OpenMed/multicare-articles huggingface dataset:
Delayed Facial Paralysis following Uneventful KTP Laser Stapedotomy: Two Case Reports and a Review of the Literature
Authors: P Révész, Z Piski, A Burián, K Harmat, I Gerlinger
Journal: Case Rep Med (2014)

Facial palsy that occurs immediately after middle ear surgery (stapedectomy, stapedotomy, and tympanoplasty) can be a consequence of the local anesthetics and it regresses completely within a few hours. In the case of delayed facial palsy, the alarming symptom occurs several days or even weeks after uneventful surgery. The mechanism of the neural dysfunction is not readily defined. Surgical stress, intraoperative trauma, or laceration of the chorda tympani nerve with a resultant retrograde facial nerve edema can all be provoking etiological factors. A dehiscent bony facial canal or a multiple microporotic fallopian canal (microtrauma or laser effect) can also contribute to the development of this rare phenomenon. The most popular theory related to the explanation of delayed facial palsy at present is the reactivation of dormant viruses. Both the thermal effect of the laser and the elevation of the tympanomeatal flap can reactivate viruses resting inside the ganglion geniculi, facial nerve, or facial nuclei. The authors report the case histories of a 55-year-old female, and a 45-year-old male who presented with a delayed facial palsy following laser stapedotomy. The clinical characteristics, the therapeutic options, and the possibility of prevention are discussed.
Severe Hypothyroidism Complicated by Myopathy and Neuropathy with Atypical Demyelinating Features
Authors: Malgorzata Monika Brzozowska, Shraddha Banthia, Simon Thompson, Manisha Narasimhan, James Lee
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Autoimmune hypothyroidism may result in a wide range of neuromuscular disorders. The frequently observed neurological manifestations of acquired hypothyroidism include mild to moderate myopathy and sensorimotor neuropathy, which usually resolve by clinical and electrophysiological criteria, in adults treated with thyroid hormone replacement. We report a case of a 30-year-old male with severe hypothyroidism secondary to chronic autoimmune thyroiditis who presented with a 2-year history of progressive fatigue, upper and lower limb weakness, myalgia, and intermittent paraesthesia. His neurological exam demonstrated proximal and distal muscle weakness, lower limb areflexia, and relatively intact sensory modalities. The patient's biochemistry revealed unusually and profoundly raised the thyroid stimulating hormone (TSH) level of 405.5 mIU/L (reference range (RR): 0.27-4.2 mIU/L) and creatine kinase (CK) level of 20,804 U/L (RR: 45-250 U/L), while his nerve conduction studies (NCS) demonstrated severe sensorimotor polyneuropathy with both axonal and demyelinating features. Thyroid hormone replacement therapy over the first 3 months resulted in biochemical normalization of his extremely deranged thyroid function tests (TFTs) and CK levels. At 12 months, despite maintaining euthyroidism and noticeable improvement in strength, his nerve conduction studies (NCS) demonstrated the continued absence of distal motor and sensory responses in his lower limbs with only partial improvement in sensory amplitudes and conduction velocities in his upper limbs. This report highlights the potential for severe neuromuscular consequences from advanced and chronic autoimmune hypothyroidism. The patient's myopathy has resolved over a period of three months with prompt normalization of CK levels. Concerningly, the patient achieved significant but incomplete recovery from his mixed axonal and demyelinating neuropathy with residual mild distal weakness and areflexia in his lower limbs and persistent motor and sensory impairments on his NCS. The severity and incomplete resolution of our patient's neurological manifestations emphasize the importance of early diagnosis and the need for prompt therapeutic intervention for hypothyroidism.
First case of amebic liver abscess 22 years after the first occurrence
Authors: Benoît Nespola, Valérie Betz, Julie Brunet, Jean-Charles Gagnard, Yves Krummel, Yves Hansmann, Thierry Hannedouche, Daniel Christmann, Alexander W Pfaff, Denis Filisetti, Bernard Pesson, Ahmed Abou-Bacar, Ermanno Candolfi
Journal: Parasite (2015)
MeSH terms: Liver Abscess, Amebic / diagnosis, Case Reports, Acute Kidney Injury / chemically induced, Aged, Antibodies, Protozoan / blood, Antiprotozoal Agents / therapeutic use, Bacterial Infections / diagnosis, Diagnostic Errors, Drug Therapy, Combination, Entamoeba histolytica / immunology, France / epidemiology, Humans, Liver Abscess, Amebic / diagnostic imaging, Liver Abscess, Amebic / drug therapy, Liver Abscess, Amebic / epidemiology, Male, Metronidazole / therapeutic use, Oxyquinoline / administration & dosage, Oxyquinoline / analogs & derivatives, Oxyquinoline / therapeutic use, Senegal, Time Factors, Tomography, X-Ray Computed, Travel, Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects, Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use, West Indies, Antibodies, Protozoan, Antiprotozoal Agents, Metronidazole, Oxyquinoline, Trimethoprim, Sulfamethoxazole Drug Combination, 5-methyl-8-hydroxyquinoline, tilbroquinol

