OpenMed/multicare-articles huggingface dataset:
Acquired thrombotic thrombocytopenic purpura in a patient with plasmodium vivax malaria: A case report
Authors: Daren Esteban Araque Gualtero, Diego Augusto Moreno Diaz, Julie Melissa Mogollón, Andrés Felipe Gómez Rueda
Journal: Rev Soc Bras Med Trop (2024)
MeSH terms: Malaria, Vivax / complications, Malaria, Vivax / diagnosis, Malaria, Vivax / drug therapy, Purpura, Thrombotic Thrombocytopenic / complications, Purpura, Thrombotic Thrombocytopenic / diagnosis, Case Reports, Aged, Humans, Male, Plasma Exchange, Thrombotic thrombocytopenic purpura, acquired

Acquired thrombotic thrombocytopenic purpura (TTP) is a rare life-threatening disorder characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and organ damage. We present the case of a 71-year-old man initially diagnosed with malaria-like symptoms and displaying markers of microangiopathic hemolytic anemia, severe thrombocytopenia, renal injury, and neurological impairment. Despite antimalarial treatment, acquired TTP was suspected. Plasma exchange and immunosuppressive therapy led to clinical improvement, normalizing the platelet count and hemolytic profile. Diagnostic confirmation revealed significantly reduced ADAMTS13 levels. Following the proposed treatment, the patient's ADAMTS13 levels normalized. This case illustrates acquired TTP linked to uncomplicated Plasmodium vivax malaria.
Case report: Pediatric low-grade gliomas: a fine balance between treatment options, timing of therapy, symptom management and quality of life
Authors: Nicolette Joh-Carnella, Glenn Bauman, Torunn I Yock, Shayna Zelcer, Sabin Youkhanna, Chantel Cacciotti
Journal: Front Oncol (2024)
Keywords: case report, chemotherapy, pediatric low-grade glioma, pilocytic astrocytoma, proton radiation
MeSH terms: Case Reports

Introduction:
Pediatric low-grade gliomas (pLGG) are the most common brain tumor in children and encompass a wide range of histologies. Treatment may pose challenges, especially in those incompletely resected or those with multiple recurrence or progression.
Case description:
We report the clinical course of a girl diagnosed with pilocytic astrocytoma and profound hydrocephalus at age 12 years treated with subtotal resection, vinblastine chemotherapy, and focal proton radiotherapy. After radiotherapy the tumor increased in enhancement temporarily with subsequent resolution consistent with pseudoprogression. Despite improvement in imaging and radiographic local control, the patient continues to have challenges with headaches, visual and auditory concerns, stroke-like symptoms, and poor quality of life.
Conclusion:
pLGG have excellent long-term survival; thus, treatments should focus on maintaining disease control and limiting long-term toxicities. Various treatment options exist including surgery, chemotherapy, targeted agents, and radiation therapy. Given the morbidity associated with pLGG, individualized treatment approaches are necessary, with a multi-disciplinary approach to care focused on minimizing treatment side effects, and promoting optimal quality of life for patients.
Acute pulmonary embolism combined with acute myocardial infarction as the first manifestation of acute leukemia: a case report
Authors: Shuzhan Zheng, Sha Luo, Yong Luo, Dan Liu, Wenwu Zheng, Qing Peng
Journal: Front Cardiovasc Med (2023)
Keywords: acute myeloid leukemia, acute myocardial infarction, percutaneous coronary intervention, pulmonary embolism, thrombocytopenia
MeSH terms: Case Reports

