may be on the edge of psychological disorder or mental disorder). The chi-square statistical method is used to analyze the basic characteristics of different youth groups of verbal violence. For the research content, the school surveys all schools and adopts questionnaire surveys and case studies to analyze the factors that influence youths' attribution of online violence behaviors and make recommendations. The impact of violence on young students will be analyzed later through psychological intervention. The results of the study found that online language violence caused serious harm to young people's psychology and caused students' depression, anxiety, and other mental illnesses. Active psychological interventions can effectively alleviate students' mental health. The improvement of students' mental health is the most obvious. The score improved by nearly 10%.
The whole treatment process and thinking of a patient with NUT carcinoma of the parotid gland: a case report
Authors: Shujuan Fu, Zhiying Wang, Cunya Li, Yun Li, Ke Zhang, Zhixian Zhong, Yi Zhong
Journal: Front Oncol (2023)
Keywords: nut carcinoma, case report, immunotherapy, overall survival (os), targeted therapy
MeSH terms: Case Reports

Background:
Primary nuclear protein in testis (NUT) carcinoma is a rare malignant tumor originating from the salivary glands that usually occurs in midline structures, such as the head and neck, and has been identified in young patients. Progression of NUT carcinoma is rapid, and there is a high degree of malignant invasion. The median survival time of NUT carcinoma patients is 6 to 9 months, and 80% of the patients die within 1 year after diagnosis.
Case description:
This case report summarizes the treatment of a 36-year-old male patient with NUT carcinoma of the right parotid gland. The overall survival of the patient was 2 years. We also discuss the applications and outcomes of immune checkpoint inhibitor and targeted therapy combination regimens in the treatment of NUT carcinoma.
Conclusion:
We suggest that targeted therapy combined with immunotherapy which has long-term clinical benefits and targeted therapy which has high clinical response rate(immunotherapy + dual-targeting three-drug regimens) is an ideal choice for the treatment of patients with rare and/or refractory tumors and will not compromise patient safety.
Clinical trial registration:
identifier ChiCTR1900026300.
Poorly differentiated mesenteric carcinoma of unknown primary site detected by abscess formation: case report
Authors: Yukinori Yamagata, Yukari Ando, Keisuke Matsusaka, Hisako Karube, Haruna Onoyama, Susumu Aikou, Hiroharu Yamashita, Kazuhiko Mori, Sachiyo Nomura, Masashi Fukayama, Yasuyuki Seto
Journal: World J Surg Oncol (2014)
MeSH terms: Abdominal Abscess / pathology, Cell Differentiation, Mesentery / pathology, Neoplasms, Unknown Primary / pathology, Peritoneal Neoplasms / pathology, Case Reports, Abdominal Abscess / surgery, Aged, Female, Humans, Mesentery / surgery, Neoplasm Invasiveness, Peritoneal Neoplasms / surgery, Prognosis, Tomography, X-Ray Computed

Background:
Carcinoma of unknown primary site (CUP) is said to account for approximately 3 to 5% of all carcinomas. However, an isolated lesion in the abdominal cavity is rare, and there are no reports describing associated abscess formation.
Case presentation:
A 76-year-old woman had consulted a previous physician complaining of fever and right lower quadrant abdominal pain. Enhanced computed tomography (CT) showed an abscess formation around the cecum. She was treated conservatively with antibiotics, but the symptoms relapsed and she consulted our hospital. Enhanced CT showed a persistent abscess, a tumorous lesion in the mesentery and right hydronephrosis. Because malignancy could not be ruled out, surgical treatment was selected. At laparotomy, encapsulated abscesses were found on the mesenteric side and outside of the ileocecal region. When we raised the ileocecal region, a tumor was found to be fixed to the right ureter, and there was leakage of white, solid tumor content. This tumor content was submitted to intraoperative frozen section diagnosis which revealed a carcinoma. Ileocecal resection with D3 lymph node dissection and retroperitoneal tumor resection was thus performed. There were no abnormal findings in the uterus and adnexa, nor any evidence of peritoneal dissemination. We regarded this case as an incomplete resection and chemotherapy with paclitaxel and carboplatin was administered. The patient has remained alive and disease-free for almost one year since the primary operation.
Conclusion:
We described a case with mesenteric CUP discovered during surgery for an intra-abdominal abscess. It is necessary to pay attention to treatment-resistant intraperitoneal abscesses as they may accompany a tumor.
Case Report: Can Ruptured Aneurysms in the Hypoplastic and Plexiform Posterior Inferior Cerebellar Arteries Be Safely Occluded?
Authors: Kun Hou, Jinlu Yu
Journal: Front Neurol (2022)
Keywords: aneurysm, endovascular treatment, hypoplastic, plexiform, posterior inferior cerebellar artery, subarachnoid hemorrhage
MeSH terms: Case Reports