A 72-year-old man consulted in November 2012 for abdominal pain in the right upper quadrant. The patient had a history of suspected hepatic amebiasis treated in Senegal in 1985 and has not traveled to endemic areas since 1990. Abdominal CT scan revealed a liver abscess. At first, no parasitological tests were performed and the patient was treated with broad-spectrum antibiotics. Only after failure of this therapy, serology and PCR performed after liver abscess puncture established the diagnosis of hepatic amebiasis. The patient was treated with metronidazole and tiliquinol-tilbroquinol. Amebic liver abscess is the most frequent extra-intestinal manifestation. Hepatic amebiasis 22 years after the last visit to an endemic area is exceptional and raises questions on the mechanisms of latency and recurrence of these intestinal protozoan parasites.
Criminal Behaviour Associated with a Novel Mutation in the VPS13A-Gene Causing Chorea-Acanthocytosis
Authors: Søren Bruno Elmgreen
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Heralded by obsessive-compulsive disorder and anxiety, chorea-acanthocytosis may initially present in a psychiatric setting. As insidious onset of involuntary movements is commonly precipitated by dopamine blocking agents, this may not prompt further neurological investigation until symptoms progress after withdrawal of the suspected offending drug. Oromandibular dystonia and frontal disinhibition should call for early neurologic evaluation.
Hepatocellular Adenoma in a Patient with Ornithine Transcarbamylase Deficiency
Authors: Lin Cheng, Yajuan Liu, Wenjing Wang, J L Merritt, Matthew Yeh
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

Ornithine transcarbamylase (OTC) deficiency is an X-linked recessive disorder that leads to hyperammonemia and liver damage. Hepatocellular adenoma in OTC deficiency patients has not been previously described. Here we report the first such case to be described in the English language scientific literature.
Report of a Leprosy case in Singapore: an age-old disease not to be forgotten in developed countries with low-prevalence settings
Authors: Yen Ee Tan, Yi Wei Yeo, David Jia Qiang Ang, Michelle Mei Fung Chan, Shiu Ming Pang, Li-Hwei Sng
Journal: Access Microbiol (2019)
Keywords: singapore, developed countries, diagnostics, healthcare worker, leprosy, low prevalence
MeSH terms: Case Reports

Introduction:
Leprosy is rarely reported in developed countries with low-prevalence settings. Its diagnosis may be missed due to its low frequency in non-endemic regions, as well as its long incubation period. The report describes an imported leprosy case of a healthcare worker in Singapore.
Case presentation:
A Filipino nursing personnel presented with a persistent non-tender erythematous plaque over his right upper back for many years despite topical treatment. He had the lesion before coming to Singapore but decided to seek medical consultation only after the lesion progressed with new erythematous papules developing over his face, trunk and upper limbs. Punch biopsies of skin lesions revealed fite-positive bacilli, which were identified to be Mycobacterium leprae by GenoType LepraeDR v1 assay (Hain LifeScience, Germany). No mutation was detected at rpoB (rifampicin), gyrA (ofloxacin) and folP1 (dapsone) gene targets. He was started on multi-drug therapy and responded to the treatment. The only prolonged close contact he had was his housemate who was screened and given a single dose of rifampicin as chemoprophylaxis.
Conclusion:
In non-endemic settings, awareness is crucial in diagnosing leprosy. The availability of molecular testing and multi-disciplinary management are essential in the confirmation and control of this disease of public health importance.
Mucoepidermoid carcinoma of the lung: a case report and literature review
Authors: S Alsidawi, J C Morris, K A Wikenheiser-Brokamp, S L Starnes, N A Karim
Journal: Case Rep Oncol Med (2013)