Thrombotic complications in acute myeloid leukemia (AML) are uncommon due to coagulation dysfunction and thrombocytopenia. We report a unique case of AML presenting as concomitant pulmonary embolism and atypical acute myocardial infarction. A 67-year-old male experienced persistent bilateral chest pain. Despite an unremarkable electrocardiogram, elevated D-dimer and mildly increased troponin T levels prompted further investigation, leading to the diagnosis of simultaneous pulmonary embolism and acute myocardial infarction. The patient underwent percutaneous coronary intervention and received triple antithrombotic therapy. However, antithrombotic therapy was discontinued following a sharp decline in hemoglobin and platelet counts, and the patient subsequently developed persistent fever. AML was diagnosed via bone marrow biopsy. Chemotherapy was not initiated due to the patient's deteriorating condition, and he ultimately succumbed to presumed intracranial bleeding.
Carnitine-acylcarnitine translocase deficiency: a case report with autopsy
Authors: Chennakeshava Thunga, Suvradeep Mitra, Devi Dayal, Sadhna Lal
Journal: Autops Case Rep (2024)
Keywords: autopsy, fatty liver, pathology
MeSH terms: Case Reports

Fatty acid oxidation defects are a heterogeneous group of disorders related to the mitochondrial fatty acid oxidation pathway. Carnitine acylcarnitine translocase (CACT) is an enzyme responsible for the unidirectional transport of acylcarnitine across the inner mitochondrial membrane. This enzyme plays a crucial role in the oxidation of fatty acids. The autopsy pathology of the CACT deficiency is described in only a few cases. We describe the autopsy pathology of a child with CACT deficiency dominantly in the form of microvesicular steatosis of the hepatocytes, renal proximal tubular epithelia, cardiac myocytes, and rhabdomyocytes. The diagnosis was further confirmed on whole exome sequencing with compound heterozygous variants in the exon 1 (c.82G>T, p.Gly28Cys; likely pathogenic) and exon 5 (c.535G>A, p.Asp179Asn; uncertain significance) of the SLC25A20 gene. This case elucidates the histopathology of the liver and the detailed autopsy of a case of CACT deficiency from India.
Thyroid storm-induced acute liver dysfunction and portal hypertension in a patient with Graves' disease: a case report
Authors: Mouna Medhioub, Amal Khsiba, Moufida Mahmoudi, Asma Ben Mohamed, Manel Yakoubi, Emna Haouet, Lamine Hamzaoui
Journal: Future Sci OA (2024)
Keywords: graves' disease, ascites, hepatic failure, portal hypertension, thyroid storm, thyrotoxicosis
MeSH terms: Case Reports

Thyroid storm is a life-threatening condition associated with multiorgan dysfunction and decompensation. We report the case of a 41-year-old woman having Graves' disease presented with thyroid storm complicated with liver dysfunction and portal hypertension in the absence of congestive heart failure or known liver disease. After successful therapeutic management, all biological, clinical and morphological abnormalities regressed.
Case report: A rare case of simultaneous necrotizing fasciitis of the breast and forearm
Authors: Ruofei Xu, Tingting Fang, Weikang Cai
Journal: Front Med (Lausanne) (2024)
Keywords: diabetes mellitus, early surgical treatment, hepatitis b, necrotizing fasciitis, severe implications
MeSH terms: Case Reports

Necrotizing fasciitis is an aggressive bacterial infection that causes necrosis of the fascia and subcutaneous tissues with rapid progression and high mortality. Early stages often lead to misdiagnosis, resulting in improper treatment and severe implications. This case study presents a patient with diabetes mellitus combined with hepatitis B who rapidly developed necrotizing fasciitis of the left forearm and left breast after trauma and controlled the infection with early surgical treatment. It is worth noting that early surgical exploration is the gold standard for the diagnosis of necrotizing fasciitis and is the most effective means of reducing mortality and amputation rates in necrotizing fasciitis.
Case report: Two cases of prostate adenocarcinoma progressing to rare sarcomatoid carcinoma with normal PSA levels following endocrine therapy
Authors: Zhicheng Dai, Weikang Wang, Haifang Guan, Xiaohui Wang, Yongheng Ren, Ying Qiu, Jie Liu
Journal: Front Oncol (2024)
Keywords: carcinoma, endocrine therapy, malignant tumor, prostate, sarcomatoid carcinoma
MeSH terms: Case Reports

