OpenMed/multicare-articles huggingface dataset:
Prosthetic valve endocarditis due to highly beta-lactam-resistant Streptococcus oralis: a case report
Authors: Ippei Tanaka, Shinichiro Morioka, Arisa Honda, Ryoichi Miyazaki, Takeaki Wajima, Hidemasa Nakaminami, Tomoyuki Kato
Journal: Access Microbiol (2022)
Keywords: streptococcus oralis, drug resistance, endocarditis, heart valve prosthesis, vancomycin, viridans streptococci
MeSH terms: Case Reports

There are limited reports of patients with prosthetic valve infective endocarditis (IE) or recurrent IE due to highly beta-lactam-resistant viridans group streptococci. We present a case in which a patient with native valve IE due to beta-lactam-susceptible Streptococcus oralis developed prosthetic valve IE due to highly beta-lactam-resistant S. oralis . A 79-year-old man with a history of native aortic valve IE caused by beta-lactam-susceptible S. oralis 21 months prior to admission and aortic valve replacement was admitted to our hospital with a 2-week history of general malaise and low-grade fever. Transesophageal echocardiography showed a 20 mm vegetation on the prosthetic aortic valve, and emergency cardiovascular surgery was performed on admission day 2. Three sets of blood cultures on admission were positive for highly beta-lactam-resistant S. oralis . Vancomycin and cefazolin were administered as initial treatment. After the surgery, the patient was given vancomycin and gentamicin for 2 weeks, followed by vancomycin for 4 weeks. He was relapse-free at the 6-month follow-up. For patients with native valve IE due to S. oralis who have undergone valve replacement more than 1 year earlier, given the possibility of methicillin-resistant Staphylococcus aureus as well as S. oralis resistance to beta-lactams, it may be advisable to start vancomycin as an initial treatment and continue it until the infecting micro-organism has been proven to be susceptible to beta-lactams.
Malabsorption Syndrome due to Intestinal Amyloidosis as Presentation of Renal Cell Carcinoma
Authors: Filipe Bessa, Pedro Gaspar, Pedro Antunes Meireles, Maria Inês Parreira, Juliana Serrazina Pedro, Marisa Teixeira da Silva, João Meneses, Rui Victorino, Catarina Mota
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Renal cell carcinoma accounts for approximately 3% of adult malignancies. Designated in the literature as "the great masquerader," the great diversity of clinical manifestations is associated with the several paraneoplastic syndromes that potentially accompany it. Paraneoplastic amyloidosis is described in about 3-8% of cases, only exceptionally as an initial manifestation, with uncommon gastrointestinal involvement. A rare case of malabsorption by intestinal amyloidosis is presented as initial manifestation of renal cell carcinoma, emphasizing the need for early recognition of these paraneoplastic conditions.
Perianal Comedones: A Rare Incidental Finding
Authors: Priscilla R Powell, Juana Irma Garza-Chapa, Joseph S Susa, Stephen E Weis
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Comedones occur when an overproliferation of keratinocytes blocks sebum secretion in a pilosebaceous duct. Comedones have multiple possible etiologies and contributing factors. While comedones are common to acne, they are also seen in occupational exposures and are associated with certain syndromes. We describe a particularly rare case of comedones at the perianus that is not associated with any known exposure or disease and is a rare incidental finding.
Deep Brain Stimulation Improves the Symptoms and Sensory Signs of Persistent Central Neuropathic Pain from Spinal Cord Injury: A Case Report
Authors: Walter J Jermakowicz, Ian D Hentall, Jonathan R Jagid, Corneliu C Luca, James Adcock, Alberto Martinez-Arizala, Eva Widerström-Noga
Journal: Front Hum Neurosci (2017)
Keywords: chronic pain, evoked pain, low-frequency stimulation, neuromodulation, pain severity, periaqueductal gray

