OpenMed/multicare-articles huggingface dataset:
Mycobacterium bovis Infection of a Deep Brain Stimulation System Following Intravesical Bacillus Calmette-Guérin (BCG) Instillation
Authors: Linda E Spruijt, Arne Mosch, Carel F E Hoffmann, Cees van Nieuwkoop, Jasper D Tijsterman, Rodi Zutt, Niels A van der Gaag, M Fiorella Contarino
Journal: J Parkinsons Dis (2024)
Keywords: bacillus calmette guerin, parkinson’s disease, deep brain stimulation, infection, mycobacterium bovis
MeSH terms: BCG Vaccine / administration & dosage, BCG Vaccine / adverse effects, Deep Brain Stimulation / adverse effects, Mycobacterium bovis, Parkinson Disease / drug therapy, Parkinson Disease / therapy, Urinary Bladder Neoplasms / drug therapy, Case Reports, Adjuvants, Immunologic / administration & dosage, Adjuvants, Immunologic / adverse effects, Administration, Intravesical, Aged, Humans, Male, Tuberculosis / drug therapy, BCG Vaccine, Adjuvants, Immunologic

Deep brain stimulation (DBS) is an advanced treatment in Parkinson's disease. We describe a 71-year-old patient in whom the DBS got infected with Mycobacterium bovis shortly after intravesical BCG instillations as an adjuvant treatment of bladder cancer. The DBS internal pulse generator and extension wires had to be replaced, and the patient was treated successfully with rifampicin, isoniazid, and ethambutol during three months. This case suggests that physicians need to be aware of the risk of this kind of infection and add a specific Mycobacterial test to the regular cultures.
Civil Society Involvement in Managing the COVID-19 Pandemic: A Case Study of a Large and Congested Urban Community in Bangkok, Thailand
Authors: Suwatjana Noinam, Noppawan Piaseu, Tiraporn Junda, Sukanya Tantiprasoplap, Phachongchit Kraithaworn, Suphanna Krongthaeo, Jantra Keawpugdee, Wanna Sanongdej, Saowaros Kongcheep, Wasana Srisuk
Journal: Health Equity (2024)
Keywords: covid-19 pandemic, thailand, civil society, community management, urban community

Introduction:
The COVID-19 pandemic has significantly impacted Thailand, including urban centers like Bangkok and surrounding areas, highlighting a critical need for effective management within densely populated communities to mitigate its effects.
Methods:
This qualitative study sought to explore community management strategies developed in Khlong Toei, a large, congested urban community in Bangkok, Thailand. Seven in-depth interviews (n=7), six focus groups (n=23), and two brainstorming sessions (n=12) were conducted for this study. Data were collected using Zoom, an online communication platform, and through on-site interviews between August 2021 and March 2022 in the congested urban community of Bangkok, Thailand. The data were analyzed using content analysis.
Results:
All informants (age range: 20-66 years, female respondents: 73.33%) were recruited by a community leader and the abbot of Saphan Temple, the community waiting area in Khlong Toei. The findings revealed two main themes: (1) Caring people, including two subthemes, and (2) Caring community, including two subthemes.
Discussion:
The study's findings provide guiding inputs for management of public fear to prevent emerging or re-emerging infectious pandemics within congested urban communities.
A Case Study and Literature Review of Local Anesthetic Systemic Toxicity During Placement of a Dual-chamber Pacemaker
Authors: Sara King, Perry Nystrom, Jonathan Wajert, Mindy Ferguson
Journal: J Innov Card Rhythm Manag (2024)
Keywords: local anesthetic toxicity syndrome, lidocaine, pacemaker implantation
MeSH terms: Case Reports

Local anesthetics are commonly deployed for a variety of medical procedures across many disciplines. Systemic toxicity is rarely seen in clinical practice, and quick recognition and how to manage this syndrome are crucial. The development of systemic toxicity is influenced by the site of administration, the type of anesthetic used, and the total dose administered. Local anesthetic systemic toxicity (LAST) syndrome is used as a diagnosis to encompass the cardiovascular and pulmonary adverse effects associated with the intradermal and subcutaneous use of local anesthetics-in our case, lidocaine. We present a case of a 37-year-old man who experienced dysarthria, bilateral arm shaking, and sinus tachycardia following the administration of 70 mL of lidocaine 2% during surgery for dual-chamber pacemaker placement. While some form of allergic reaction remained a possibility, the strongest clinical correlation and diagnosis were attributed to LAST.
Pachydermoperiostosis with bilateral ptosis and its associated systemic comorbidities: a rare case report
Authors: Su Su Hlaing, Adeola Yvonne Field, Lizette Lillene Mowatt, Hsu Lei Yee, Cynthia Marie Noguera, Gordon Leon Palmer, Angela Christine Mattis, Christine Carol Nelson, James Christian Fleming
Journal: Pan Afr Med J (2023)
Keywords: jamaica, pachydermia, case report, pachydermoperiostosis, ptosis
MeSH terms: Blepharoptosis / etiology, Osteoarthropathy, Primary Hypertrophic / diagnosis, Case Reports, Comorbidity, Eye, Face, Humans, Rare Diseases