Background:
Patients with prostate adenocarcinoma undergoing regular endocrine therapy may maintain normal PSA levels during follow-up, yet still progress to the highly malignant and rare prostatic sarcomatoid carcinoma, which is seldom reported. This article presents two case studies of prostatic sarcomatoid carcinoma. To date, only a few publications have described prostatic sarcomatoid carcinoma, and the clinical, morphological, and molecular dimensions of prostate adenocarcinoma warrant further investigation.
Case description:
Patient A was admitted two years ago due to difficulty urinating, with a PSA level of 6.35 ng/ml. A prostate needle biopsy was performed, and the postoperative pathology diagnosed prostate adenocarcinoma with a Gleason score of 9 (5 + 4, grade group 5). Citing personal reasons, the patient declined a radical prostatectomy and instead received ongoing androgen deprivation therapy (ADT), comprising goserelin, abiraterone, and prednisone. During follow-up, regular PSA tests showed no abnormalities. One year ago, the patient was admitted again due to difficulty urinating and hematuria, choosing to address only the urethral obstruction. Transurethral resection of the prostate was performed, and the postoperative pathology diagnosed sarcomatoid carcinoma of the prostate. Patient B was admitted three years ago due to difficulty urinating accompanied by hematuria. A prostate MRI and a whole-body radionuclide bone scan suggested prostate cancer with bone metastasis. Prostate needle biopsy confirmed the diagnosis. The patient was then regularly treated with androgen deprivation therapy, using goserelin. Throughout the follow-up period, the PSA levels consistently remained within normal limits. One year ago, the patient was admitted due to rectal bleeding. It was speculated that the symptoms of rectal bleeding might have been caused by the prostate cancer invading the rectal wall. A prostate needle biopsy was performed, and the pathology diagnosed sarcomatoid carcinoma of the prostate.
Conclusions:
This case underscores the inadequacy of relying solely on PSA levels to monitor high-grade prostate adenocarcinoma during endocrine therapy, as patients may progress to highly malignant atypical variants despite normal PSA levels. We propose that for high-grade prostate cancer patients who are unable to undergo radical prostatectomy, regular and frequent MRI screenings or repeat biopsies should be integral during endocrine therapy and follow-up. Furthermore, a detailed review of the patient's treatment history and clinical data, including immunohistochemical findings, might offer deeper clinical insights into prostatic sarcomatoid carcinoma.
Isolation of Mycoplasma salivarium in the empyema of a diabetic patient with deep neck infection and necrotizing mediastinitis: A case report
Authors: Ning-Chun Weng, Wen-Liang Yu
Journal: IDCases (2023)
Keywords: empyema, m salivarium, maldi-tof-ms, mycoplasma spp, pcr
MeSH terms: Case Reports

Mycoplasma species (spp.) are predominantly found in the human oropharynx, and extracavity infections are rare. Conventional culture limitations hinder Mycoplasma spp. recovery, potentially causing overlooked infections. Molecular techniques reveal their roles in various infections. Mycoplasma pneumoniae causes pneumonia, while Mycoplasma salivarium (M. salivarium) in empyema is scarcely reported. We present a case of a 61-year-old man who suffered from tonsillitis, deep neck infection, necrotizing mediastinitis, and bilateral pleural infections. Mixed pathogens, mainly M. salivarium, were implicated.
Case report of a ruptured right atrial aneurysm in a child and a comprehensive literature review
Authors: Jie Zhou, Hao Xin, Qiao Li, Mei Zhu
Journal: Front Pediatr (2024)
Keywords: atrial aneurysm, echocardiography, pericardial effusion, right atrium, rupture
MeSH terms: Case Reports

