OpenMed/multicare-articles huggingface dataset:
Indian research on sleep disorders
Authors: Nilesh Shah, Abha Bang, Aparna Bhagat
Journal: Indian J Psychiatry (2010)
Keywords: indian literature on sleep disorders, sleep disorders

Literature on sleep disorders from our country, India, can mainly be found in the Indian journal of Sleep medicine, Indian Journal of psychiatry, The Annals of Indian Academy of Neurology and certain other journals and books. The article highlights the contribution of various Indian doctors in the field of sleep disorders, which includes review articles, prevalence studies, studies on etiology and treatment options, case reports and a couple of case control studies. Also included are studies on various sleep related syndromes as well as studies about awareness and knowledge of sleep disorders amongst the medical fraternity. This is a humble attempt to compile the rich data available in the country on sleep disorders in order to aid further research in the field.
Severe Sepsis due to Clostridium perfringens Bacteremia of Urinary Origin: A Case Report and Systematic Review
Authors: Michael A Millard, Kathleen A McManus, Brian Wispelwey
Journal: Case Rep Infect Dis (2016)

Clostridium perfringens bacteremia is an uncommon yet serious clinical syndrome that typically arises from a gastrointestinal source. However, clinicians should consider nongastrointestinal sources as well. We present a rare case of C. perfringens bacteremia of urinary origin that required surgical intervention for definitive treatment. A 61-year-old male presented with acute nausea and vomiting, altered mental status, and chronic diarrhea. His physical exam revealed right costovertebral tenderness and his laboratory work-up revealed acute renal failure. Percutaneous blood cultures grew C. perfringens. Cross-sectional imaging revealed a right-sided ureteral stone with hydronephrosis, which required nephrostomy placement. On placement of the nephrostomy tube, purulent drainage was identified and Gram stain of the drainage revealed Gram-variable rods. A urinary source of C. perfringens was clinically supported. Although it is not a common presentation, nongastrointestinal sources such as a urinary source should be considered in C. perfringens bacteremia because failure to recognize a nongastrointestinal source can delay appropriate treatment, which may include surgical intervention.
Ovarian germ cell tumors with rhabdomyosarcomatous components and later development of growing teratoma syndrome: a case report
Authors: Usama Al-Jumaily, Maysa Al-Hussaini, Fatenah Ajlouni, Abdulrahman Abulruz, Iyad Sultan
Journal: J Med Case Rep (2012)

Introduction:
Development of a sarcomatous component in a germ cell tumor is an uncommon phenomenon. Most cases reported have a grim prognosis. Growing teratoma syndrome is also an uncommon phenomenon and occurs in approximately 2% to 7% of non seminomatous germ cell tumors and should be treated surgically.
Case presentation:
We report the case of a 12-year-old Asian girl with an ovarian mixed germ cell tumor containing a rhabdomyosarcomatous component. She was treated with a germ cell tumor chemotherapy regimen and rhabdomyosarcoma-specific chemotherapy. Towards the end of her treatment, she developed a retroperitoneal mass that was increasing in size. It was completely resected, revealing a mature teratoma, consistent with growing teratoma syndrome. She is still in complete remission approximately three years after presentation.
Conclusion:
The presence of rhabdomyosarcoma in a germ cell tumor should be treated by a combined chemotherapy regimen (for germ cell tumor and rhabdomyosarcoma). In addition, development of a mass during or after therapy with normal serum markers should raise the possibility of growing teratoma syndrome that should be treated surgically.
Cutaneous silicone granuloma mimicking breast cancer after ruptured breast implant
Authors: Waseem Asim Ghulam El-Charnoubi, Trine Foged Henriksen, Jens Joergen Elberg
Journal: Case Rep Dermatol Med (2011)
MeSH terms: Case Reports

Cutaneous manifestations due to migration of silicone from ruptured implants are rare. Migrated silicone with cutaneous involvement has been found in the chest wall, abdominal wall, and lower extremities. We describe a case of cutaneous silicone granuloma in the breast exhibiting unusual growth mimicking breast cancer after a ruptured implant.
Disseminated varicella-zoster virus infection in an aplastic anemia- paroxysmal nocturnal hemoglobinuria syndrome patient: A case report
Authors: Jie Wang, Zheng Yang, Danhong Ren, Zhanli Shi, Kun Fang, Zhihui Li
Journal: Front Cell Infect Microbiol (2023)
Keywords: aa-pnh syndrome, aplastic anemia, case report, disseminated varicella zoster infection, varicella zoster virus
MeSH terms: Anemia, Aplastic / complications, Chickenpox / complications, Chickenpox / diagnosis, Exanthema / complications, Hemoglobinuria, Paroxysmal / complications, Hemoglobinuria, Paroxysmal / diagnosis, Herpes Zoster / complications, Herpes Zoster / diagnosis, Varicella Zoster Virus Infection / complications, Varicella Zoster Virus Infection / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Herpesvirus 3, Human, Humans, Male