Central neuropathic pain (CNP) is a significant problem after spinal cord injury (SCI). Pharmacological and non-pharmacological approaches may reduce the severity, but relief is rarely substantial. While deep brain stimulation (DBS) has been used to treat various chronic pain types, the technique has rarely been used to attenuate CNP after SCI. Here we present the case of a 54-year-old female with incomplete paraplegia who had severe CNP in the lower limbs and buttock areas since her injury 30 years prior. She was treated with bilateral DBS of the midbrain periaqueductal gray (PAG). The effects of this stimulation on CNP characteristics, severity and pain-related sensory function were evaluated using the International SCI Pain Basic Data Set (ISCIPBDS), Neuropathic Pain Symptom Inventory (NPSI), Multidimensional Pain Inventory and Quantitative Sensory Testing before and periodically after initiation of DBS. After starting DBS treatment, weekly CNP severity ratings rapidly decreased from severe to minimal, paralleled by a substantial reduction in size of the painful area, reduced pain impact and reversal of pain-related neurological abnormalities, i.e., dynamic-mechanical and cold allodynia. She discontinued pain medication on study week 24. The improvement has been consistent. The present study expands on previous findings by providing in-depth assessments of symptoms and signs associated with CNP. The results of this study suggest that activation of endogenous pain inhibitory systems linked to the PAG can eliminate CNP in some people with SCI. More research is needed to better-select appropriate candidates for this type of therapy. We discuss the implications of these findings for understanding the brainstem's control of chronic pain and for future progress in using analgesic DBS in the central gray.
Case hepatic endometriosis: a continuing diagnostic dilemma
Authors: P J Goldsmith, N Ahmad, D Dasgupta, J Campbell, J A Guthrie, J P A Lodge
Journal: HPB Surg (2009)
MeSH terms: Endometriosis / diagnosis, Liver Diseases / diagnosis, Case Reports, Endometriosis / pathology, Female, Humans, Liver / pathology, Liver Diseases / pathology, Middle Aged

Background:
Intraparenchymal endometriosis of liver is rare. It may present as liver tumour and the diagnosis is not usually established till after surgery.
Case outline:
A 48-year-old postmenopausal woman presented with right upper quadrant pain and a cystic liver mass. Liver function tests and tumour markers (alphaFP, CEA, CA 19-9, and CA 125) were normal. Radiological imaging (USS, CT and MRI) suggested a thick walled cystic mass involving segments IV and VIII with complex intracystic septations. Frozen section at operation suggested a benign cystadenoma. The cyst was enucleated using a CUSA (Cavitron ultrasonic aspirator). The final histology confirmed endometriosis.
Discussion:
Eleven cases of hepatic endometrioma have been reported and only four in postmenopausal women. Preoperative diagnosis poses a challenge and so far none of the cases have been diagnosed preoperatively. Surgery remains the treatment of choice. Accurate diagnosis at time of operation may avoid extensive liver surgery and its associated morbidity.
Cystoscopy-Guided Laparoscopic Excision of Prostatic Utricle: Report of a Case
Authors: Ozlem Boybeyi-Turer, Huseyin Demirbilek, Tutku Soyer
Journal: European J Pediatr Surg Rep (2020)
Keywords: cystoscopy, laparoscopy, prostatic utricle
MeSH terms: Case Reports

Prostatic utricle (PU) is incomplete regression of Müllerian duct and may cause recurrent urinary tract infections (UTIs), stone formation, postvoid dribbling, and recurrent epididymitis. Although surgical excision is recommended to avoid complications, surgical access to PU has been challenging. Cystoscopy-guided laparoscopic management of PU in a 3-year-old boy is reported to discuss use of other endoscopic aids in the surgical treatment of PU. He was admitted with disordered sexual development with karyotype of 47,XYY/46,XY and has been experiencing recurrent UTIs. Voiding cystourethrogram (VCU) demonstrated large PU (IKOMA II). Cystoscopy was performed confirming PU and the cystoscope was left in situ to aid laparoscopic exploration after bladder was emptied. A 5-mm umbilical port and two 5-mm ports in both lower quadrants were inserted. The peritoneum was dissected behind bladder. The cystoscope in PU was used as guidance in identification and dissection of PU. The vas deferens was identified and could be secured. The neck of PU was ligated with surgiloop. PU was retrieved from umbilical port. Postoperative VCU revealed normal posterior urethra. He has been free of UTIs for the last 6 months. Laparoscopy is safe and feasible alternative in surgical management of PU, by providing good visual exposure, easy dissection in deep pelvis, and improved cosmesis. The cystoscopic guidance is an important aid in identification and dissection of PU.
Submental intubation including extubation: airway complications of maxillomandibular fixation
Authors: Santosh Kumar Yadav, Gopendra Deo
Journal: Case Rep Anesthesiol (2012)