Background:
The right atrial aneurysm is a rare cardiac malformation of unknown origin. It is typically asymptomatic but can occasionally lead to life-threatening and serious complications.
Case description:
We present a case of a right atrial aneurysm in an eight-year-old child who experienced complications including rupture of the atrial aneurysm, thrombosis, and recurrent large pericardial effusions over a one-month period. Following surgical treatment, the child had a favorable prognosis.
Conclusion:
A congenital right atrial aneurysm may manifest as either a widespread enlargement of the right atrium or a localized, smaller sac-like protrusion. In the latter case, diagnosis can be challenging to confirm through transthoracic echocardiography alone, and may require a cardiac computed tomography angiography examination for a definitive diagnosis. For patients experiencing recurrent large volumes of bloody pericardial effusion within one month, and exhibiting no atrial enlargement but showing abnormalities of the atrial wall in echocardiography, it is important to be vigilant about the potential for atrial aneurysm rupture in the heart. Timely treatment is essential to prevent the progression of the condition, which could otherwise result in a poor prognosis.
The Importance of Fetoplacental Doppler Velocimetry for Fetal Surveillance During General Anesthesia for Non-obstetric Surgery
Authors: Silvio Tartaglia, Bruno A Zanfini, Salvatore Gueli Alletti, Gaetano Draisci, Antonio Lanzone
Journal: Cureus (2024)
Keywords: cesarean section (cs), doppler ultrasound, electronic fetal monitoring, fetal heart rate, general anesthesia
MeSH terms: Case Reports

Fetal heart rate monitoring during general anesthesia for non-obstetric surgery at viable gestational ages is recommended to evaluate fetal well-being during the intervention. Alteration induced by anesthetic drugs could mimic fetal acute hypoxia, leading to pointless Cesarean sections. We report a case of a pregnant woman in the third trimester undergoing neurosurgical surgery. The continuous heart rate registration showed a non-reassuring pattern, potentially inducing the multidisciplinary team to expedite the delivery. The seriate fetoplacental Doppler evaluations were reassuring about normal fetal conditions, suggesting that ultrasound surveillance could be more reliable than intraoperative heart rate monitoring.
Rehabilitation of Ectodermal Dysplasia Using CAD/CAM Mandibular Complete Denture and Maxillary Overdenture: A Clinical Report
Authors: Hatem Alqarni, Faisal Alzeghaibi, Sahar Alotaibi, Raghad Alamri, Raghad Aljohani, Majed S Altoman, Mohammed A Alfaifi
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Ectodermal dysplasia is a genetic disorder characterized by the abnormal development of two or more ectodermally driven structures, leading to various clinical manifestations such as sparse hair, dry skin, and hypodontia or anodontia. The absence of teeth significantly impacts the quality of life for individuals affected by this condition. This article presents a clinical case report of a patient with ectodermal dysplasia who underwent full mouth rehabilitation using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate a mandibular complete denture and a maxillary overdenture.
Non-capsulated Neisseria meningitidis sepsis in a paroxysmal nocturnal hemoglobinuria patient treated with ravulizumab: case report and review of the literature
Authors: Nicole Galli, Loredana Pettine, Mauro Panigada, Laura Daprai, Grazia Suriano, Anna Grancini, Wilma Barcellini, Bruno Fattizzo
Journal: Front Immunol (2023)
Keywords: neisseria meningitides, eculizumab, paroxysmal nocturnal hemoglobinuria, proximal complement inhibitors, ravulizumab
MeSH terms: Hemoglobinuria, Paroxysmal / diagnosis, Hemoglobinuria, Paroxysmal / drug therapy, Neisseria meningitidis, Pancytopenia, Sepsis / diagnosis, Sepsis / drug therapy, Sepsis / etiology, Thrombosis / drug therapy, Review, Case Reports, Research Support, Non-U.S. Gov't, Complement Inactivating Agents / therapeutic use, Hemolysis, Humans, ravulizumab, Complement Inactivating Agents

