OpenMed/multicare-articles huggingface dataset:
Subcutaneous Eikenella corrodens, Actinomyces sp., and α-Hemolytic Streptococcus Abscess of the Thigh following a Vitamin B12 Injection
Authors: Micheal G Adondakis, John G Skedros, Bert K Lopansri, Stephen C Merrell
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

This case report describes a 38-year-old female presenting with a thigh abscess caused by Eikenella corrodens, Actinomyces sp., and α-hemolytic Streptococcus following an intramuscular vitamin B12 injection administered at an outpatient clinic. After failure to improve clinically with intravenous daptomycin and after visualization of the abscess with gas bubbles on CT scan, she was taken to the operating room for three separate surgical irrigation and debridement procedures. Treatment also included intravenous ampicillin/sulbactam followed by oral amoxicillin/clavulanic acid therapy. She remained symptom free and without infection at nine months following hospitalization. It was suspected that poor hygiene played a role in the infection, but a definitive cause was not identified.
Case report: Familial glycogen storage disease type IV caused by novel compound heterozygous mutations in a glycogen branching enzyme 1 gene
Authors: Yiyang Li, Chuan Tian, Si Huang, Weijie Zhang, Qiuyu Liutang, Yajun Wang, Guoda Ma, Riling Chen
Journal: Front Genet (2022)
Keywords: gbe1, gsd iv, asymptomatic hypoglycemia, case report, liver transplantation
MeSH terms: Case Reports

Glycogen storage disease type IV (GSD IV), caused by a mutation in the glycogen branching enzyme 1 (GBE1) gene, is a rare metabolic disorder with an autosomal recessive inheritance that involves the liver, neuromuscular, and cardiac systems. Here, we reported a case of familial GSD IV induced by novel compound heterozygous mutations in GBE1. The proband (at age 1) and her younger brother (at age 10 months) manifested hepatosplenomegaly, liver dysfunction, and growth retardation at onset, followed by progressive disease deterioration to liver cirrhosis with liver failure. During the disease course, the proband presented rare intractable asymptomatic hypoglycemia. The liver pathology was in line with GSD IV. Both cases carried pathogenic compound heterozygous mutations in GBE1 mutations, i.e., a missense mutation (c.271T>A, p. W91R) in exon 2 and a deletion mutation in partial exons 3-7. Both mutations are first reported. The internationally pioneered split-liver transplantation was performed during progression to end-stage liver disease, and the patients had normal liver function and blood glucose after. This study broadens the mutation spectrum of the GBE1 gene and the phenotypic spectrum of GSD IV.
Response to Olaparib in a Patient with Germline BRCA2 Mutation and Breast Cancer Leptomeningeal Carcinomatosis
Authors: Pedro Exman, Robert M Mallery, Nancy U Lin, Heather A Parsons
Journal: NPJ Breast Cancer (2019)
Keywords: breast cancer
MeSH terms: Case Reports

Leptomeningeal carcinomatosis (LC) is a devastating complication of metastatic cancer that disproportionately affects patients with advanced breast cancer. Moreover, those with BRCA1/2-mutated disease more often experience leptomeningeal metastasis. Treatment options for LC are limited and often include significant toxicities. PARP inhibitors offer an important potential treatment for patients with BRCA1/2-mutated breast and ovarian cancers, but clinical studies excluded patients with central nervous system (CNS) metastases, including LC. Efficacy data in this area are therefore limited, although a phase I study of olaparib in glioblastoma did show CNS penetration. Here we report a case of a patient with BRCA2-mutated breast cancer and solitary recurrence in the leptomeninges with ongoing complete response to treatment with the PARP inhibitor olaparib. PARP inhibitors may be an important treatment option for patients with BRCA-mutated disease and LC, and warrant further study.
Vancomycin nephrotoxicity: Vancomycin tubular casts with characteristic electron microscopic findings
Authors: Ngoentra Tantranont, Chizoba Obi, Yosu Luque, Luan D Truong
Journal: Clin Nephrol Case Stud (2019)
Keywords: biopsy, electron microscopy, immunostain, nephrotoxicity, tubular casts, vancomycin
MeSH terms: Case Reports

