OpenMed/multicare-articles huggingface dataset:
Obsessive-Compulsive Disorder Associated with Posterior Cranial Fossa Meningioma
Authors: Nobuyuki Takeuchi, Etushi Kato, Kousuke Kanemoto
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

We report here a patient in whom the effects of a cerebellum mass may have led to development of obsessive-compulsive disorder (OCD). A 33-year-old woman showed symptoms of OCD, including obsessive worry about infection from tainted blood and repetitive confirmation, which worsened during pregnancy. She had comprehension in regard to her illness and no evidence of cognitive dysfunction and did not meet other DSM-5 criteria such as depression. One month after giving childbirth, the symptoms worsened, while headache and dizziness also developed. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score was 34. The patient was examined for a headache and a posterior cranial fossa meningioma was found. Following resection of the meningioma, the OCD symptoms were remarkably reduced (Y-BOCS score 10). There is only one previous report of pure OCD associated with a cerebellar mass and the present findings should help to elucidate the mechanism.
Case report: Type I diastematomyelia with breast abnormalities and clubfoot
Authors: Shenshen Hao, Zenan Yue, Xin Yu, Zhenfu Gao, Hongke Li, Shuai Liu, Shengli Dong
Journal: Front Surg (2022)
Keywords: breast abnormalities, case report, clubfoot, diastematomyelia, surgery
MeSH terms: Case Reports

Background:
Diastematomyelia is a rare congenital spinal cord malformation, classified as type I or type II, with over half of the cases considered type I. However, type I diastematomyelia with breast abnormality and clubfoot is extremely rare in clinical practice.
Case presentation:
We admitted an 18-year-old female patient with type I diastematomyelia with breast abnormalities and clubfoot. She was underwent surgical treatment. After the surgical removal of the pressure-causing bone spur, the weakness of the right lower limb was significantly relieved. During the 22-month follow-up, there was no complication and no recurrence.
Conclusion:
Surgical removal of the pressure-causing bone spur can relieve symptoms in the lower limbs. However, further research is warranted to explore the breast abnormalities in patients with diastematomyelia.
Solitary Fibrous Tumour of the Parotid Gland: A Case Report and Review of the Literature
Authors: Matthew M Kwok, Muthukumar Subramaniyan, Sor Way Chan
Journal: Case Rep Otolaryngol (2015)

Introduction. Solitary fibrous tumours (SFT) of the parotid gland are a very rare group of spindle-cell tumours with only 28 cases reported in the literature. This review aims to report an additional case of parotid SFT and provide a review of all reported cases of this rare condition. Case Presentation. A 26-year-old male presented a 3 cm well-demarcated, slowly enlarging mass which was completely excised, revealing histological and immunohistochemical features of SFT. Discussion. Reviews of all reported cases suggest that histology and immunohistochemistry are paramount in the diagnosis of SFT. These features, along with clinical presentation and management of this rare condition, will be discussed.
Mandibular fracture in a child resulting from a dog attack: a case report
Authors: Hannah Cottom, Dery Tuopar, Phillip Ameerally
Journal: Case Rep Dent (2011)
MeSH terms: Case Reports

Dog attacks are extremely frequent and are thought to be responsible for an average of 250,000 minor injuries and emergency unit attendances each year. Children in particular are more likely to experience dog-bite injuries with 5-9-year olds most susceptible. The majority of injuries are to the head region, with the lips, cheeks, and nose often affected. Most injuries experienced are confined to the soft tissues; nevertheless, maxillofacial fracture is a potential albeit rare complication. The incidence of facial fractures in relation to dog bites is unknown; however, some have estimated that facial fractures could occur in 5% of dog attacks. However mandibular fracture following a dog bite is extremely rare, with review of the literature only identifying three cases. We present a further case in which a five-year-old sustained numerous soft-tissue lacerations to the face and hand, together with fracture of the mandibular symphysis following a dog attack. The fracture was successfully repaired using open reduction and internal fixation with titanium plates and screws. The case emphasises that although maxillofacial fracture is rare, it may occur following a dog bite and that thorough and systematic examination of the facial skeleton is crucial to exclude the presence of such injuries.
Remote Cerebellar Hemorrhage after Removal of a Supratentorial Glioma without Perioperative CSF Loss: A Case Report
Authors: Takuma Hara, Masahide Matsuda, Shinya Watanabe, Kei Nakai, Tetsuya Yamamoto, Akira Matsumura
Journal: Case Rep Surg (2013)