Paroxysmal nocturnal haemoglobinuria (PNH) is a rare acquired haematopoietic stem cell disease characterized by complement-mediated intravascular hemolysis, thrombosis, and bone marrow failure. Eculizumab and ravulizumab are anti-C5 monoclonal antibodies that reduce hemolysis, anaemia and thrombotic risk, but are associated with increased risk of infection with encapsulated bacteria, including Neisseria meningitidis. We report a case of life-threatening infection by non-groupable Neisseria meningitidis in a young PNH patient treated with ravulizumab. Despite prompt admission to the intensive care unit, microbe isolation was delayed due to the negativity of capsular antigens, and the patient required intubation, dialysis, and transfusion support for pancytopenia. Notably, PNH disease activity remained controlled and no additional anti-C5 doses were administered. Increasing awareness regarding septic risk in PNH patients on complement inhibitors despite vaccinations is pivotal. A warning about serotypes generally not pathogenetic and not covered by vaccination, such as non-capsulated forms, is emerging.
Pembrolizumab Therapy Leading to Complete Remission for Recurrence of Pulmonary Metastases after their Resection and Radical Cystectomy following Gemcitabine and Cisplatin Therapy
Authors: Kyohei Ishida, Go Hasegawa, Takehisa Hashimoto, Yohei Ikeda, Noboru Hara, Tsutomu Nishiyama
Journal: Case Rep Urol (2024)
MeSH terms: Case Reports

A 64-year-old man was diagnosed with invasive bladder and right lower ureteral urothelial cancer with right pelvic lymph node and lung metastases. He received four courses of gemcitabine and cisplatin therapy. He underwent lung metastasectomy and radical cystoprostatectomy, with not only primary lesions but also metastatic lesions showing a complete response. New multiple lung metastases were revealed five months after adjuvant chemotherapy. On starting pembrolizumab therapy, the metastatic lesions are notably reduced in size. He is currently receiving pembrolizumab therapy, and no recurrence has been observed for over one year.
Anaphylactic Shock Due to Technetium (99mTc)-Tetrofosmin During Myocardial Perfusion Scintigraphy: A Case Report
Authors: Sho Hashimoto, Tetsuya Tanaka, Yoshiaki Shimoda, Mariko Tanaka, Morihiko Kondo
Journal: Cureus (2024)
Keywords: allergic reaction, anaphylactic shock, myocardial scintigraphy, stable ischemic heart disease, technetium tc-99m
MeSH terms: Case Reports

Myocardial perfusion scintigraphy is a popular minimally invasive method for evaluating chronic coronary disease (CCD). We performed myocardial scintigraphy to assess CCD in a 74-year-old man with a history of allergy to contrast media. The patient developed anaphylactic shock immediately after the administration of the technetium (99mTc)-tetrofosmin preparation. This is the first report of anaphylactic shock due to 99mTc-tetrofosmin administration during myocardial perfusion scintigraphy.
Chronic Morel-Lavallée Lesion in a Pediatric Patient: An Underrecognized Sequela after Trauma
Authors: Anthony O Kamson, Bradley Lazzari, Joshua Murphy
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Morel-Lavallée lesions are serious internal degloving injuries associated with trauma. Its diagnosis and treatment can be challenging. We describe the surgical treatment of a case of a chronic Morel-Lavallée lesion in a pediatric patient who sustained an injury to her left thigh during an all-terrain vehicle accident more than a year ago.
Description of the parasitic fauna of a specimen of Didelphis albiventris at Rio Grande do Sul
Authors: Julia Somavilla Lignon, Diego Moscarelli Pinto, Silvia Gonzalez Monteiro, Natália Soares Martins, Julia Victória de Souza, Giulia Ribeiro Meireles, Tamires Silva Dos Santos, Felipe Geraldo Pappen, Fábio Raphael Pascoti Bruhn
Journal: Braz J Vet Med (2024)
Keywords: coproparasitological, endoparasites, marsupial, wildlife, zoonosis
MeSH terms: Case Reports