Background:
Varicella-zoster virus (VZV) is a common and widespread human-restricted pathogen. It is famous for its dermatological manifestations, such as varicella and herpes zoster. Patients with aplastic anemia-paroxysmal nocturnal hemoglobinuria (AA-PNH) syndrome complicated with fatal disseminated varicella zoster virus infection are very rare and in danger.
Patient concerns:
A 26-year-old man with a history of AA-PNH syndrome was receiving cyclosporine and corticosteroid treatment in the hematology department. During his hospitalization in our hospital, he developed fever, abdominal pain, and lower back pain, and his face, penis, trunk, and limbs developed itchy rash. Subsequently, the patient had to undergo cardiopulmonary resuscitation because of sudden cardiac arrest, and be transferred to ICU for treatment. It was presumed that the cause is unknown severe sepsis. The patient's condition quickly progressed to multiple organ failure, accompanied by liver, respiratory, and circulatory failure, and signs of disseminated intravascular coagulation. Unfortunately, the patient died after 8 h of active treatment. Finally, we collected all the evidence and concluded that the patient died of AA-PNH syndrome combined with poxzoster virus.
Conclusion:
AA-PNH syndrome patients treated with steroids and immunosuppressants are prone to various infections, considering that herpes virus infection with chickenpox and rash as the initial manifestations is characterized by rapid progress and often accompanied by serious complications. It is more difficult to distinguish it from AA-PNH syndrome with skin bleeding points. If it is not identified in time, it may delay the treatment opportunity, make the condition worse, and cause serious adverse prognosis. Therefore, clinicians need to pay attention to it.
Asymptomatic and Biochemically Silent Pheochromocytoma with Characteristic Findings on Imaging
Authors: Andrew Spiro, Aqueel Usman, Asif Ajmal, Thanh D Hoang, Mohamed K M Shakir
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Pheochromocytomas are tumors that originate from the chromaffin tissue of the adrenal medulla and commonly produce catecholamines. The diagnosis is typically established by the measurement of catecholamines or their metabolites in urine or plasma, and tumors are localized with the use of radiographic and scintigraphic studies. Pheochromocytomas can occur in asymptomatic patients, and the preferred treatment is surgical removal of the tumor. We report a 48-year-old male with a left adrenal incidentaloma, which progressively increased in size from 1.1 cm to 2.6 cm over a 4-year period, as measured by an adrenal computed tomography (CT) scan. Throughout his entire course of treatment, he was asymptomatic with normal blood pressure readings. His biochemical screening was unremarkable for the first three years of tumor surveillance. Follow-up imaging, including CT and MRI, showed findings suspicious for pheochromocytoma, and the diagnosis was ultimately made with the combination of imaging and laboratory studies. He underwent laparoscopic resection of the adrenal mass with confirmation of pheochromocytoma on histology. This case illustrates how CT and MRI findings can alert providers to the presence of a pheochromocytoma, even in an asymptomatic, biochemically negative patient.
Giant Right Atrial Aneurysm Accompanying Intrahepatic Cholestasis
Authors: Ayse Sulu, Osman Baspinar, Selim Kervancıoglu, Samil Hizli
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Right atrial aneurysms were first described in 1955, and subsequently, only a few cases have been reported. The etiology of this condition is unknown. Its comorbidity with cholestasis has not previously been reported in the literature. An 11-month-old baby female, who was an offspring from a first-cousin marriage, was referred to our hospital for investigation of jaundice. She underwent echocardiography because of a heart murmur, and this revealed a giant right atrial aneurysm. In addition, her liver biopsy confirmed the diagnosis of progressive familial intrahepatic cholestasis (PFIC) type 3. Although both conditions are rare, we found their comorbidity interesting and are thus reporting the case.
Spontaneous rupture of a renal artery pseudoaneurysm in a previously hypertensive patient
Authors: Myung-Sung Kim, Young-Bae Lee, Jae-Hyuk Lee, Chae-Wan Lim, Jun-Hyoung Kim, Hye-Min Choi, Dong-Jin Oh
Journal: Clin Hypertens (2015)
Keywords: false aneurysm, hypertension, renal artery, spontaneous rupture
MeSH terms: Case Reports