Pachydermoperiostosis is a rare genetic disease known as primary or idiopathic hypertrophic osteoarthropathy (HOA)/Touraine-Solente-Gole syndrome. It is an autosomal dominant or recessive disorder comprising digital clubbing, periostosis, hyperhidrosis, and pachydermia (thickening of facial skin). Ocular manifestations are uncommon; however, blepharoptosis may occur. This case presented with severe bilateral ptosis due to the disease progression. A large 20 mm upper lid resection with levator advancement was performed to improve his ability to see. This is the first reported case of pachydermoperiostosis (PDP) in Jamaica. We present a rare case of pachydermoperiostosis with severe blepharoptosis, who attained a good result with surgical intervention.
Disitamab Vedotin (RC48) combined with bevacizumab for treatment of HR-negative/HER2-positive metastatic breast cancer with liver and brain involvement: A case report
Authors: Fei Qu, Qian Liu, Rongrong Lu, Wei Li
Journal: Front Oncol (2023)
Keywords: her2-positive, rc48, anti-angiogenesis, brain metastatic breast cancer, case report
MeSH terms: Case Reports

Background:
The overexpression of human epidermal growth factor receptor 2 (HER2) is strongly correlated with an elevated risk of developing distant metastases, particularly brain metastases, in breast cancer (BC) cases. RC48 (also known as Disitamab vedotin), represents a promising antibody-drug conjugate (ADC), that comprises three well-defined components: hertuzumab against the prominent tumor target-HER2, monomethyl auristatin E (MMAE) and a cleavable linker. Preclinical studies have demonstrated its robust antitumor activity in BC patient-derived xenograft models with HER2-positive or HER2-low expression. Additionally, antiangiogenic drugs like bevacizumab have shown potential efficacy on advanced BC via inhibiting pathological neovascularizationits.
Case presentation:
Here, we will share our experience in treating a 49-year-old woman initially diagnosed with stage IV breast cancer characterized by hormone receptor (HR)-negativity and HER2-positivity. This complex case entailed brain and liver metastases, and the patient exhibited resistance to various HER2-targeted treatment regimens. Finally, the patient received RC48 plus bevacizumab as the advanced forth-line treatment, which was well tolerated with no observed toxicities. Subsequent radiological assessments revealed remarkable regression in the brain metastatic lesions, classified as having partial response based on the RECIST 1.1 system. The period of progression-free survival (PFS) was 7 months.
Conclusion:
The present study underscores the efficacy of systemic treatment with RC48 in conjunction, showcasing substantial enhancement in both radiographic indicators and clinical symptomatology among patients with brain metastatic breast cancer (BMBC). More specifically, the sequential application of ADCs in combination with antiangiogenics presents a novel avenue for advancing the treatment landscape of metastatic BC.
Case report: Acute necrotizing encephalopathy: a report of a favorable outcome and systematic meta-analysis of outcomes with different immunosuppressive therapies
Authors: Stefanie Zaner Fischell, Jonathan Fischell, Tamara Kliot, Jamie Tumulty, Stephen J Thompson, Madiha Q Raees
Journal: Front Neurol (2023)
Keywords: acute necrotizing encephalopathy, autoimmune diseases of the nervous system, immunosuppressive therapy, meta-analysis, outcomes, pediatric neurology
MeSH terms: Systematic Review