Introduction. Mucoepidermoid carcinoma (MEC) of the lung is a rare form of lung cancer that is classified into low grade and high grade based on histological features. Surgical resection is the primary treatment for low-grade MEC with excellent outcomes, while high-grade MEC is a more aggressive form of malignancy. Clinical Case. We report a case of a 46-year-old woman who presented with dyspnea on exertion. Imaging studies revealed a mass involving the right upper lobe bronchus. Bronchoscopy, surgical resection, and pathological examination revealed a low-grade MEC with tumor-free margins. No adjuvant treatment was given. Discussion. Primary pulmonary MEC is a rare type of lung cancer with only few reported cases. This patient illustrates a typical presentation for low-grade MEC wherein surgical resection is considered curative. In contrast, high-grade MEC is a more aggressive malignancy with a poorer outcome. The role of targeted therapy directed against EGFR or a novel CRTC1-MAML2 fusion protein expressed in some high-grade tumors is yet to be determined.
Case Report: Surgical Treatment for Intranasal Meningoencephalocele in a Cat
Authors: Yuta Nozue, Midori Yamazaki, Kohei Nakata, Yukiko Nakano, Go Yuki, Arata Kimata, Hiroaki Kamishina
Journal: Front Vet Sci (2020)
Keywords: case report, cribriform plate reconstruction, graft, meningoencephalocele, surgical treatment, tunica vaginalis
MeSH terms: Case Reports

A 4-month-old cat with epileptic seizures and nasal discharge was presented, and diagnosed with intranasal meningoencephalocele based on the clinical symptoms and findings of CT and MRI. As liquorrhea was suspected, the meningoencephalocele was surgically excised and the postoperative course was favorable. For cribriform plate reconstruction, the autologous tunica vaginalis was used. Rhinorrhea of the cerebrospinal fluid and seizures disappeared after surgery. On CT and MRI at 7 months after surgery, septum formation between the cranial and nasal cavities was confirmed. Currently, no seizures have occurred even though no oral antiepileptic agent was administered. There are few reports of surgical treatment for meningoencephalitis, and there are no reports of reconstruction of the cribriform plate using tunica vaginalis, so we reported the details.
Lemierre's disease: a case with bilateral iliopsoas abscesses and a literature review
Authors: Nicholas Te Bird, Derek Cocker, Paul Cullis, Richard Schofield, Ben Challoner, Alastair Hayes, Martin Brett
Journal: World J Emerg Surg (2014)
Keywords: bilateral, fusobacterium, fusobacterium necrophorum, iliopsoas abscess, lemierre
MeSH terms: Review

Lemierre's disease is characterized by sepsis, often with an oropharyngeal source, secondary septic emboli and internal jugular vein thrombosis (Lancet 1:701-3, 1936. Clin Microbiol Rev 20(4):622-59, 2007). Septic emboli affecting many bodily sites have been reported, including the lungs, joints, bones, and brain. The case report describes an unusual case of Lemierre's disease in a 64 year old gentleman causing profound sepsis, acute kidney injury, bilateral iliopsoas abscesses and a right hand abscess. To our knowledge, this is the first reported case of Lemierre's disease in the context of bilateral psoas abscesses, and highlights the ambiguity surrounding the definition of Lemierre's disease. The clinical literature review highlights the difficulty in definitively diagnosing the condition and offers some suggestions for recognising and refining the diagnostic criterion of Lemierre's.
An Unusual Case of Collagenous Gastritis: Incidental Finding in a Patient Presenting with Dysphagia
Authors: Chiu-Hsiang Liao, Maruf Saddik, Stephen Ip
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Collagenous gastritis is a condition characterized by subepithelial deposition of collagen in the gastric mucosa. This condition is rare, with less than 100 cases reported in the literature. Patients with collagenous gastritis typically present with pain or diarrhea. Here, we present a case of a young woman with dysphagia who was found to have esophageal webs and an incidental finding of diffuse gastritis with a cobblestone appearance of the mucosa on endoscopy. Subsequent histology demonstrated features of collagenous gastritis, including mucosal inflammatory infiltrates and collagen deposition. This is one of the few case reports of incidental collagenous gastritis and highlights the importance of judicious use of biopsies.
Adenine Phosphoribosyltransferase Deficiency: A Rare Cause of Recurrent Urolithiasis
Authors: Ata Jaffer, Adrian Joyce, Philip Koenig, Chandra Shekhar Biyani
Journal: J Endourol Case Rep (2017)
Keywords: 2,8-dihydroxyadenine, adenine phosphoribosyl transferase deficiency, urolithiasis
MeSH terms: Case Reports