Previously, renal artery pseudoaneurysms were thought to be extremely uncommon. However, these lesions are now being detected more frequently as incidental findings on computed tomography, magnetic resonance imaging, and the extensive use of angiography. The incidence of ruptured renal artery pseudoaneurysms is very low. We report a case of a giant renal artery pseudoaneurysm (9.4-cm diameter) with severe left flank pain and a syncopal attack in a young woman who did not control high blood pressure for a couple of years.
HIV-Associated CD8 Encephalitis: A UK Case Series and Review of Histopathologically Confirmed Cases
Authors: Sebastian B Lucas, Kum T Wong, Sam Nightingale, Robert F Miller
Journal: Front Neurol (2021)
Keywords: cd8 encephalitis, hiv, antiretroviral therapy, autopsy, brain, corticosteroids, immune reconstitution inflammatory syndrome, viral escape

HIV-associated CD8-encephalitis (HIV-CD8E) is a severe inflammatory disorder dominated by infiltration of the brain by CD8+ T-lymphocytes. It occurs in people with HIV, typically when the virus is apparently well-controlled by antiretroviral treatment (ART). HIV-CD8E presents with symptoms and signs related to marked cerebral inflammation and swelling, and can lead to coma and death unless treated promptly with corticosteroids. Risk events such as intercurrent infection, antiretroviral therapy interruption, immune reconstitution inflammatory syndrome (IRIS) after starting ART, and concomitant associations such as cerebrospinal fluid (CSF) HIV viral escape have been identified, but the pathogenesis of the disorder is not known. We present the largest case series of HIV-CD8E to date (n = 23), representing histopathologically confirmed cases in the UK. We also summarize the global literature representing all previously published cases with histopathological confirmation (n = 30). A new variant of HIV-CD8E is described, occurring on a background of HIV encephalitis (HIVE).Together these series, totalling 53 patients, provide new insights. CSF HIV viral escape was a frequent finding in HIV-CD8E occurring in 68% of those with CSF available and tested; ART interruption and IRIS were important, both occurring in 27%. Black ethnicity appeared to be a key risk factor; all but two UK cases were African, as were the majority of the previously published cases in which ethnicity was stated. We discuss potential pathogenic mechanisms, but there is no unifying explanation over all the HIV-CD8E scenarios.
Case Report: Emphysematous Pyelonephritis With a Congenital Giant Ureterocele
Authors: Hiroyuki Kitano, Keisuke Hieda, Hiroki Kitagawa, Yusuke Nakaoka, Yumiko Koba, Kohei Ota, Norifumi Shigemoto, Tetsutaro Hayashi, Seiya Kashiyama, Jun Teishima, Nobuaki Shime, Hiroki Ohge, Nobuyuki Hinata
Journal: Front Pediatr (2021)
Keywords: actinotignum schaalii, peptoniphilus asaccharolyticus, children, congenital ureterocele, emphysematous pyelonephritis
MeSH terms: Case Reports

A 14-year-old girl noticed malodorous urine and experienced left flank pain. The patient was presented to our hospital with gradually increasing pain. She had no underlying disease but had a history of pain on micturition for several days. Hematologic examination indicated low white blood cell and platelet counts and a high serum lactate level. Computed tomography showed that a part of the parenchyma of the left kidney had poor contrast and was deteriorated, with fluid and gas retention from the perirenal region to the retroperitoneal cavity. A left hydroureter and large ureterocele were observed in the bladder. She was diagnosed with emphysematous pyelonephritis (EPN) with a giant congenital ureterocele. Vasopressors and blood transfusion failed to maintain normal circulatory dynamics, and an open left nephrectomy and transurethral ureterocele fenestration were performed. The excised outer portion of the left kidney was dissolved by the infection and replaced with blood clots and necrotic tissue. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry identified the inflammatory, gas-producing bacteria Actinotignum schaalii, Peptoniphilus asaccharolyticus, and Actinomyces odontolyticus. Meropenem was administered for 4 days postoperatively and then de-escalated to sulbactam/ampicillin for another 10 days. The patient was discharged on day 17 of hospitalization, and the postoperative course remained favorable. EPN is extremely rare in pediatric patients, and it is believed that nephrectomy is sometimes necessary if the patient does not have normal circulatory dynamics despite the use of catecholamines.
HBV-Associated Postinfectious Acute Glomerulonephritis: A Report of 10 Cases
Authors: Yong Zhang, Junxia Li, Weihua Peng, Guoqing Yu, Liping Wang, Jian Chen, Feng Zheng
Journal: PLoS One (2016)
MeSH terms: Glomerulonephritis / complications, Hepatitis B / complications, Case Reports, Acute Disease, Adolescent, Adult, Child, Female, Glomerulonephritis / pathology, Humans, Kidney Glomerulus / pathology, Kidney Glomerulus / ultrastructure, Male