We herein report a 46-year-old man with diabetes who developed acute kidney injury and oliguria after receiving vancomycin to treat his foot infection. Renal biopsy revealed typical features of advanced diabetic nephropathy as well as features of acute vancomycin nephrotoxicity. Several changes typical for acute vancomycin nephrotoxicity, but hitherto not adequately described, were seen. There was an element of acute tubulointerstitial injury associated with frequent tubular casts consisting of typical hyaline casts, pale glassy material suggestive of uromodulin, and distinctive features suggestive of vancomycin deposition. Coprecipitation of vancomycin and uromodulin was confirmed by immunostain. Electron microscopic study showed features supportive for the diagnosis of diabetic nephropathy and distinctive concentric appearance of vancomycin tubular casts within the fibrillary background of uromodulin. The patient's renal function improved rapidly after cessation of vancomycin and initiation of steroid therapy, suggesting that vancomycin-associated tubular injury is potentially reversible over time with proper management.
Neonatal Intrathoracic Gastric Volvulus in Marfan's Syndrome
Authors: Javier Serradilla, Alba Bueno, Carlos De La Torre, Eduardo Alonso Gamarra, Martha Muñoz Romo, Francisco de Borja Nava Hurtado de Saracho, María Álvarez Barrial, Manuel Gomez Cervantes, Manuel Lopez Santamaria
Journal: European J Pediatr Surg Rep (2018)
Keywords: marfan's syndrome, gastric volvulus, hiatal hernia, intrathoracic stomach, neonatal
MeSH terms: Case Reports

We report a 12-day-old male who was admitted with vomiting because of an unusual early complication of Marfan's syndrome (MS): a sliding hiatal hernia. Initial ultrasound showed no stomach at its normal position and the chest X-ray presented an intrathoracic gas bubble with the nasogastric tube inside. An upper gastrointestinal contrast study confirmed the complete herniation of the stomach into the thorax. Via an exploratory laparotomy it was carefully reintroduced into the abdomen, following a hiatal reconstruction. A Thal fundoplication and a gastrostomy were also performed to guarantee its fixation. Although characterized by cardiac/aortic abnormalities, MS should be considered in any infant with hiatal/paraesophageal hernia, which should be repaired early to avoid gastric ischemia/volvulus.
Bilateral dentigerous cysts and ectopic teeth in the maxillary sinuses: A case report and literature review
Authors: Badria AlKhudair, Abdulrahman AlKhatib, Ghaleb AlAzzeh, Ali AlMomen
Journal: Int J Surg Case Rep (2019)
Keywords: case report, dentigerous cyst, ectopic teeth, maxillary sinus, recurrent sinusitis

Introduction:
Dentigerous cysts are the second most common form of benign odontogenic cysts. These cysts are commonly single lesions. Bilateral and multiple dentigerous cysts are very rare.
Case presentation:
This article presents a rare case report of bilateral dentigerous cysts associated with two ectopic teeth located atypically in the maxillary sinuses in a 19-year-old male manifesting as bilateral upper jaw pain, post-nasal discharge and recurrent sinusitis which was managed via the endonasal endoscopic approach by enucleation of the cysts and teeth removal.
Conclusion:
This paper presented our experience in the management of a rare case of bilateral dentigerous cysts associated with ectopic teeth in the maxillary sinuses. Ct scan of the paranasal sinuses confirmed the diagnosis and the endonasal endoscopic approach is superior to the external approaches in preserving physiological function in managing these patients.
An unusual intraoral lipoma: case report and review of the literature
Authors: Youssra Azzouz, Soukaina Abidi, Fatima Zahra Zidane, Saliha Chbicheb
Journal: Pan Afr Med J (2022)
Keywords: oral lipoma, buccal mucosa, case report, treatment
MeSH terms: Lipoma / diagnosis, Lipoma / pathology, Lipoma / surgery, Mouth Neoplasms / diagnosis, Mouth Neoplasms / pathology, Mouth Neoplasms / surgery, Case Reports, Review, Anesthesia, Local, Female, Humans, Middle Aged, Mouth Mucosa / pathology, Wound Healing

