OpenMed/multicare-articles huggingface dataset:
Considerations on Immunization and Immunosuppression of Patients With Autoimmune Blistering Diseases During COVID-19 Pandemic in Brazil: Case Report
Authors: Denise Miyamoto, Claudia Giuli Santi, Celina Wakisaka Maruta, Valeria Aoki
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, sars-cov-2, autoimmune blistering diseases, immunosuppressants, pemphigus, rituximab, vaccine
MeSH terms: Case Reports

Autoimmune blistering diseases comprise a rare group of potentially life-threatening dermatoses. Management of autoimmune disorders poses a challenge in terms of achieving disease control and preventing adverse events. Treatment often requires an individualized approach considering disease severity, age, comorbidities, and infectious risk especially in the context of the ongoing COVID-19 pandemic. Knowledge regarding SARS-CoV-2 infection is still evolving and no specific antiviral therapy is available yet. We report four patients with active disease that required adjustment of treatment during the pandemic to discuss the use of immunosuppressants and immunobiologics, weighing potential risks and benefits of each therapy modality and vaccination status.
A Case of Relapsing Peritoneal Dialysis-Associated Peritonitis by Dokdonella koreensis
Authors: Jamie Bee Xian Tan, Alvin Ren Kwang Tng, Htay Htay
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Peritonitis is a common and serious complication of peritoneal dialysis (PD) with significant morbidity. We report the first case of relapsing Dokdonella koreensis peritonitis in a patient on peritoneal dialysis. A 63-year-old Chinese man, with history of renal failure on continuous ambulatory peritoneal dialysis, presented with cloudy peritoneal effluent and abdominal pain. There was no sign or symptom suggestive of exit-site/tunnel tract infection. Peritoneal effluent cultures yielded Dokdonella koreensis which was initially misidentified as Weeksella virosa and Brevundimonas species by the API® 20 NE and VITEK® 2 GN ID card, respectively. He was treated with intraperitoneal amikacin, but the infection relapsed within a few days upon completing each antibiotic course. He eventually required removal of catheter and was transferred to hemodialysis. Infections due to unusual organisms may pose a diagnostic issue as currently available commercial tests will not be able to identify them. There is a role for using 16S rRNA sequencing to help identify these organisms and guide patient management.
Enzyme Replacement Therapy (ERT) on Heart Function Changes the Outcome in Patients with Infantile-Onset Pompe Disease: A Familial History
Authors: Marco Lecis, Katia Rossi, Maria Elena Guerzoni, Ilaria Mariotti, Lorenzo Iughetti
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Background:
Lysosomal acid alpha-glucosidase (GAA) deficiency, also known as Pompe disease, is an autosomal recessive disorder that leads to the accumulation of glycogen in lysosomes and cytoplasm, resulting in tissue destruction. Infantile-onset GAA deficiency is characterized by cardiomyopathy and severe generalized hypotonia. Without treatment, most patients die within the first two years of life. The demonstration of reduced GAA activity, followed by sequencing of the GAA gene, confirms the disease. GAA deficiency is currently treated with enzyme replacement therapy (ERT) with improved clinical outcomes and survival. Case Presentation. We describe the case of DGAA in two siblings, in which the diagnostic time point, treatment, and outcomes were completely different. The girl was diagnosed with DGAA at the age of 6 months during investigations for poor weight gain and excessive sleepiness. The finding of severe cardiomyopathy through EKG and echocardiography led to the suspicion of storage disease, and the GAA deficiency was later confirmed by genetic analysis. The girl died of complications due to the clinical picture before starting ERT. Conversely, her younger brother had the opportunity to receive an early diagnosis and the rapid onset of ERT. He is showing a regression of cardiac hypertrophy.
Conclusion:
The advent of ERT improved clinical outcomes and survival in infantile-onset PD. Its impact on cardiac function is still under study, but different reports in the literature have shown encouraging data. Early recognition of DGAA and prompt initiation of ERT is therefore crucial to prevent the progression of the disease and improve the outcomes.
A modified design for posterior inlay-retained fixed dental prosthesis
Authors: Abdulaziz Samran, Mohammad Zakaria Nassani, Marwan Aswad, Amid Abdulkarim
Journal: Case Rep Dent (2015)