Background: Recurrent urolithiasis is troublesome for both patient and clinician, and in most cases, an underlying cause is not found. An important and underdiagnosed cause is adenine phosphoribosyltransferase (APRT) deficiency that gives rise to 2,8-dihydroxyadenine (2,8-DHA) stones. If diagnosed early, patient morbidity as well as the financial cost of treating stone recurrence can be avoided with simple medical therapy. Case Presentation: A 36-year-old white, Caucasian male with recurrent urolithiasis was found to have 2,8-DHA stones. This was difficult to manage, as these stones were often large, bilateral, matrix in structure, and translucent on plain X-rays. He underwent a multitude of interventions including both retrograde and anterograde endoscopic approaches as well as extracorporeal shock wave lithotripsy. The specific stone type was eventually discovered through infrared spectroscopy and he was promptly commenced on allopurinol, which significantly improved his stone burden and frequency of presentation with renal colic. Conclusion: APRT deficiency is underdiagnosed given the estimated prevalence of 1/50,000-1/100,000, however, with less than 300 reported cases worldwide. This is likely because of both a lack of awareness of the disorder among clinicians and the challenges of identifying 2,8-DHA stones. Increasing awareness of 2,8-DHA urolithiasis among urologists as well as physicians is, therefore, key in tackling this condition.
First Case of Subcutaneous Mycoses Caused by Dirkmeia churashimaensis and a Literature Review of Human Ustilaginales Infections
Authors: Fengming Hu, Chong Wang, Peng Wang, Lei Zhang, Qing Jiang, Abdullah M S Al-Hatmi, Oliver Blechert, Ping Zhan
Journal: Front Cell Infect Microbiol (2021)
Keywords: dirkmeia, moesziomyces, pseudozyma, ustilaginales, infection, subcutaneous
MeSH terms: Mycoses / drug therapy, Ustilaginales, Case Reports, Research Support, Non-U.S. Gov't, Review, Aged, 80 and over, Antifungal Agents / pharmacology, Antifungal Agents / therapeutic use, Basidiomycota, Echinocandins, Fluconazole, Humans, Microbial Sensitivity Tests, Voriconazole, Antifungal Agents, Echinocandins, Fluconazole, Voriconazole, Dirkmeia churashimaensis

Objective:

Dirkmeia churashimaensis, belonging to Ustilaginales fungi, has never been reported as clinical pathogenic until very recently. In this study, we report an unusual subcutaneous infection with Dirkmeia churashimaensis and reviewed all human Ustilaginales infections. The aim is to better understand their epidemiology, infection type, risk factors, and the sensitivity to antifungal agents.
Methods:
An 80-year-old female farmer developed extensive plaques and nodules on her left arm within 2 years. Pathological and microbiological examinations identified a new pathological agent, Dirkmeia churashimaensis, as the cause of this infection. The patient was successfully cured by oral itraconazole. We reviewed a total of 31 cases of Ustilaginales cases, among of which only three were skin infections.
Results:
Local barrier damage (i.e., surgery, trauma, and basic dermatosis) and systemic immunodeficiency (i.e., preterm and low birthweight, Crohn's disease, malignant cancer, and chemotherapy) are risk factors for Ustilaginales infection. The D1/D2 and ITS regions are the frequently used loci for identifying the pathogens together with phenotype. Most patients could survive due to antifungal treatment, whereas seven patients died. Amphotericin B, posaconazole, itraconazole, and voriconazole showed good activity against these reported strains, whereas fluconazole, 5-flucytosine, and echinocandins usually showed low susceptibility. Itraconazole had good efficiency for subcutaneous infections.
Conclusions:
The present case study and literature review reveal that Ustilaginales can be opportunistic pathogenic normally in immunocompromised and barrier damage people. A proper identification of fungi can be crucial for clinical treatment, and more data of antifungal are needed for choice of medication against this kind of infections.
Achromobacter xylosoxidans Relapsing Peritonitis and Streptococcus suis Peritonitis in Peritoneal Dialysis Patients: A Report of Two Cases
Authors: Rafał Donderski, Magdalena Grajewska, Agnieszka Mikucka, Beata Sulikowska, Eugenia Gospodarek-Komkowska, Jacek Manitius
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