A 44-year-old man presented with the rare complication of remote cerebellar hemorrhage (RCH) after removal of a supratentorial glioma without the loss of a large volume of cerebrospinal fluid (CSF). He presented with severe headache, nausea, and vomiting for a few days, then he developed neurological deterioration including progressive disturbance of consciousness and left hemiparesis. Magnetic resonance imaging revealed a large tumor with intratumoral hemorrhage in the right frontal lobe that led to subfalcial and transtentorial herniation. The tumor was removed en bloc without excessive loss of CSF throughout the perioperative period. Although the level of consciousness remained unchanged from the preoperative level and no new neurological deficit was detected, routine postoperative computed tomography showed a bilateral RCH. Careful conservative therapy was provided and follow-up computed tomography demonstrated no further progression of hemorrhage. Compensatory acute engorgement of venous sinuses derived from the rapid decrease in intracranial pressure that occurred due to removal of the huge tumor might have caused cerebellar hemorrhagic venous infarction.
Case report on postmortem fentanyl measurement after overdose with more than 67 fentanyl patches
Authors: L E J Peeters, I T Vleut, G E Tan, E A Croes, C Bethlehem
Journal: Forensic Toxicol (2022)
Keywords: drug overdose, fentanyl, humans, postmortem, tandem mass spectrometry, toxicology
MeSH terms: Cocaine, Drug Overdose / diagnosis, Opiate Overdose, Case Reports, Adult, Autopsy, Fentanyl, Humans, Male, Young Adult, Fentanyl, Cocaine

Purpose:
Fentanyl is an analgesic that is frequently prescribed, which resulted in non-intentional as well as intentional misuse and deaths. Here, we present a postmortem case of a patient who clearly died of a fentanyl overdose due to an extensive number of fentanyl patches combined with oral intake of fentanyl and cocaine. We aimed to show how postmortem analysis can be used to interpret postmortem fentanyl concentrations in unique cases like the one we present.
Case description:
A 23-year-old male was found dead in his bedroom with 67 non-prescribed patches of fentanyl on his body. In the room, there also were fentanyl tablets of 100 µg and cocaine powder, which had possibly also been taken by the deceased. To confirm the cause of death, urine and subclavian blood were retrieved to perform a standard postmortem toxicology screening. The toxicological screening revealed the presence of several drugs, including cocaine, fentanyl, lidocaine and paracetamol. Further analysis of the quantitative postmortem values of fentanyl with ultra-performance liquid chromatography-tandem mass spectrometry revealed a fentanyl concentration of 57.9 µg/L. Considering several issues around postmortem drug analyses, this value seemed to be in line with concentrations found in previously reported postmortem cases.
Conclusion:
We were able to confirm the expected cause of death with an extensive toxicological screening in combination with the circumstantial evidence. We identified fentanyl as most important cause for the fatal outcome in this specific case and simultaneously contributed to the limited availability of knowledge on postmortem fentanyl concentrations.
Misdiagnoses of Epilepsy as Ekbom Syndrome, Mood Instability, and Nocturnal Visual Hallucinations
Authors: M Duarte Mangas, Y Martins, L Bravo, A Matos Pires
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Epileptic seizures may be misdiagnosed if they manifest as psychiatric symptoms. We report three female patients with no preexisting history of epilepsy that were unsuccessfully treated as primary psychiatric disorder: one patient was initially diagnosed with somatization and Ekbom syndrome; the second was referred to psychiatrist due to mood instability and visual hallucinations; and the third one was referred for anxiety and hallucinations related to sleep. A carefully taken medical history clarified diagnoses of epilepsy. None of the patients responded to medications aimed at treating psychiatric symptoms, and all the patients had favorable response to antiepileptic treatment. These cases illustrate that epileptic patients may experience nonconvulsive seizures that might be misdiagnosed as primary psychiatric disorder.
Case Report: A Recovered SARS CoV-2 Patient Protected From Reinfection
Authors: Waleed Mahallawi
Journal: Front Med (Lausanne) (2020)
Keywords: sars cov-2, herd immunity, protection, reinfection, vaccines
MeSH terms: Case Reports