The aim of this paper is to report a clinical case with bilateral missing mandibular second premolars that were restored by metal-ceramic inlay-retained fixed dental prostheses. The first prosthesis was of a traditional design and the second was of a modified design. The suggested design is created by modifying the retainer wings of the traditional resin-bonded inlay-retained fixed dental prosthesis and covering the wings with composite resin. The modified design is relatively conservative, esthetic and provides an extra element for the retention of posterior metal-ceramic inlay-retained fixed dental prostheses.
Scaling up paediatric HIV care with an integrated, family-centred approach: an observational case study from Uganda
Authors: Emmanuel Luyirika, Megan S Towle, Joyce Achan, Justus Muhangi, Catherine Senyimba, Frank Lule, Lulu Muhe
Journal: PLoS One (2013)
MeSH terms: Delivery of Health Care, Integrated / methods, Family, HIV Infections / diagnosis, HIV Infections / therapy, Pediatrics / methods, Observational Study, Research Support, Non-U.S. Gov't, Adult, Child, Female, HIV Infections / prevention & control, Health Services Accessibility, Humans, Mothers, Organizations, Policy Making, Uganda

Family-centred HIV care models have emerged as an approach to better target children and their caregivers for HIV testing and care, and further provide integrated health services for the family unit's range of care needs. While there is significant international interest in family-centred approaches, there is a dearth of research on operational experiences in implementation and scale-up. Our retrospective case study examined best practices and enabling factors during scale-up of family-centred care in ten health facilities and ten community clinics supported by a non-governmental organization, Mildmay, in Central Uganda. Methods included key informant interviews with programme management and families, and a desk review of hospital management information systems (HMIS) uptake data. In the 84 months following the scale-up of the family-centred approach in HIV care, Mildmay experienced a 50-fold increase of family units registered in HIV care, a 40-fold increase of children enrolled in HIV care, and nearly universal coverage of paediatric cotrimoxazole prophylaxis. The Mildmay experience emphasizes the importance of streamlining care to maximize paediatric capture. This includes integrated service provision, incentivizing care-seeking as a family, creating child-friendly service environments, and minimizing missed paediatric testing opportunities by institutionalizing early infant diagnosis and provider-initiated testing and counselling. Task-shifting towards nurse-led clinics with community outreach support enabled rapid scale-up, as did an active management structure that allowed for real-time review and corrective action. The Mildmay experience suggests that family-centred approaches are operationally feasible, produce strong coverage outcomes, and can be well-managed during rapid scale-up.
Vertebral Osteomyelitis Caused by Mycobacterium arupense Mimicking Tuberculous Spondylitis: First Reported Case and Literature Review
Authors: Ayu Kasamatsu, Kazuaki Fukushima, Yuriko Igarashi, Satoshi Mitarai, Yuka Nagata, Masao Horiuchi, Noritaka Sekiya
Journal: Open Forum Infect Dis (2023)
Keywords: mycobacterium arupense, mycobacterium infections, nontuberculous mycobacteria, osteomyelitis, spondylitis
MeSH terms: Case Reports

Mycobacterium arupense is a slow-growing, nontuberculous mycobacterium widely found in the environment and is known to cause tenosynovitis and osteomyelitis, mainly in the hands and wrists. We present the first case of vertebral osteomyelitis caused by M arupense in a 78-year-old man with renal cell carcinoma. The patient had a history of tuberculous pleuritis in childhood. Although the nucleic acid amplification test of the vertebral tissue for Mycobacterium tuberculosis was negative, we initiated tuberculosis treatment based on the history and pathological findings of auramine-rhodamine-positive organisms and epithelioid cell granulomas. Subsequently, the isolated mycobacterium was identified as M arupense by genome sequencing. Accordingly, the treatment regimen was changed to a combination of clarithromycin, ethambutol, and rifabutin. Owing to a subsequent adverse event, rifabutin was switched to faropenem, and the patient was treated for a total of 1 year. In previous literature, we found 15 reported cases of bone and soft tissue infections caused by M arupense, but none of them had vertebral lesions. Physicians should be aware that M arupense can cause vertebral osteomyelitis mimicking tuberculous spondylitis. In addition, molecular testing of isolated mycobacteria is essential for diagnosis, even if tuberculous spondylitis is suspected.
Salivary duct carcinoma of the parotid gland: A case report and review of the literature
Authors: Shule Xie, Hongyu Yang, Marius Bredell, Shiyue Shen, Huijun Yang, Long Jin, Shanshan Zhang
Journal: Oncol Lett (2015)
Keywords: clinic, immunohistology, salivary duct carcinoma, salivary gland