Acute Necrotizing Encephalopathy (ANE) is a condition characterized by symmetric, bilateral lesions affecting the thalamus and potentially other areas of the brain following an acute febrile illness. It manifests clinically as abrupt development of encephalopathy, or alteration in mental status that often includes development of seizures and progression to coma. Treatment strategies combine immunosuppressive therapies and supportive care with varying levels of recovery, however there are no universally accepted, data-driven, treatment algorithms for ANE. We first report a case of a previously healthy 10-year-old female with acute onset diplopia, visual hallucinations, lethargy, and seizures in the setting of subacute non-specific viral symptoms and found to have bilateral thalamic and brainstem lesions on MRI consistent with ANE. She was treated with a combination of immunomodulatory therapies and ultimately had a good outcome. Next, we present a meta-analysis of 10 articles with a total of 158 patients meeting clinical and radiographic criteria for ANE. Each article reported immunosuppressive treatments received, and associated morbidity or mortality outcome for each individual patient. Through our analysis, we confirm the effectiveness of high-dose, intravenous, methylprednisolone (HD-IV-MP) therapy implemented early in the disease course (initiation within 24 h of neurologic symptom onset). There was no significant difference between patients treated with and without intravenous immunoglobulin (IVIG). There was no benefit of combining IVIG with early HD-IV-MP. There is weak evidence suggesting a benefit of IL-6 inhibitor tocilizumab, especially when used in combination with early HD-IV-MP, though this analysis was limited by sample size. Finally, plasma exchange (PLEX) improved survival. We hope this meta-analysis will be useful for clinicians making treatment decisions for patients with this potentially devastating condition.
Case report: A novel combination of anomalies in a patient with 22q11.2 deletion syndrome
Authors: Connor Byeman, Ravi Ashwath
Journal: Front Pediatr (2023)
Keywords: 22q112 deletion, digeorge syndrome, atrial septal defect, cervical aortic arch, coarctation of the aorta, conotruncal defects, crisscross pulmonary artery, ventricular septal defect
MeSH terms: Case Reports

A frequently occurring genetic disorder, 22q11.2 deletion syndrome can manifest with various abnormalities. The range of cardiac anomalies associated with this syndrome is extensive, with conotruncal defects being the most prevalent. In this study, we report the case of a patient with a unique combination of anatomical abnormalities such as crisscross pulmonary arteries, a cervical aortic arch with coarctation of the aorta, and a ventricular septal defect. The patient underwent initial surgical intervention, which resulted in significant clinical improvement.
Managing a Pregnancy in the Presence of the Rare Blood Group Antibody PP1Pk
Authors: Alexandra Bonmatí-Santané, Roberto Céspedes López, Jehimy Jean Alvarez Saltos, Jordi Calabia Martínez, Cristina Noboa Paez, Jordi Piedra Sánchez, Natalia Visa Figueredo, Anna Maroto González
Journal: Womens Health Rep (New Rochelle) (2024)
Keywords: anti-pp1pk, autologous blood donation, miscarriage, p phenotype, plasmapheresis
MeSH terms: Case Reports

Pregnant women with p phenotype, who lack antigens P, P1, and Pk, spontaneously form anti-PP1Pk antibodies whose primary target is the placenta. The risk of miscarriage in these women is 50%-70% and reaches 87% in the second trimester. The therapies aim to reduce the titer of antibodies early in pregnancy. They also have risk of hemolytic transfusion reaction, with very few compatible red blood cell donors in the world. In this study, we present a case of successful pregnancy managed with autologous blood donations and plasmapheresis.
A Rare Case of Neurosyphilis with Calvaria Osteitis Presenting in Pregnancy
Authors: Gisella M Newbery, Christine E Henricks, Julie A Vircks, Andreina Colina, David C Mundy
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Background:
The incidence of syphilis throughout the world is increasing. Rates in pregnancy are similarly rising, presenting risks of an untreated syphilis infection that can be detrimental to the mother and fetus. Although routine screening for syphilis infections is recommended at the initial prenatal visit, there is a lack of universal agreement on rescreening pregnant people and approximately 50% of syphilis cases are asymptomatic in the general population. Furthermore, some symptoms of syphilis can overlap with nonspecific pregnancy-related symptoms. Meanwhile, Treponema pallidum can spread to various maternal and fetoplacental tissues quickly after infection and occur at any stage of syphilis.
Case:
A 26-year-old gravida 5 para 2 presented with a new onset headache and visual and auditory changes at 23 weeks of gestation. A computerized tomography scan revealed numerous ill-defined lytic lesions throughout the calvarium, suspicious for syphilitic osteitis. She tested positive for syphilis antibodies with a rapid plasma reagin (RPR) titer of 1 : 32. Cerebrospinal fluid evaluation from a lumbar puncture resulted in reactive fluorescent treponemal antibody (FTA) testing. She was diagnosed with secondary syphilis with osteitis and neuro and otic components. She completed 14 days of intravenous aqueous crystalline penicillin G with additional benzathine penicillin G 2.4 million units intramuscular weekly for two weeks. There was no evidence of congenital syphilis on neonatal examination.
Conclusion:
Syphilitic osteitis and neuro, otic, or ocular syphilis infections occur rarely in the nonpregnant population, and therefore, little data in pregnancy is available to inform outcomes in these specific disease states. It is of paramount importance to complete appropriate syphilis screening, recognize symptoms, and consider utilizing rescreen protocols to ensure prompt infection identification and treatment. For neuro, otic, and ocular syphilis, aqueous crystalline penicillin G (as opposed to benzathine penicillin G) is required to achieve treponemicidal concentrations in those physiologic compartments. There is no agreement as to the appropriate treatment regimen for the rare finding of syphilitic osteitis.
Synovial Chondromatosis in a Young Athlete: A Report of a Rare Case
Authors: Vivek H Jadawala, Sanjay Deshpande, Salahuddin Ahmed, Sachin Goel, Anmol Suneja
Journal: Cureus (2024)
Keywords: arthroscopy, joint pathology, knee joint, osteochondromatosis, synovial chondromatosis, synovial hypertrophy, synovitis
MeSH terms: Case Reports