The COVID-19 pandemic caused by SARS CoV-2 is a worldwide emergency, and is taking a substantial toll on human health, lives, and the global economy. Due to the novelty of this virus, no SARS CoV-2-specific treatments or licensed vaccines are available though few vaccines are undergoing clinical trials. Therefore, continued research into an effective vaccine is an urgent necessity. The reinfection of recovered patients is one of the major concerns of healthcare providers worldwide. Health authorities are currently seeking evidence of protection from reinfection in recovered individuals. This is the first case report in Saudi Arabia on a patient who was diagnosed as COVID-19-positive; recovered; and after successful recovery was protected against reinfection.
A case of generalized argyria presenting with muscle weakness
Authors: Inha Jung, Eun-Jeong Joo, Byung Seong Suh, Cheol-Bae Ham, Ji-Min Han, You-Gyung Kim, Joon-Sup Yeom, Ju-Yeon Choi, Ji-Hye Park
Journal: Ann Occup Environ Med (2017)
Keywords: generalized argyria, myopathy, polyneuropathy, silver
MeSH terms: Case Reports

Background:
Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness.
Case presentation:
A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids.
Conclusions:
Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.
Acute Digital Ischemia After Arterial Injection of Crushed Zolpidem Tablets: Role of Microcrystalline Cellulose? A Case Report
Authors: Grégoire Détriché, Guillaume Goudot, Lina Khider, Alexandre Galloula, Matthieu Guillet, Agnès Lillo-Le Louët, Emmanuel Messas, Tristan Mirault
Journal: Front Pharmacol (2020)
Keywords: acute digital ischemia, case report, drug misuse, microcrystalline cellulose, zolpidem
MeSH terms: Case Reports

Literature is scarce on acute ischemia after intra-arterial injection of crushed tablets and no effective medical treatment against the progression of lesions is reported. The only factor able to modify the outcome is the delay between injection and management by a specialized vascular team. Moreover the risk of necrosis seems higher after benzodiazepine intra-arterial injection than with other drugs. We tried to find out mechanistic explanations. We report on the case of a 31-year-old drug addict woman who self-injected into her left brachial artery crushed tablets of zolpidem. She developed an acute ischemia of the left hand, with necrosis of the intermediate and distal phalanges of fingers II, III, and IV. Angiogram of the left upper arm confirmed the distal arterial occlusions with no run-off after the palmar arch in the necrotic fingers. Once she was admitted into our vascular unit, intravenous vasodilator therapy by iloprost, heparin and local protective care were rapidly introduced. After delineation between living and necrotic tissues, she required distal amputations of the affected fingers. The clinical severity of arterial injections of benzodiazepine tablets is linked to the association of several pathophysiological mechanisms. Rather than related benzodiazepine pharmacologic effects with tissue ischemia, by the inhibition of phosphodiesterase, a vasodilator intermediate, or through the peripheral benzodiazepine-type receptor, the predominant mechanism is more likely in relation with microcrystalline cellulose, one component of zolpidem tablets, known as potential embolic agents. They are insoluble and resistant to degradation in water. These properties are probably prominent in the case we described here. Through this case report we want to drag attention of physicians in charge of a patient with acute ischemia after crushed tablet accidental intra-arterial injection, not only to look at the drug injected but also the other components of the tablet and especially to microcrystalline cellulose.
Case report: Olaparib as an experimental therapy in a BRCA2-mutated patient with metastatic ovarian adenocarcinoma that originated from liver cancer
Authors: Caixia Li, Wenlei Ye, Wenni Zhou, Zhikang Ye, Weihong Yang, Zhongping Cheng
Journal: Front Oncol (2022)
Keywords: case report, liver cancer, metastasis, olaparib, secondary ovarian tumor
MeSH terms: Case Reports