Lipoma is a common tumor of soft tissue with rare occurrence in oral cavity accounting for only 1-4% of benign oral tumours. It may be noticed only during routine dental examinations. Most of them rarely cause pain, resulting in delay to seek treatment. Lipoma of the oral cavity may occur in any region. The buccal mucosa, tongue, and floor of the mouth are among the common locations. A case of large intraoral lipoma occurring in mental region in a 60-year-old female patient is reported. It was treated surgically under local anesthesia, and 6 month follow up showed excellent healing without any recurrence.
The comorbidity of reduplicative paramnesia, intermetamorphosis, reverse-intermetamorphosis, misidentification of reflection, and capgras syndrome in an adolescent patient
Authors: Ozden Arısoy, A Evren Tufan, Rabia Bilici, Sarper Taskiran, Zehra Topal, Nuran Demir, M Akif Cansız
Journal: Case Rep Psychiatry (2014)

Delusional misidentification syndromes may be superimposed on neurological or psychiatric disorders and include delusional beliefs that the people, objects, or places around the patient change or are made to change with one another. In this paper, an adolescent patient displaying Capgras syndrome, metamorphosis, reverse-intermetamorphosis, misidentification of reflection, and reduplicative paramnesia was presented. The findings that our patient struggled with visuospatial tests applied in the acute phase as well as the observation that she refused to meet her family face-to-face while accepting to speak on the phone may support the role of right hemisphere and visuospatial functions in the development of those syndromes. Further studies or case series evaluated more extensively are needed to reveal the relationship between right hemisphere functions and delusional misidentification syndromes.
Surgical extraction after thrombosis around the Avalon dual lumen cannula
Authors: V Kalem, D Buchwald, J Strauch, A Sidiropoulos, R Meindl, T A Schildhauer, J Swol
Journal: Ann R Coll Surg Engl (2014)
MeSH terms: Catheterization / adverse effects, Extracorporeal Membrane Oxygenation / adverse effects, Thrombosis / etiology, Case Reports, Acute Disease, Adult, Device Removal, Equipment Failure, Extracorporeal Membrane Oxygenation / instrumentation, Humans, Male, Respiratory Insufficiency / therapy, Spinal Fractures / complications, Systemic Inflammatory Response Syndrome / complications, Thrombosis / surgery

The use of a dual lumen cannula (DLC) for venovenous extracorporeal membrane oxygenation (ECMO) has several advantages and reports of complications are rare. We present a case of thrombosis around and inside the Avalon Elite™ bicaval DLC (Avalon Laboratories, Rancho Dominguez, CA, US), for which simple removal by retraction was impossible. A 30-year-old man had experienced an unstable C6/7 fracture with spinal contusion and haematoma in the spinal canal with incomplete neurological paraplegia and thoracic trauma. He developed acute respiratory failure due to posttraumatic systemic inflammatory response syndrome and venovenous extracorporeal membrane oxygenation (ECMO) support was indicated. The cannulation was performed with an Avalon Elite™ cannula (31Fr) in the right jugular vein under fluoroscopy. After 18 days of ECMO therapy, despite the continuous administration of heparin (400iu/h), ECMO was discontinued because of the formation of a massive thrombus in the oxygenator. At that time, the patient's haemodynamic and respiratory parameters were stable, and we were able to induce a rapid weaning from ECMO. The surgical removal of the cannula became necessary and was performed using a small neck incision without complications. We report this case to emphasise that any resistance encountered during an attempt to extract the Avalon Elite™ cannula may cause serious complications. In such cases, surgical removal must be considered.
The needs for diagnostic imaging in cases of group A streptococcal meningitis in children: a case report and review of the literature
Authors: Lise van Dijk, Tom F W Wolfs, Sylvia B Debast, Veerle V J Langenhorst
Journal: Access Microbiol (2019)
Keywords: cerebral complication, cerebritis, diagnostic imaging, group a streptococcus, meningitis
MeSH terms: Case Reports