Hernandez first described the submental route for endotracheal intubation in 1986 as an alternative airway maneuver for maxillofacial procedures. Since that time, several case studies have been performed demonstrating the efficacy of the submental approach. This method was recently implemented in the case of a patient with altered nasal anatomy who sustained a mandibular fracture necessitating maxillomandibular fixation. Unlike most of the cases described in the literature, this patient's operative course was confounded by the need to extubate through the submental tunnel. The patient tolerated the procedure well and was able to avoid other forms of surgical airway.
A Surgical Opinion in a 36-Week Pregnant with Tibia Fracture: Intramedullary Nailing
Authors: Celal Bozkurt, Baran Sarikaya
Journal: Case Rep Orthop (2016)
MeSH terms: Case Reports

The operative treatment of tibial fractures in late pregnancy is a controversial issue that is rarely discussed in the literature. Here we present a case of a tibial diaphyseal fracture in a woman that was 36 weeks pregnant, which was treated with intramedullary nails under noninvasive foetal monitoring with cardiotocography. The patient underwent a successful surgery, and no harm or adverse events to either the mother or the foetus were reported during or after the procedure. Following surgery, the mother had a comfortable pregnancy and a normal spontaneous vaginal delivery with a healthy newborn.
Spontaneous bilateral quadriceps tendon rupture: a case report
Authors: Kelechukwu Mc'Clement Onuoha, Olubukola Khadija Ajiboye, Rajeev Kumar
Journal: Pan Afr Med J (2020)
Keywords: quadriceps tendon rupture, proximal myopathy, transosseous
MeSH terms: Knee Injuries / surgery, Tendon Injuries / surgery, Case Reports, Humans, Knee Injuries / pathology, Male, Middle Aged, Rupture, Spontaneous, Tendon Injuries / pathology

Quadriceps tendon rupture is an uncommon injury and mostly occurs among middle aged individuals that are involved in sports such as running or jumping. Spontaneous bilateral quadriceps tendon rupture is a rarer injury, however, can be debilitating. Patients with such injuries usually present with history of minor trauma, swelling and inability to actively extend the knee. Its occurrence secondary to minor trauma is mostly associated with chronic diseases and long-term use of certain medications. Occurrence of simultaneous bilateral quadriceps tendon rupture in the absence of trauma in a healthy patient with no known medical condition is yet to be reported and therefore requires a high index of suspicion for early diagnosis and effective management to avoid complications. The aim of this case report is to create awareness of the spontaneous occurrence of this injury in the absence of the reported risk factors. We report the unusual case of a 60-year old healthy man who presented with a spontaneous simultaneous bilateral quadriceps' tendon rupture in the absence of trauma and no medical risk factors. We report the unusual case of a 60-year old healthy man who presented with a spontaneous simultaneous bilateral quadriceps tendon rupture in the absence of trauma and no medical risk factors. Consent was taken from him to be used as a case report being a rare case. The man had full recovery after surgery and physiotherapy and was discharged home. Spontaneous bilateral quadriceps tendon rupture is a rare occurrence. The index case report is important as there was no history of trauma and it was bilateral.
Conservative, Surgical, and Prosthetic Treatment of a Patient with a Periapical Lesion Associated with an Atypical Intraoral Sinus Tract
Authors: Michael Wolgin, Peter Tschoppe, Andrej M Kielbassa
Journal: Case Rep Dent (2015)

This report describes a clinical case with an atypical intraoral sinus tract formation from diagnosis and treatment to short-term outcome and definitive prosthetic rehabilitation. In detail, the patient underwent conservative nonsurgical root canal treatment followed by guided bone augmentation of the regions involved in periapical inflammation and sinus tract formation. The removal of the inflammatory source of the lesion as well as the affected tissue clearly led to a healing of the surrounding bone tissues. Subsequently, the tooth was reconstructed using a fibreglass post and a metal-ceramic crown; an implant was successfully placed in the previously inflamed bone region.
Dysregulation of FOXG1 by ring chromosome 14
Authors: Daniela Alosi, Laura Line Klitten, Mads Bak, Helle Hjalgrim, Rikke Steensbjerre Møller, Niels Tommerup
Journal: Mol Cytogenet (2015)
Keywords: 14q12, dynamic mosaicism, epilepsy, foxg1, intellectual disability, ring chromosome 14
MeSH terms: Case Reports