Secondary ovarian tumor [secondary tumor of the ovary (STO)] is not a frequent disease. To date, there is still a lack of standard treatment for STO due to the relative heterogeneity. Liver cancer metastasis to the ovary is extremely rare, with only 17 living cases having been reported so far, making it impossible to launch large-scale prospective studies and formulate the standard intervention for patients. We herein report a rare case of STO with liver primary cancer metastasis to the ovary and omentum in a 66-year-old woman. The patient underwent debulking surgery with the removal of the uterus, bilateral fallopian tubes, bilateral ovaries, appendix, and a large part of the omentum majus. Next-generation sequencing was conducted after the operation, identifying BRCA2 mutation. Because strongly refusing chemotherapy, she received olaparib as an experimental therapy. After the administration of surgery and olaparib, the serum value of cancer antigen 125 (CA125) and alpha fetoprotein (AFP) decreased dramatically and basically remained within the normal range. So far, she has achieved nearly 2-year survival and lives a relatively normal life with good quality.
Feasibility and Safety of Sodium Glucose Cotransporter-2 Inhibitors in Adults with Heart Failure after the Fontan Procedure
Authors: Jun Muneuchi, Yuichiro Sugitani, Masaru Kobayashi, Hiroki Ezaki, Hiromu Yamada, Mamie Watanabe
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Sodium glucose cotransporter-2 (SGLT-2) inhibitors have been widespread in patients with heart failure; however, there is little information regarding its feasibility and safety among patients after the Fontan procedure. We presented five adults after the Fontan procedure who were treated with SGLT-2 inhibitors. All patients reduced oedema and/or pleural effusion despite other conjunct medications were ineffective. Although we did not measure the urine volume in all patients, all patients themselves reported an increase in urinary output after the administration of a SGLT-2 inhibitor. In addition, administration of a SGLT-2 inhibitor resulted in weight loss (4/5), an increase in systemic oxygen saturation (4/5), an increase in serum albumin level (4/5), an increase in estimated glomerular filtration ratio (4/5), and a decrease in plasma brain natriuretic peptide level (4/5). Our case series supported the feasibility and safety of SGLT-2 inhibitors in patients with Fontan circulatory failure, although the exact changes in urinary output were unknown in all patients. Further investigation will be required to explore a diuretic effect by SGLT-2 in patients after the Fontan procedure.
Coexistent Relapsing Polychondritis and Clinically Amyopathic Dermatomyositis: A Rare Association of Autoimmune Disorders
Authors: Rafael A Ríos-Rivera, Luis M Vilá
Journal: Case Rep Rheumatol (2023)
MeSH terms: Case Reports

Relapsing polychondritis (RPC) is an uncommon autoimmune systemic disease characterized by recurrent inflammation of the cartilage tissue. It can occur alone or in association with other autoimmune diseases, vasculitis, or hematologic disorders. However, the association of RPC with dermatomyositis is extremely rare. Herein, we present a case of a 38-year-old man who developed concurrent RPC and clinically amyopathic dermatomyositis (CADM) manifested by auricular chondritis, nasal chondritis, polyarthritis, gottron papules, fingertip papules, skin biopsy consistent with dermatomyositis, and positive antimelanoma differentiation-associated gene 5 (MDA5) antibodies. RPC features resolved with corticosteroids, but CADM manifestations were resistant to corticosteroids, cyclophosphamide, azathioprine, and hydroxychloroquine. Subsequent therapy with rituximab was effective to control CADM manifestations. This case highlights the importance of recognizing CADM as part of the autoimmune diseases linked with RPC and maintaining a high level of awareness to initiate effective therapy to avoid the long-term complications associated with these conditions.
Isolated liver metastasis of sacrococcygeal chordoma: case report and review of the literature
Authors: Murat Akyol, Umut Varol, Ibrahim Yildiz, Ibrahim Vedat Bayoglu, Yasar Yildiz, Lutfiye Demir, Ahmet Dirican, Alper Can, Suna Cokmert, Mine Tunakan Oztop, Ahmet Alacacioglu, Yuksel Kucukzeybek, Mustafa Oktay Tarhan
Journal: Case Rep Oncol Med (2014)

Chordomas are rare neoplasms arising from notochordal remnants and may develop anywhere in the body while the most common anatomic site is the sacrococcygeal area. The most effective treatment of chordoma is surgery. Chordomas rarely metastasize to lung, bone, soft tissue, liver, lymph nodes, and skin. However, there is currently no standard systemic treatment for advanced stage chordoma. Here, we reported a rare presentation of chordoma patient with liver only metastases and poor prognosis.
Lung Abscess in a Patient With VAP: A Rare Case of Lung Infection Complicated by Two Pathogens
Authors: Christina Mystakelli, Stavros Gourgiotis, Paraskevi Aravosita, Charalampos Seretis, Efthymia Kanna, Stavros Aloizos
Journal: J Clin Med Res (2013)
Keywords: abscess, acinetobacter baumannii, klebsiella pneumoniae, lung, ventilator-associated pneumonia
MeSH terms: Case Reports