Group A streptococcus (GAS) is a rare cause of bacterial meningitis in children and is associated with a high cerebral complication rate. In this case report, we present a 9-year-old girl with GAS meningitis complicated with cerebritis. Clear guidelines about choice of treatment and indications of follow-up by imaging tests are lacking, making GAS meningitis unpredictable and difficult to treat. Eventually, we found 25 paediatric cases of GAS meningitis presented in the literature and reviewed their treatment choices, outcomes and follow-up by imaging tests. Penicillin and ceftriaxone are most preferred for the treatment of GAS meningitis and adding rifampicin to the antibiotic treatment could be of potential benefit. When considering the duration of antibiotic treatment and follow-up by imaging tests, no clear recommendations were found. We found that GAS meningitis is associated with higher mortality and cerebral complication rates compared to other, more common, bacterial causes of meningitis in children. This should alert the clinician to consider imaging tests routinely, even if the patient improves clinically. We advise clinicians to routinely evaluate for possible cerebral complications through magnetic resonance imaging (MRI) scans. When cerebral complications are found, antibiotic treatment should be prolonged and adding rifampicin to the antibiotic regime may be considered.
Ovarian Teratoma Masquerading as a CSF Pseudocyst in a Female with a Ventriculoperitoneal Shunt
Authors: John M K Mislow, Jonathan R Slotkin, Mark R Proctor
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Background. In today's fast-paced and high-acuity emergency departments, clinicians are often compelled to triage cases so rapidly that a differential diagnosis consistent with the history and physical examination is not comprehensive. Case Report. This case report describes the unexpected finding of a cystic ovarian neoplasm in a young female with an abdominal mass and a ventriculoperitoneal shunt, initially diagnosed as a cerebrospinal fluid pseudocyst. We use this case to illustrate that the astute clinician must always synthesize a diagnosis from all data sources and not to rely on initial radiographic evaluations. Conclusions. This remarkable case demonstrates that all differential diagnoses must be entertained in order to rapidly and accurately diagnose a patient with a cystic abdominal mass.
Colonic Interposition between the Liver and Diaphragm: "The Chilaiditi Sign"
Authors: Nita Nair, Zeina Takieddine, Hassan Tariq
Journal: Can J Gastroenterol Hepatol (2016)
MeSH terms: Chilaiditi Syndrome / diagnostic imaging, Case Reports, Abdominal Pain / etiology, Aged, 80 and over, Chilaiditi Syndrome / complications, Humans, Male, Tomography, X-Ray Computed, Urinary Retention / etiology

A 90-year-old wheelchair bound male was brought to the emergency department with complaints of worsening abdominal pain over the last 2-3 days. The patient also had difficulty in passing urine. Abdominal examination revealed tenderness in the umbilical and hypogastric area without rebound tenderness or guarding. Computed tomography (CT) of the abdomen showed a loop of colon interpositioned between the liver and the right hemidiaphragm (the Chilaiditi sign), mimicking free air. Foley's catheter was placed and the patient was managed conservatively. The patient clinically improved with improvement of the abdominal pain.
Case report: A novel missense variant in melanopsin associates with delayed sleep phenotype: Whole genome sequencing study
Authors: Sandra P Smieszek, Christos M Polymeropoulos, Gunther Birznieks, Mihael H Polymeropoulos
Journal: Front Genet (2022)
Keywords: dswpd, circadian clock, melanopsin (opn4), risk locus, sequencing
MeSH terms: Case Reports

Melanopsin (OPN4) is a blue light-sensitive opsin-type G-protein coupled receptor. It is highly expressed in photosensitive retinal ganglion cells which mediate responses to light, including regulation of sleep, circadian photoentrainment, and pupillary light response. Mutations in OPN4 were shown to affect responses to light, ultimately affecting the regulation of circadian rhythms and sleep. In this study, we describe a male carrier of the OPN4 missense variant diagnosed with delayed sleep-wake phase disorder (DSWPD), with a consistent recurrent pattern of delayed sleep onset The rs143641898 [NM_033282.4:c.502C>T p.(Arg168Cys)] variant in the OPN4 gene was shown in a functional study to render the OPN4 protein non-functional. The variant is rare and likely increases the risk of DSWPD via its direct effect on the melanopsin pathway. This study offers useful insights for the differential diagnosis and ultimately treatment of DSWPD risk in which patients carry pathogenic variants in the OPN4 gene.
Myelodysplastic syndrome and autoimmunity: a case report of an unusual presentation of myelodysplastic syndrome
Authors: Andrea L Merrill, Hedy Smith
Journal: Case Rep Hematol (2011)
MeSH terms: Case Reports