Aneurysms arising from the posterior inferior cerebellar artery (PICA) are not rare and may originate from the proximal or peripheral segment of the PICA. However, when the affected PICA is hypoplastic and plexiform, it is difficult to occlude the aneurysm without sacrificing the parent vessel, the PICA. This type of aneurysm is rare, and whether it is safe to occlude the aneurysm and the parent artery, in cases of a ruptured aneurysm of the hypoplastic and plexiform PICA, has not been adequately studied and is still open to debate. In this report, two patients with ruptured aneurysms in the hypoplastic and plexiform PICA were presented. Both patients were admitted to our hospital for subarachnoid hemorrhage. After team discussions between the neurosurgeons and neurointerventionalists, the aneurysm and parent PICA had to be occluded via endovascular treatment under general anesthesia. One of the patients developed postprocedural brainstem infarction and exhibited favorable recovery. The other patient died of pulmonary infection, although improvement in the postoperative state was observed. Although rare, aneurysms can originate from the hypoplastic and plexiform PICA. Occluding the aneurysm and hypoplastic parent PICA via endovascular treatment might be a reasonable option.
Detecting changes in the blood flow of the optic disk in patients with nonarteritic anterior ischemic optic neuropathy via optical coherence tomography-angiography
Authors: Qing Xiao, Chuan-Bin Sun
Journal: Front Neurol (2023)
Keywords: ganglion cell complex (gcc), nonarteritic anterior ischaemic optic neuropathy, optical coherence tomography angiography, vessel density (vd), visual field (vf)

Purpose:
This study aimed to evaluate the changes in the blood flow of the optic disk in patients with nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography-angiography (OCTA) and to investigate the relationship among the changes in the blood flow of the optic disk, visual field defect, peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell complex (mGCC).
Methods:
This was a prospective observational case series study. A total of 89 patients (89 eyes) with NAION were included in this study. All patients underwent best corrected visual acuity (BCVA), slit-lamp and direct ophthalmoscopic examinations, color fundus photography, visual field test, and blood flow indicators of the radial peripapillary capillaries (RPC) including whole en face image vessel density (VD), peripapillary VD by OCTA, the peripapillary RNFL, and mGCC by spectral-domain optic coherence tomography (OCT). The changes of blood flow in the optic disk at ≤3, 4-8, 9-12, 13-24, and >24 weeks of the natural course of NAION were measured, and the relationship among the changes in the blood flow of the optic disk, visual field defect, peripapillary RNFL, and mGCC was also analyzed.
Results:
The mean age of 89 patients with NAION was 56.42 ± 6.81 years (ranging from 39 to 79). The initial RPC whole en face image VD was significantly reduced after acute NAION (≤3 weeks) (F = 45.598, P < 0.001) and stabilized from the eighth week onward. Over the course of NAION, the superonasal RPC, superior mGCC, and superotemporal RNFL decreased mostly with time (F = 95.658, 109.787, 263.872, respectively; P < 0.001). Maximal correlations were found between superior mGCC and temporosuperior RPC in the NAION phase (R = 0.683, P < 0.01) and between superonasal RPC and superonasal RNFL (R = 0.740, P < 0.01). The mean defect was correlated with temporosuperior RPC (R = -0.281, P < 0.01) and superior mGCC (R = -0.160, P = 0.012).
Conclusion:
Over the course of NAION, OCTA shows a tendency toward change in the retinal capillary plexus of the optic disk. OCTA is proved to be a practical and useful tool for observing papillary perfusion in NAION.
Does PD-1 blockade play a decisive role in the pathological complete remission of unresectable MSS, BRAF V600E-mutated metastatic colorectal cancer: A case report
Authors: Li Tan, Qing-Shu Li, Dong Peng, Yong Cheng
Journal: Front Oncol (2023)
Keywords: case report, colorectal cancer (crc), immunotherapy, microsatellite-stable (mss), programmed death-1 inhibitor (pd-1 inhibitor), targeted therapy
MeSH terms: Case Reports

Background:
Colorectal cancer (CRC) ranks third in highest incidence among human cancers. With the continuous development of anti-cancer drugs, CRC patients are treated more and more effectively. However, the treatment of patients with unresectable metastatic CRC (mCRC) remains a core point for surgeons worldwide, especially for those with microsatellite stability (MSS) and BRAF V600E mutation, who have been reported to have the worst prognosis.
Case description:
We report a case of pathological complete remission in a patient with unresectable MSS, BRAF V600E-mutated metastatic rectal cancer after using Vemurafenib and Cetuximab in combination with Camrelizumab.
Conclusions:
This case suggested that Vemurafenib and Cetuximab combined with Camrelizumab is effective in the treatment of MSS, BRAF V600E-mutated mCRC. To benefit more patients, further studies need to be completed.