In this study we performed molecular characterization of a patient with an extra ring chromosome derived from chromosome 14, with severe intellectual disability, epilepsy, cerebral paresis, tetraplegia, osteoporosis and severe thoraco-lumbal scoliosis. Array CGH analysis did not show any genomic imbalance but conventional karyotyping and FISH analysis revealed the presence of an interstitial 14q12q24.3 deletion and an extra ring chromosome derived from the deleted material. The deletion and ring chromosome breakpoints were identified at base-pair level by mate-pair and Sanger sequencing. Both breakpoints disrupted putative long non-coding RNA genes (TCONS00022561;RP11-148E17.1) of unknown function. However, the proximal breakpoint was 225 kb downstream of the forkhead box G1 gene (FOXG1), within the known regulatory landscape of FOXG1. The patient represents the first case of a r(14) arising from an interstitial excision where the phenotype is compatible with dysregulation of FOXG1. In turn, the phenotypic overlap between the present case, the FOXG1 syndrome and the r(14) syndrome supports that dysregulation of FOXG1 may contribute to the classical r(14)-syndrome, likely mediated by dynamic mosaicism.
Late-Onset Ileocutaneous Fistula Eight Years After Plug Repair With Polypropylene Mesh: A Case Report
Authors: Jiankang Zhang, Zeming Hu, Xuan Lin, Bin Chen
Journal: Front Surg (2021)
Keywords: case report, inguinal hernia, intestinal fistula, laparoscopic exploration, late-onset, mesh
MeSH terms: Case Reports

Introduction: As one of the short-term complications after inguinal hernia repair, mesh infection frequently occurs but rarely leads to ileocutaneous fistula. We present a rare case of ileocutaneous fistula 8 years after inguinal hernia plug repair with polypropylene mesh. Case Presentation: The patient was a 67-year-old male who underwent a plug repair with polypropylene mesh of the right inguinal hernia. Eight years after the primary repair, skin ulceration with pus presented in the right groin area, and the final diagnosis was enterocutaneous fistula. According to laparoscopic exploration, the ileum below the fistula closely adhered to the abdominal wall. After gently separating the bowel loop, a defect area of about 2 × 3 cm was observed on the surface of the ileum. In laparotomy, the plug was found embedded in the ileum and then was completely removed, and an ileum side-to-side anastomosis was performed. The patient was discharged 2 weeks after the surgery, and follow-up at the sixth month revealed complete healing of the wound and no evidence of hernia recurrence. Conclusion: Late-onset ileocutaneous fistula should be considered in the differential diagnosis in patients who present inflammation and abscess formation after hernia repair. Besides, for patients with suspected intestinal fistula after hernia repair, laparoscopic exploration should be given priority, and the mesh removal approach should be tailored according to the results of laparoscopic exploration.
Familial Interstitial Lung Disease Caused by Mutation of the STING1 Gene
Authors: Jinying Li, Shuhua An, Zhongdong Du
Journal: Front Pediatr (2020)
Keywords: familial interstitial lung disease, mutation, polyarthralgia, stimulator of interferon genes (sting), transmembrane protein 173 (tmem173)
MeSH terms: Case Reports

Mutations that affect the STING1 (TMEM173) gene cause a rare autoinflammatory syndrome, which is known as STING-associated vasculopathy with onset in infancy (SAVI) and which was initially described in 2014 (1). Thus far, only four reports have been conducted regarding families affected with SAVI in the literature. In this article, the clinical, laboratory, and genetic characteristics of two generations (three cases) of SAVI are described. Unlike previously reported cases that were caused by STING1 mutation, the initial and major clinical manifestations of the mentioned cases are largely identified in the lungs with interstitial lung disease (ILD), and the evidence of typical extrapulmonary symptoms of early-onset systemic inflammation (e.g., cutaneous vasculopathy) were minimal except for the proband, who was diagnosed with arthritis 8 years after onset. In addition, a younger sibling showed no symptoms. Such reports are rarely related to mutations in STING1. The proband was examined with bronchoscopy and alveolar lavage to determine the cause. This study emphasizes that, in the clinical assessment of interstitial pneumonia in children, the possibility of STING1 mutation should be considered, especially in patients with arthritis in addition.
Case Report: TFE3 Positive Xp11.2 Translocation Renal Cell Carcinoma (TRCC) - A Case Study and Review of the Literature
Authors: Ignacy Miroński, Jan Mateusz Zaucha, Jacek Kowalski, Renata Zaucha
Journal: Front Oncol (2022)
Keywords: tfe3, trcc, microphtalmia-associated transcription factor, non-clear renal cell carcinoma, translocation renal cell cancer
MeSH terms: Case Reports