Synovial chondromatosis is a rare and benign disorder that involves the synovial lining of joints, synovial sheaths and bursae. The synovial layer of the joint is affected by a metaplastic process which in turn converts it into cartilagenous tissue. Eventually, it gets dislodged and transformed into a loose body in the large joints. We report the case of a 24-year-old young athlete who presented with complaints of painful movements and restriction of joint movements associated with a growing deformity in the right knee joint. This case report aims to describe a rare synovial pathology that necessitated arthroscopic synovectomy and diagnostic arthroscopy to treat, particularly in younger individuals. The atypical feature, in this case, was metaplastic development from the peripheral joint capsule attached to the surrounding cartilage, which, to the extent that the authors are aware, has only been documented in one instance in the record. Magnetic resonance imaging (MRI) was performed which demonstrated evidence of the joint effusion, synovial hypertrophy and a loose calcific body just anterior of the distal femoral condyle causing pressure over the patellar tendon anteriorly as well as a hyper-dense cyst in the popliteal region. Treatment often requires partial or complete synovectomy with either an arthroscopic or open approach.
Management of primary anorectal mucosal melanoma during the COVID-19 pandemic
Authors: Edgar Fermín Yan-Quiroz, Folker Mijaíl Agreda-Castro, Lita Diaz-Lozano, Richard Tenazoa-Villalobos, Lissett Jeanette Fernández-Rodríguez
Journal: Ecancermedicalscience (2023)
Keywords: covid-19, peru, anorectal melanoma, nivolumab, radiation therapy, radiotherapy, surgery
MeSH terms: Case Reports

Anorectal melanoma is a rare and difficult-to-diagnose highly malignant cancer with a poor prognosis. The treatment usually involves surgery and often includes adjuvants such as radiation therapy and immunotherapy. We present a case of a 77-year-old Peruvian who was eventually diagnosed with this cancer during the COVID-19 pandemic, which complicated her treatment and allowed the cancer to spread. Her treatment included abdominoperineal resection, bilateral pelvic lymphadenectomy, left internal iliac vein raffia and end colostomy, followed by 3D radiation therapy (50 Gy, 25 sessions) and systemic treatment with nivolumab, all of which were well tolerated. The patient was alive as of 20 August 2023, having survived for more than 3 years since the onset of symptoms.
Efficacy of omadacycline in the treatment of Legionella pneumonia: a case report
Authors: Yao Wang, Shui-Min Yi, Si-Min Huang, Wei-Xin Xu, Yi-Wen Wei, Qiang Qu, Jian Qu
Journal: Front Cell Infect Microbiol (2024)
Keywords: legionella, legionella pneumonia, moxifloxacin, novel tetracycline, omadacycline
MeSH terms: Anti-Bacterial Agents / pharmacology, Anti-Bacterial Agents / therapeutic use, Legionella pneumophila / drug effects, Legionnaires' Disease / drug therapy, Legionnaires' Disease / microbiology, Tetracyclines / therapeutic use, Case Reports, Community-Acquired Infections / drug therapy, Community-Acquired Infections / microbiology, Humans, Male, Middle Aged, Moxifloxacin / therapeutic use, Treatment Outcome, omadacycline, Tetracyclines, Anti-Bacterial Agents, Moxifloxacin