Salivary duct carcinoma (SDC) is a rare and aggressive parotid malignancy that most commonly affects males in the fifth and sixth decades of life. Histopathology specimens obtained from SDC patients demonstrate a resemblance to ductal carcinoma of the breast. Therefore, to distinguish SDC from breast ductal carcinoma, several immunohistochemical markers exist that may enable surgeons to make an accurate diagnosis. In this study, the case of a 54-year-old male with salivary duct carcinoma of the right parotid gland is presented. The results of the present case study revealed that the SDC sample was positive for the expression of human epidermal growth factor 2 (Her-2), cytokeratin (CK) 8/CK 18, p63, high molecular weight CK and calponin, and negative for expression of the estrogen receptor and progesterone receptor. Based on the result, an ipsilateral selective neck dissection followed by adjuvant post-operative radiation therapy was suitable at the primary treatment stage. At one year of follow-up, the patient was alive and free of recurrence. In advanced cases of SDC, treatment with anti-HER-2 monoclonal antibodies, such as trastuzumab, is recommended.
Osteophyte formation causes neurological symptoms after anterior cervical discectomy and fusion (ACDF): A case report
Authors: Haiming Jin, Jiangtao Luo, Yuhan Jiang, Jinghao Lin, Junchen Jiang, Rufeng Ren, Weiyuan Fang, Yaosen Wu, Xiangyang Wang
Journal: Front Surg (2023)
Keywords: acdf = anterior cervical discectomy and fusion, cervical open-door laminoplasty, myelopathy, osteophyte, strong fixation
MeSH terms: Case Reports

Spinal surgeons have been drawn to the incidence of osteophytes following intervertebral disc degeneration in clinical practice. However, the production of osteophytes, particularly in the spinal canal, after anterior cervical discectomy and fusion (ACDF) is uncommon. We described a 42-year-old male patient who underwent C4-6 ACDF due to cervical stenosis two years prior in another public hospital in the province. His primary symptoms were significantly relieved, but he developed new pain and weakness in his right leg six months after surgery. The imaging results revealed a large posterior osteophyte at C5/6, compressing the spinal cord anteriorly. Accordingly, we performed cervical open-door laminoplasty to decompress the spinal cord. The patient's clinical symptoms had significantly improved at the one-year follow-up. This case seeks to inform surgeons that cautious, routine follow-ups are necessary for the event that a severe intracanal osteophyte develops at the operated level following ACDF. The comprehensive osteophyte removal and strong fixation at the operative level during ACDF warrant more consideration as these procedures may lower the incidence of new osteophytes. Additionally, surgical procedures may be required.
Finasteride induced Gynecomastia: Case report and Review of the Literature
Authors: Yuval Ramot, Tali Czarnowicki, Abraham Zlotogorski
Journal: Int J Trichology (2009)
Keywords: androgenetic alopecia, finasteride, gynecomastia
MeSH terms: Case Reports