Peritonitis is considered to be the most common complication of peritoneal dialysis (PD). It is usually caused by Gram positive Staphylococcus epidermidis. Achromobacter xylosoxidans (A. xylosoxidans) and Streptococcus suis (S. suis) are rare pathogens, but there is emerging evidence that they may be also responsible for PD related peritonitis. We described 2 cases of rare peritonitis treated in our center. In our opinion this is the first described case of PD related peritonitis caused by Streptococcus suis.
Meningococcemia Masquerading as a Nonspecific Flu-Like Syndrome
Authors: Paula J Watts, Natasha Fazel, Dmitriy Scherbak
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Neisseria meningitidis is a cause of bacterial meningitis and meningococcemia worldwide. Rarely, it causes invasive disease with significant lifelong sequela if survived. Early clinical recognition is key as meningococcemia is an easily treatable disease, yet mortality is 50% if it is left untreated. In this case review, we present a classic case of meningococcemia, with an atypical presentation.
A rare occurrence of primary hepatic leiomyosarcoma associated with epstein barr virus infection in an AIDS patient
Authors: Haritha Chelimilla, Kanthi Badipatla, Ariyo Ihimoyan, Masooma Niazi
Journal: Case Rep Gastrointest Med (2013)

Primary hepatic leiomyosarcoma is exceedingly rare accounting for less than 1% of the hepatic tumors. Close to 45 cases have been reported in the English literature. Presentation is usually nonspecific and diagnosis is often delayed until tumors reach a large size. This leads to a dismal prognosis. The tumors are not yet fully understood, hence the standard of care is not well defined. Curative resection remains the mainstay of management. Close association of Epstein Barr virus (EBV) induced soft tissue sarcomas is proven, especially in the presence of immunosuppression encountered in HIV/AIDS patients and in posttransplant patients. We herein present a case report of a 54-year-old man diagnosed to have HIV/AIDS and EBV infection admitted to our hospital with complaints of intractable hiccups for more than a week. Extensive workup revealed primary leiomyosarcoma of the liver.
Acute idiopathic velopharyngeal insufficiency
Authors: Malika El Omri, Oumaima Gabsi, Wassim Kermani, Mohamed Abdelkefi
Journal: Pan Afr Med J (2020)
Keywords: velopharyngeal, acute, idiopathic, insufficiency
MeSH terms: Speech Disorders / diagnosis, Velopharyngeal Insufficiency / diagnosis, Case Reports, Acute Disease, Adult, Female, Humans, Magnetic Resonance Imaging, Speech Disorders / etiology, Velopharyngeal Insufficiency / physiopathology

Idiopathic velopharyngeal insufficiency is a rare clinical entity. Typical clinical features are rhinolalia and nasopharyngeal regurgitation. It is usually observed in children. We report a case of a 28-year-old female with this rare disorder. The symptoms were rhinolalia and regurgitation of liquids into the nose. The magnetic resonance imaging of the brain and upper cervical region was normal. The infectious serologies were negative.
Role of High-Frequency Oscillation in Locating an Epileptogenic Zone for Radiofrequency Thermocoagulation
Authors: Xin Xu, Xingguang Yu, Guixia Kang, Zhiqi Mao, Zhiqiang Cui, Longsheng Pan, Rui Zong, Yuan Tang, Ming Wan, Zhipei Ling
Journal: Front Hum Neurosci (2021)
Keywords: epilepsy, gray matter nodular heterotopia, high-frequency oscillation, radiofrequency thermocoagulation, stereotactic-electroencephalogram
MeSH terms: Case Reports

Radiofrequency thermocoagulation (RFTC) has been proposed as a first-line surgical treatment option for patients with drug-resistant focal epilepsy (DRE) that is associated with gray matter nodular heterotopia (GMNH). Excellent results on seizures have been reported following unilateral RFTC performed on ictal high-frequency-discharge, fast-rhythm, and low-voltage initiation areas. Complex cases (GMNH plus other malformations of cortical development) do not have good outcomes with RFTC. Yet, there is little research studying the effect of high-frequency oscillation in locating epileptogenic zones for thermocoagulation on unilateral, DRE with bilateral GMNH. We present a case of DRE with bilateral GMNH, treated using RFTC on unilateral GMNH and the overlying cortex, guided by stereotactic electroencephalogram (SEGG), and followed up for 69 months. Twenty-four-hour EGG recordings, seizure frequency, post-RFTC MRI, and neuropsychological tests were performed once yearly. To date, this patient is seizure-free, the electroencephalogram is normal, neuropsychological problems have not been found, and the trace of RFTC has been clearly identified on MRI. His dosage of antiepileptic medication has, furthermore, been significantly reduced. It is concluded that RFTC on unilateral DRE with bilateral GMNH may achieve good long-term effects, lasting up to, and perhaps longer than, 69 months. Ictal high-frequency oscillation (fast ripple) inside the heterotopia and the overlying cortex may be the key to this successful effect.