Postinfectious acute glomerulonephritis (PIGN) may occur after various bacterial and viral infections. Hepatitis B virus (HBV) infection is a cause of chronic glomerulonephritis. We report here 10 cases (ages 7-20 years-old) of chronic HBV carriers with acute glomerulonephritis, with positive glomerular staining of hepatitis B surface antigen, and detectable presence of HBV DNA in the glomeruli. This form of PIGN, HBV-PIGN, has not been previously identified. To further characterize clinical and pathological features of HBV- PIGN, we selected 10 cases of age-matched non-HBV PIGN for comparison. While both HBV associated PIGN and non-HBV PIGN similarly presented as proteinuria, hematuria, and hypertension, there was a trend of higher acute kidney injury and worsened prognosis in HBV-PIGN. 6 months after the onset, 4 patients with HBV associated PIGN did not show improvement from the disease, whereas all patients with non-HBV PIGN had complete or partial recovery. Pathologically, both HBV associated PIGN and non-HBV PIGN showed typical diffuse glomerular endocapillary proliferation, but HBV associated PIGN differed from classical PIGN with much fewer sub-epithelial glomerular "hump-shape" immune complex depositions. In conclusion, we have identified a novel association of HBV infection with acute glomerulonephritis.
Peritoneal Sarcoidosis Mimicking Peritoneal Tuberculosis and Advanced Ovarian Carcinoma
Authors: Brittany N Robles, Catherine Shea, Ghadir Salame
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Sarcoidosis is an inflammatory disease that affects one or multiple organs, most commonly the lungs and lymph nodes. This disease can present in a variety of ways which often makes diagnosis difficult. A 54-year-old postmenopausal African American female with a history of omental carcinomatosis of unknown origin was referred to the gynecology-oncology service at a local community hospital following a laparoscopic incarcerated hernia repair where multiple abdominal lesions suspicious of ovarian carcinomatosis were visualized. She was brought to the operating room for a diagnostic laparoscopy at which point the intra-abdominal survey revealed white tubercle-like lesions that were consistent with peritoneal tuberculosis. The lesions were excised and sent to pathology. The omentum biopsy was originally reported as adipose tissue showing focal fibrosis, focal mild acute inflammation, few cyst formation, and multiple granulomatous chronic inflammation, with multinucleated giant cells. Periodic acid-Schiff stain and acid fast bacilli stain were negative, and a diagnosis of peritoneal tuberculosis was made. The patient was started on an antituberculosis treatment regimen; however, she was not improving. The pathology slides were reexamined and revealed nonnecrotizing granulomatous inflammation consistent with sarcoidosis. The patient was immediately referred to the department of pulmonology and rheumatology, at which point she was started on corticosteroids and had an improvement in her condition.
Case report: First case of neuromelioidosis in Europe: CNS infection caused by Burkholderia pseudomallei
Authors: Nikolaos G Dimitriou, Greta Flüh, Sabine Zange, Aykut Aytulun, Bernd Turowski, Hans-Peter Hartung, Sven G Meuth, Michael Gliem
Journal: Front Neurol (2022)
Keywords: burkholderia pseudomallei, europe, mri, case report, neuromelioidosis
MeSH terms: Case Reports