Finasteride (1 mg/day) is widely utilized by dermatologists for the treatment of androgenetic alopecia. Although enjoying a relatively good safety profile, several sex-related adverse effects have been reported with this drug. Here we report two cases of gynecomastia, one of them bilateral, caused by Propecia((R)) prescribed for the treatment of androgenetic alopecia. Although relatively rare, physicians should be aware of this side effect and inform their patients when prescribing this medication.
The First Case Report of Preschool-Onset SS/SLE Coexisting With NMOSD of Chinese Origin
Authors: Liqun Liu, Li Tang, Lu Zhang, Xingfang Li, Peng Huang, Jie Xiong, Yangyang Xiao, Lingjuan Liu
Journal: Front Immunol (2022)
Keywords: aqp-4, sjogren’s syndrome, child ss/sle overlap syndrome with nmosd, neuromyelitis optica spectrum disorder, systemic lupus erythematosus
MeSH terms: Connective Tissue Diseases / complications, Lupus Erythematosus, Systemic / complications, Neuromyelitis Optica / diagnosis, Sjogren's Syndrome / complications, Sjogren's Syndrome / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Aged, Autoantibodies, Child, Child, Preschool, China, Female, Humans, Liver Cirrhosis / complications, Middle Aged, Autoantibodies

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease (CTD), the main features of which are multiple serum autoantibodies and extensive involvement of multiple systems. The onset age of patients varies from childhood to middle age, with nearly 1/5 in childhood. Sjogren's syndrome (SS) is also an autoimmune disease characterized by high-degree lymphocytic infiltration of exocrine glands, usually occurring in middle-aged and older women, and rarely in childhood. Neuromyelitis optica spectrum disorder (NMOSD) is an immune-mediated inflammatory demyelinating disease of the central nervous system (CNS) mainly involving the optic nerve and spinal cord. The coexistence of NMOSD and SLE and/or SS is well recognized by both neurologists and rheumatologists, but cases in children have been rarely reported. In this paper, we reported a case of a girl with onset at age 5 clinically featured by recurrent parotid gland enlargement, pancytopenia, hypocomplementemia, multiple positive serum antibodies, and cirrhosis. She was initially diagnosed with SS/SLE overlap syndrome at age 5. Four years later, the patient suffered a sudden vision loss and was examined to have positive AQP4 antibodies in serum and cerebrospinal fluid (CSF), and long segmental spinal swelling, in line with the diagnostic criteria for NMOSD. Up to now, the current patient is of the youngest onset age to develop SS/SLE coexisting with NMOSD, also with cirrhosis. It is important for clinicians to be aware of the possibility of CTDs coexisting with NMOSD in children, especially in those with positive anti-multiple autoantibodies, and to decrease the rate of missed diagnosis.
Severe Gastrointestinal Hemorrhage due to Monkeypox Virus-Associated Proctocolitis
Authors: Sobaan Taj, Chris Austin, Azhar Hussain, Maryam Salma Babar, Harshavardhan Sanekommu, Steven Imburgio, Anmol Johal, Alejandro CruzPonce, Apurva Vedire, Edward Liu
Journal: Case Rep Gastrointest Med (2023)
MeSH terms: Case Reports

Monkeypox is primarily a painful cutaneous disease with occasional systemic manifestations. Monkeypox is transmitted predominantly through close physical contact and occasionally sexual contact. The first case was reported in the United States on May 17, 2022, in a recent monkeypox worldwide outbreak. We present a case of severe gastrointestinal bleeding as an atypical manifestation of monkeypox infection in a 40-year-old male with HIV. In our case, monkeypox-induced proctocolitis progressed to severe rectal bleeding requiring one unit of packed red blood cells transfusion despite one week of tecovirimat (TPOXX) therapy. So, patients should be educated about the possibility of unusual complications of monkeypox infection, i.e., bleeding in immunocompromised hosts.
Tuberculous otitis media with facial paralysis: a clinical and microbiological diagnosis-a case report
Authors: Nicola Quaranta, Paolo Petrone, Alexandra Michailidou, Luisa Miragliotta, Marilina Santantonio, Raffaele Del Prete, Adriana Mosca, Giuseppe Miragliotta
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