Ventilator-associated pneumonia (VAP) is defined as pneumonia occurring in a patient after intubation with an endotracheal tube or tracheostomy tube lasting for 48 hours or more. We describe a case of 75-year-old male who initially presented with pneumonia of the right basis with accompanying plevritis. The patient was intubated and his condition was complicated with a VAP infection while he developed a lung abscess. The antibiotic therapy was based on susceptibility bronchial secretions isolated acinetobacter baumannii and klebsiella pneumoniae; these pathogens were also isolated from the drained abscess. The patient was discharged in good health. The interest of this case is recommended in the existence of two responsible pathogens, the paucity of the development of lung abscess in a patient with VAP, and the successful treatment of the patient with the combination of controlled drainage of the abscess and appropriate antibiotic therapy.
Tale of two hearts: a TNNT2 hypertrophic cardiomyopathy case report
Authors: Justin H Pham, John R Giudicessi, Marysia S Tweet, Lauren Boucher, D Brian Newman, Jeffrey B Geske
Journal: Front Cardiovasc Med (2023)
Keywords: tnnt2, cardiac troponin t, case report, familial cardiomyopathy, hypertrophic cardiomyopathy, incomplete genetic penetrance, variable genetic expressivity
MeSH terms: Case Reports

Hypertrophic cardiomyopathy (HCM) is a heritable cardiomyopathy that is predominantly caused by pathogenic mutations in sarcomeric proteins. Here we report two individuals, a mother and her daughter, both heterozygous carriers of the same HCM-causing mutation in cardiac Troponin T (TNNT2). Despite sharing an identical pathogenic variant, the two individuals had very different manifestations of the disease. While one patient presented with sudden cardiac death, recurrent tachyarrhythmia, and findings of massive left ventricular hypertrophy, the other patient manifested with extensive abnormal myocardial delayed enhancement despite normal ventricular wall thickness and has remained relatively asymptomatic. Recognition of the marked incomplete penetrance and variable expressivity possible in a single TNNT2-positive family has potential to guide HCM patient care.
Hemoperitoneum in a cirrhotic patient due to rupture of retroperitoneal varix
Authors: Igor Rafael Sincos, Grace Mulatti, Sheila Mulatti, Ilana Cristina Sincos, Sergio Q Belczak, Valdir Zamboni
Journal: HPB Surg (2009)
MeSH terms: Hemoperitoneum / etiology, Hemostasis, Surgical / methods, Hypertension, Portal / diagnosis, Liver Cirrhosis / complications, Varicose Veins / surgery, Case Reports, Abdominal Pain / diagnosis, Abdominal Pain / etiology, Blood Transfusion, Brazil, Disease Progression, Emergency Service, Hospital, Emergency Treatment / methods, Fatal Outcome, Female, Hemoperitoneum / diagnosis, Hemoperitoneum / surgery, Humans, Hypertension, Portal / complications, Laparotomy / methods, Ligation / methods, Liver Cirrhosis / diagnosis, Middle Aged, Multiple Organ Failure / diagnosis, Postoperative Complications / physiopathology, Retroperitoneal Space / blood supply, Rupture, Spontaneous / etiology, Rupture, Spontaneous / surgery, Severity of Illness Index, Varicose Veins / complications, Varicose Veins / diagnosis

The rupture of retroperitoneal varices is a rare and catastrophic complication of portal hypertension. We describe a case of this nature, the first in Brazilian medical literature, and also reviewing all previous 34 cases. We systematically analyzed all therapeutic approach and propose a management algorithm for diagnosis and treatment of this lethal condition. The majority of the patients presented with abdominal pain, distention and hypotension, and developed hemorrhagic shock. Rupture of retroperitoneal varices can be properly managed if an early diagnosis is made and surgery is performed promptly, which is the only effective treatment. Arteriography should be used when the suspicion is of rupture of hepatocellular carcinoma.