Didelphis albiventris is considered the most common marsupial in Rio Grande do Sul. With omnivorous and synanthropic habits, it can serve as a host to various parasites, playing an important role in maintaining their biological cycle. Despite being a widespread and abundant species, it has a relatively little-known parasitic fauna. Therefore, the aim of this study was to report the diversity of parasites in a fecal sample from D. albiventris in Rio Grande do Sul, Southern Brazil. Modified Centrifugal-flotation and Spontaneous sedimentation techniques were used, revealing a high taxonomic diversity of parasites. Eggs of Ancylostoma spp., Toxocara spp., and Anoplocephalidae were reported for the first time in the host in the southern region of the country, along with the first report of pseudoparasitism by Syphacia spp. and Monocystis spp. in this animal species. The presence of different parasites in the feces of D. albiventris is of utmost importance, primarily for public health, but also for understanding the biodiversity of parasites present in wildlife, which has been poorly studied until now. This allows the implementation of effective strategies for controlling, preventing and treating these diseases.
Expectant management for umbilical artery thrombosis in the third trimester of pregnancy: a case report
Authors: Mei-Qin Gong, Yong-Qing Zhang, Xiao-Dong Wang
Journal: Front Pharmacol (2024)
Keywords: case report, fetal distress, third trimester, ultrasound monitoring, umbilical artery thrombosis
MeSH terms: Case Reports

Background:
Umbilical artery thrombosis (UAT) is a rare complication of pregnancy and is associated with adverse pregnancy outcomes, including fetal intrauterine distress, intrauterine growth restriction, and still birth. UAT is unpredictable, and prenatal diagnosis is challenging. There is no consensus on the treatment strategy of UAT, especially for patients with prenatal detection of one of the umbilical artery embolisms. In most previous cases, an emergency cesarean section was performed, or intrauterine fetal death occurred at the time of UAT diagnosis.
Case presentation:
In this report, we describe a case of thrombosis in one of the umbilical arteries detected by routine ultrasonography at 31+3 weeks of gestation in a 34-year-old woman. Following expectant management with intensive monitoring for 4 four days, an emergency cesarean section was performed because of abnormal fetal umbilical cord blood flow and middle cerebral artery blood flow; the newborn was in good condition at birth. The final umbilical cord histopathology revealed thrombosis in one of the umbilical arteries. Both mother and newborn described in this case underwent long-term follow-up for nearly 2 two years and are currently in good health without any complications.
Conclusions:
Based on our experience, obstetricians should comprehensively consider the current gestational age and fetal intrauterine status when UAT is suspected to determine the best delivery time. The appropriate gestational age should be prolonged as long as the mother and fetus are stable when the fetus is immature, trying our best to complete the corticosteroid treatment to promote fetal lung maturity and magnesium sulfate to protect fetal brain. During expectant management, ultrasound monitoring, electronic fetal heart monitoring, and fetal movement counting should be strengthened. Clinicians should ensure that the patients and their families are informed about all potential risks of expectant management for UAT.
Fatal hyperpyrexia caused by xylazine: a case report
Authors: Ping Dai, Yanqing Chen, Xianqin Luo, Zhiqiang Zhou, Mengdi Shi, Aerbusili Genjiafu, Xiangdong Jian
Journal: Front Pharmacol (2024)
Keywords: drugs, human, hyperpyrexia, poisoning, xylazine
MeSH terms: Case Reports

Xylazine is used in veterinary medicine as a sedative, analgesic, and muscle relaxant. However, in recent decades, it has frequently been detected in illicit drugs. Xylazine poisoning is characterized by depression of the central nervous and cardiovascular systems. Herein, we present a case of a 41-year-old man who not only had severe depression of the central nervous and cardiovascular systems, but also developed hyperpyrexia during the treatment of xylazine poisoning, which led to his death 3 days after poisoning. This case indicates that, in addition to its other effects, xylazine may also cause hyperthermia, which has not yet been reported in humans.