The tuberculosis of the ear is rare, and in most cases the clinical picture resembles that of a chronic otitis media. The diagnosis is often delayed, and this can lead to irreversible complications such as hearing loss and/or facial paralysis. In view of its rare occurrence, we report a case of primary tuberculous otitis media in a 87-year-old female patient. The diagnosis was made on the basis of both histological and microbiological findings. In particular, gene amplification techniques such as real-time polymerase chain reaction are useful method for rapid diagnosis and detecting tuberculous bacilli usually present at very low number. Early diagnosis is essential for the prompt institution of antituberculous therapy.
Case report: Imaging findings of true thymic hyperplasia at 18F-FDG PET/CT in an infant
Authors: Jiazhong Ren, Zheng Fu, Yaqing Zhao
Journal: Front Oncol (2023)
Keywords: 18f‐fdg pet/ct, ct, mth, tth, mediastinum
MeSH terms: Case Reports

True thymic hyperplasia (TTH) in children is rare and difficult to distinguish from other thymic tumors such as thymoma and thymic carcinoma. A 3-year-old girl underwent an 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) scan (18F-FDG PET/CT) and a chest CT scan to evaluate an anterior mediastinal mass. 18F-FDG PET/CT revealed a mediastinal mass showing heterogeneously increased FDG uptake with a maximum standardized uptake value (SUVmax) of 7.1. Eventually, postoperative pathological diagnosis demonstrated TTH. So far, there are no reports of 18F-FDG PET/CT imaging of this disease.
Erupted compound odontomas: a case report
Authors: Avinash Tejasvi M L, Balaji Babu B
Journal: J Dent Res Dent Clin Dent Prospects (2011)
Keywords: compound odontoma, compound complex odontoma, erupted odontoma, hamartoma
MeSH terms: Case Reports

The tumors in which odontogenic differentiation is fully expressed are the odontomas. Odontomas are considered as hamartomas rather than a true neoplasm. These tumors are composed of enamel, dentine, cementum and pulp tissue. It is most commonly associated with the eruption of the teeth. They are usually discovered on routine radiographic examination. In exceptional cases, the odontoma erupts in to the mouth. Nine cases of erupted compound odontomas are reported in the English literature, and the present paper reports another case of an erupted compound odontoma in a 22-year-old female patient.
Case Report: Upper Thoracic Purely Extradural Spinal Meningioma With Nerve Root Attachment: A Case Report and Literature Review
Authors: Zhao-Lin Wang, Jian-Hui Mou, Dong Sun, Peng Liu
Journal: Front Surg (2022)
Keywords: 2766 extradural spinal meningioma, case report, hemilaminectomy, nerve root, rare
MeSH terms: Case Reports

Introduction:
We describe a case of purely extradural spinal meningioma (EDSMs) with nerve root attachment and present the clinical profiles, radiological findings, operative management, and follow-up data, along with a literature review. This case study is purely extradural spinal meningioma attached to the nerve root, and the available literature review discusses the diagnosis and treatment. Purely epidural spinal meningiomas are extremely rare, and only a few clinical reports are published on this disease. Although epidural meningioma is a benign tumor, the recurrence rate is higher when compared with ordinary meningioma.
Case study:
A 39-year-old male complained of chest and back pain with ring-shaped radiations to the precordial area and numbness in both the lower extremities. After a long walk, he felt disharmony in both his lower limbs. Magnetic resonance imaging showed a mass located on the left posterolateral side of the T1-T3 spinal cord and exhibited a dumbbell-type growth outward at the level of the T2-T3 intervertebral foramen. On the left side of the thoracic, a hemilaminectomy procedure was performed. The tumor was found in the ventral side of the left nerve root of T1 and was surrounded by the left nerve root of T2. To obliterate the tumor, the T2 nerve root was severed. The patient was advised to come for the follow-up on the 3rd, 6th, and 12th months postoperatively, and there were no complaints or signs of recurrence.
Conclusion:
Purely extradural spinal meningioma with nerve root attachment is rare and has no clinical symptoms and image findings. To completely resect the lesion and avoid recurrence, the affected nerve root, epidural fat tissue, and nerve root sheath should be extensively resected and burned, coagulating the adjacent ventral posterior longitudinal ligament.