Legionella, one of the main pathogens that causes community-acquired pneumonia, can lead to Legionella pneumonia, a condition characterized predominantly by severe pneumonia. This disease, caused by the bacterium Legionella pneumophila, can quickly progress to critical pneumonia and is often associated with damage to multiple organs. As a result, it requires close attention in terms of clinical diagnosis and treatment. Omadacycline, a new type of tetracycline derivative belonging to the aminomethylcycline class of antibiotics, is a semi-synthetic compound derived from minocycline. Its key structural feature, the aminomethyl modification, allows omadacycline to overcome bacterial resistance and broadens its range of effectiveness against bacteria. Clinical studies have demonstrated that omadacycline is not metabolized in the body, and patients with hepatic and renal dysfunction do not need to adjust their dosage. This paper reports a case of successful treatment of Legionella pneumonia with omadacycline in a patient who initially did not respond to empirical treatment with moxifloxacin. The patient also experienced electrolyte disturbance, as well as dysfunction in the liver and kidneys, delirium, and other related psychiatric symptoms.
Beyond Benign: A Case of Subependymal Giant Cell Astrocytomas Provoking Hydrocephalus in Tuberous Sclerosis Complex
Authors: Antonio Navarro-Ballester, Rosa Álvaro-Ballester, Miguel Ángel Lara-Martínez
Journal: Acta Med Litu (2024)
Keywords: glioma, hydrocephalus, tuberous sclerosis
MeSH terms: Case Reports

22-year-old male diagnosed with Tuberous Sclerosis Complex (TSC), a genetic disorder characterized by benign tumors in various organs, with a focus on neurological implications. Central to the study is the development of Subependymal Giant Cell Astrocytomas (SEGAs), leading to hydrocephalus in the patient. The diagnosis of TSC was made in the patient's childhood, and he was monitored regularly. The study highlights a significant growth in a subependymal nodule, leading to monoventricular hydrocephalus. MRI scans played a crucial role in identifying the progression of SEGAs and the subsequent hydrocephalus. The treatment approach involved endoscopic surgical removal of the SEGA, with histopathology confirming the diagnosis. Post-surgical outcomes over an eight-year follow-up period showed a normalization in ventricular size and the stability of other subependymal nodules, without any complications. This case underscores the importance of regular monitoring for TSC patients, early intervention for complications like hydrocephalus, and the need for a multidisciplinary treatment approach. The case study provides valuable insights into the management of neurodevelopmental disorders and the complexities surrounding TSC and SEGAs.
Case report: Solitary fibrous tumor of the paracervical uterus combined with vaginal wall adenocarcinoma
Authors: Xiaowei Zhang, Jun Chen, Junqiang Du, Jiajia Ying
Journal: Front Med (Lausanne) (2024)
Keywords: mesenchymal tumors, pleura, solitary fibrous tumor, total hysterectomy, uterine cervix, vaginal wall adenocarcinoma
MeSH terms: Case Reports

Background:
Solitary fibrous tumors are rare mesenchymal tumors that typically occur in the pleura. Solitary fibrous tumors of the uterine cervix are uncommon. We report the first case of a patient who underwent total hysterectomy for vaginal wall adenocarcinoma and was found to have a concurrent solitary fibrous tumor in the paracervical-uterus.
Case presentation:
A 51-year-old woman was admitted to our hospital due to contact bleeding. A gynecological examination revealed nodules of 3.0 × 1.0 cm on the vaginal wall, and a colposcopy with biopsy revealed adenocarcinoma of the vaginal wall. After the recommended staging examinations, the patient underwent total hysterectomy, double adnexectomy, pelvic lymph node dissection, and vaginal wall resection. During surgery, a nodule measuring approximately 2 × 2 cm was found in the middle of the mass in the left paracervical region. Subsequent postoperative histopathological examination confirmed an solitary fibrous tumor of the uterine cervix with adenocarcinoma of the vaginal wall. The patient was followed up for 46 months after hospitalization, and no recurrence or distant metastases were observed.
Conclusion:
In rare cases, solitary fibrous tumors may form large masses in the cervical or vaginal wall. They can easily be misdiagnosed as benign or malignant cervical tumors before and during surgery. Postoperative pathology and immunohistochemistry are helpful for diagnosis. Most solitary fibrous cervical tumors are benign, occasionally with low malignant potential, and surgical treatment is feasible and effective.