Microphthalmia-associated transcription factor renal cell cancer, also known as translocation renal cell cancer, belongs to the group of extremely rare non-clear-cell kidney neoplasms. Their incidence is lower in adulthood than in childhood. The only known risk factor for the development of this tumor is prior chemotherapy. In the operable stage of the disease, the prognosis depends on the status of regional lymph nodes. Interestingly lymph node positivity worsens the prognosis only in the adult patient population. Radical surgical excision is the best therapy in the early stage. The optimal treatment strategy for locally advanced and metastatic disease has not been established, given the lack of evidence in such a rare disease. We present the case of a patient with an aggressive course of this neoplasm treated with temsirolimus, who achieved 10-month control of this neoplasm accompanied by a discussion on other therapeutic possibilities.
Treatment of Central Nervous System Relapse in Acute Promyelocytic Leukemia by Venetoclax: A Case Report
Authors: Xuzhao Zhang, Jinliang Chen, Weiqin Wang, Xian Li, Yanbin Tan, Xiaohong Zhang, Wenbin Qian
Journal: Front Oncol (2021)
Keywords: csf concentration, acute promyelocytic leukemia, central nervous system, relapse, venetoclax
MeSH terms: Case Reports

Extramedullary relapse of acute promyelocytic leukemia is a rare phenomenon and is associated with a poor prognosis, with the central nervous system being the most common site of relapse. The current treatments are still limited. Venetoclax, a selective inhibitor of BCL2, is a small molecule that can cross the blood-brain barrier and shows a potential efficacy in the treatment of chronic lymphocytic leukemia with central nervous system involvement. Although venetoclax has also been used in the treatment of acute myeloid leukemia in recent years, there are no reports of its use in the treatment of central nervous system relapse in acute promyelocytic leukemia. Here, we report a case of central nervous system relapse in acute promyelocytic leukemia that achieved complete remission after oral treatment with venetoclax. The presence of venetoclax in the patient's CSF was confirmed by testing CSF and plasma by mass spectrometry. The concentration of venetoclax in CSF was approximately 1/300 of that in plasma trough concentration. The treatment experience in this case demonstrates the potential ability of venetoclax to treat of central nervous system relapse/involvement in acute promyelocytic leukemia, thus providing a new treatment option for this kind of patient.
Ultra-Low-Dose Radiotherapy for Palliation of Mycosis Fungoides
Authors: İpek Pınar Aral, Neşe Göçer Gürok, Aykut Oğuz Konuk, Özlem Üçer
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Introduction. Mycosis fungoides (MF) is a form of primary cutaneous T-cell lymphomas, and radiotherapy (RT) has been used to treat localized/limited lesions of MF. In this case report, the results of low-dose RT applied for palliative purpose are shared. Case Report. A 70-year-old male patient was admitted to the outpatient clinic 7 months ago with a generalized itchy rash. The result of the biopsy was reported as mycosis fungoides. Systemic treatment was not performed due to comorbid diseases. The hemibody RT was applied. 2 Gy was given per fraction, with a total dose of 6 Gy. The significant clinical relief was observed with 6 Gy RT. The patient died due to multiorgan failure 2 months later, and no recurrence was observed. Conclusion. The palliation was achieved in the advanced MF patient with fractionated 6 Gy hemibody RT for the remaining 2 months of life.
The Monitoring of Preoperative External Detorsion with Diffusion-Weighted Imaging in a Patient with Acute Testicular Torsion
Authors: Mehmet Beyazal, Fatma Beyazal Çeliker, Mehmet Fatih İnecikli, Maksude Esra Kadioğlu, Hasan Rıza Aydın, Tuğba Durakoğlugil
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Testicular torsion is one of the main causes of acute scrotum and may result in permanent damage of the testicular tissue. Color Doppler imaging has been frequently used in the diagnosis of testicular torsion and posttreatment follow-up period of the disease. There are some studies reporting the value and usefulness of diffusion-weighted imaging in the diagnosis of testicular torsion. However, to the best of our knowledge, there is no report regarding the monitoring of preoperative external detorsion in testicular torsion with diffusion-weighted imaging examination. In this article, diffusion-weighted imaging findings in the management of preoperative external detorsion in a case with testicular torsion were presented.