Myelodysplastic syndrome (MDS) commonly presents asymptomatically or with symptomatic cytopenias. However, autoimmune phenomena in association with MDS have been well described in several case reports and case series. Typically, these autoimmune phenomena take the form of vasculitides, arthritis, connective tissue diseases, pulmonary infiltrates, or polymyalgia rheumatica. We present the case of a woman with MDS (karyotype 46,XX,+1,der(1;7)(q10;p10)[20], that evolved with an additional trisomy 8 clone) and a novel spectrum of autoimmune diseases including acute fibrinous and organizing pneumonia (AFOP) and lacrimal gland pseudotumor.
Moderna COVID-19 Vaccine: A New Player in Vaccine-Induced Thrombosis Without Thrombocytopenia
Authors: Harmehar K Kohli, Ankita Gore, Imran Baig, Viraj Modi
Journal: Cureus (2023)
Keywords: covid-19, covid-19 moderna vaccine, covid-19 vaccine side effects, hypercoagulability, vaccine-induced thrombosis
MeSH terms: Case Reports

This is a case of a 31-year-old male with no past medical history who developed extensive pulmonary embolism (PE) and deep venous thrombosis (DVT) three days after receiving the second dose of the Moderna vaccine. The patient presented with left calf swelling and mild shortness of breath, with no fever or hemodynamic instability. Doppler ultrasound of the left lower extremity showed thrombus in the common femoral, superior, mid-, and distal femoral, popliteal, and posterior tibial veins. Chest CT angiography (CTA) visualized extensive pulmonary emboli in the bilateral main pulmonary, lobar, and segmental arteries. Comprehensive hypercoagulable workup was unrevealing. The leading diagnosis was postulated as vaccine-induced thrombosis (VIT). Due to the diagnosis of bilateral sub-massive PE, the patient was initiated on enoxaparin and continued on direct-acting oral anticoagulation for at least one year. Our report showcases a plausible link between the Moderna vaccine and thrombosis due to the extensive and unprovoked nature of DVT/PE in this patient with a negative hypercoagulable workup. Although the mechanisms behind the messenger ribonucleic acid (mRNA) and double-stranded deoxyribonucleic acid (dsDNA) vaccines vary, the possibility of vaccine-induced thrombosis (VIT) after the Moderna vaccine is highly probable. Vaccine-induced thrombosis should be considered in a patient presenting with unprovoked thrombosis after the Moderna COVID-19 vaccine, and further research needs to be conducted to ascertain the correlation. However, these findings should not dissuade the use of the Moderna vaccine given its proven benefits.
Silent Tumefactive Demyelinating Lesions and Radiologically Isolated Syndrome
Authors: Ozgul Ekmekci, Cenk Eraslan
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Demyelinating lesions larger than 2 cm in diameter, with or without edema, are known as tumefactive demyelinating lesions (TDLs). They constitute a rare inflammatory demyelinating disorder of the central nervous system. TDLs are typically characterized by headaches, cortical symptoms such as aphasia, hemiparesis, hemisensory deficits, seizures, and changes in consciousness. TDLs may occur in patients with or without an established diagnosis of MS or may occur as the initial demyelinating event. They may also be observed during follow-up in patients with MS, neuromyelitis optica, acute disseminated encephalomyelitis, or other autoimmune diseases. Differential diagnosis includes brain tumors, abscess, granulomatous diseases, and vasculitis. In some cases, it may be very difficult to distinguish TDLs from a tumor, such that biopsy might be needed. However, no cases of asymptomatic TDLs have yet been reported in the literature. Hence, in this report, we present a case involving an asymptomatic TDL detected incidentally during magnetic resonance imaging in an 18-year-old man. The patient did not develop any symptoms during the 1-year follow-up period. During follow-up, the patient was diagnosed with a radiologically isolated syndrome. TDLs have not previously been identified as radiologically isolated syndrome. Thus, reporting similar cases in the future will help in further understanding this phenomenon.