Neuromelioidosis is a rare CNS infection caused by Burkholderia pseudomallei and is characterized by high morbidity and mortality. Our report presents the diagnostic and therapeutic approach of the first case of neuromelioidosis confirmed in Europe. A 47-year-old man with a medical history of recurrent otitis with otorrhea and fever after tympanoplasty and radical cavity revision operation on the left ear was admitted with headache, decreased level of consciousness, dysarthria, left-sided hemiparesis, and urinary incontinence. After extensive investigations including MRI, microbiological, serological, and CSF analyses, and, ultimately, brain biopsy, a diagnosis of neuromelioidosis was established. Despite antibiotic treatment, the patient showed no clinical improvement and remained in a severely compromised neurological state under mandatory mechanical ventilation. Neuromelioidosis can pose a diagnostic challenge requiring an extensive diagnostic evaluation because of its uncommon clinical and radiological presentations.
VHL syndrome without clear family history: A rare case report and literature review of Chinese patients
Authors: Yaheng Li, Xiaohong Xin, Wenzhu Song, Xuan Zhang, Shengli Chen, Qian Wang, Aizhong Li, Yafeng Li
Journal: Front Neurol (2022)
Keywords: von hippel–lindaut syndrome, gene mutation, genetic testing, literature, whole exome sequencing
MeSH terms: Case Reports

Objective:
To analyze the clinical manifestations and imaging features of a hospitalized patient with intermittent headache who was finally diagnosed with von Hippel-Lindau (VHL) syndrome and to perform whole-exon gene detection to improve the understanding of the diagnosis and treatment strategies of the disease.
Methods:
A case of suspected VHL syndrome in Shanxi Provincial People's Hospital was analyzed. Proband DNA was also extracted for whole exome sequencing and screened for causative mutation sites, which were validated by Sanger sequencing. The literature about VHL gene mutations in Chinese patients in the past 10 years were also reviewed.
Results:
There is a heterozygous mutation site c.499C > G on the VHL gene on the short arm of chromosome 3 of the patient, which is a missense mutation. The mutation results in the substitution of arginine with glycine at amino acid 167 of the encoded protein, which may be primarily responsible for the disease in the patient with VHL syndrome. However, the mutation did not occur in other family members.
Conclusion:
Early recognition and treatment of VHL syndrome can be available with genetic testing technology. Strengthening the understanding of this complex genetic disease and improving the diagnostic rate of VHL syndrome are helpful for the precise treatment of patients with this disease, which may help prolong the survival time of patients to a certain extent and improve their quality of life.
Lability of IgE Levels Early in Life
Authors: Koffi N'guessan, David Ternant, François Labarthe, Hervé Watier
Journal: J Allergy (Cairo) (2011)
MeSH terms: Case Reports

We report a case of a very fast and intriguing decrease in IgE concentrations after exclusion from the diet of any CM lysate in an unusual clinical presentation of cow's milk allergy in an infant. Analysis of IgE kinetics after allergen elimination suggests rapid cessation of IgE biosynthesis and a short IgE half-life.
Use of anabolic-androgenic steroids masking the diagnosis of pleural tuberculosis: a case report
Authors: Carlos Fernández de Larrea, Aglae Duplat, Ismar Rivera-Olivero, Jacobus H de Waard
Journal: J Med Case Rep (2009)

Introduction:
Tuberculous pleural effusions are not always easy to diagnose but the presence of a lymphocyte-rich exudate associated with an increased adenosine deaminase level and a positive skin test result are highly sensitive diagnostic signs.
Case presentation:
We report a case of pleural tuberculosis in a 31-year-old white male patient from Caracas, Venezuela who was negative for human immunodeficiency virus and presented 2 weeks after injecting the anabolic-androgenic steroid nandrolone decanoate, in whom all the tests for tuberculosis were initially negative; an eosinophilic pleural effusion with a low adenosine deaminase level, a negative tuberculin skin test and negative for acid-fast bacilli staining and culture of the pleural fluid. After excluding other causes of eosinophilic pleural effusion malignant pleural effusion was suspected. The patient did not return until 4 months later. The second thoracentesis obtained a pleural fluid suggestive for tuberculosis, with a predominance of lymphocytes, an elevated adenosine deaminase level (51 U/l) and a positive tuberculin skin test. Culture of pleural fragments confirmed pleural tuberculosis.
Conclusion:
This case suggests that the use of an anabolic-androgenic steroid masks the definitive diagnosis of pleural tuberculosis by changing the key diagnostic parameters of the pleural fluid, a finding not previously reported. Available evidence of the effects of anabolic steroids on the immune system also suggests that patients using anabolic-androgenic steroids might be susceptible to developing tuberculosis in either reactivating a latent infection or facilitating development of the disease after a recent infection.