OpenMed/multicare-articles huggingface dataset:
Case Report: Compromised Airway Following Anesthesia and Its Correlation With the Use of ACE Inhibitors-An Unexpected Clinical Event and Review of Literature
Authors: Sanjeev Mohanty, Ashish Bangaari, Kumaran Gnanasekaran
Journal: Front Surg (2021)
Keywords: airway, angioedema, angiotensin-converting enzyme, bradykinin, tongue oedema
MeSH terms: Case Reports

Angiotensin-converting enzyme inhibitors associated angioedema involving the upper aerodigestive tract is indisputably a hazardous airway condition which is clinically poorly recognized and frequently underestimated. We describe and present case of a 70-year old man on ramipril who developed massive tongue swelling post-operatively after unremarkable laryngeal mask anaesthesia which was fortuitously managed conservatively. High index of suspicion, timely recognition and knowledge of pathophysiology and the clinical course should guide airway and further supportive management in these patients.
Wegener's granulomatosis: a rare cause of hydronephrosis
Authors: Julien Lillaz, Stéphane Bernardini, Marie-Paule Algros, Hugues Bittard, François Kleinclauss
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

A seventy-one-year-old woman was hospitalized at our institution for a right-sided "renal colic" associated with an infectious background. Alithiasic ureterohydronephrosis was diagnosed by imaging. A urinary diversion was thus performed using a double J endoureteral stent. The etiologic assessment of the hydronephrosis showed the presence of a periureteral mass that caused extrinsic ureteral compression. After surgical excision of the ureteral lesion, the Wegener's granulomatosis diagnosis was established. This report is the clinical description of a case of "atypical" Wegener's granulomatosis revealed by the onset of a ureteral disease mimicking a neoplastic process.
Calciphylaxis - a challenging & solvable task for plastic surgery? A case report
Authors: Savas Tsolakidis, Gerrit Grieb, Andrzej Piatkowski, Ziyad Alharbi, Erhan Demir, David Simons, Norbert Pallua
Journal: BMC Dermatol (2013)
MeSH terms: Calciphylaxis / chemically induced, Calciphylaxis / surgery, Phenprocoumon / adverse effects, Plastic Surgery Procedures / methods, Skin Transplantation / methods, Case Reports, Abdominal Wall, Adult, Anticoagulants / adverse effects, Humans, Male, Pulmonary Embolism / drug therapy, Thigh, Young Adult, Anticoagulants, Phenprocoumon

Background:
Calciphylaxis (calcific uremic arteriolopathy) is rare and its pathogenesis is not fully understood. Indeed, Calciphylaxis presents a challenge through the course of its management which involve different specialities but unfortunately this disease so far has a poor prognosis. We herein present, in this case report, a multidisciplinary approach involving plastic surgeons with special regards to reconstructive approach after debridement procedures.
Case presentation:
We present a 21 years old male with a BMI of 38,2, who was transferred to our department from another hospital. Calciphylaxis has been diagnosed after receiving anticoagulation with phenprocoumon after a single event of pulmonary embolism. The INR on admission was 1,79. He had necrotic spots on both sides of the abdominal wall and on both thighs medially. During this time he underwent several reconstructive procedures in our department.
Conclusion:
It can be suggested that this agonizing disease needs indeed a multidisciplinary approach involving Nephrologists, Dermatologists, Intensive Care Physicians and Plastic Surgeons, taking into consideration that surgical correction can achieve further improvement in a specialized centre. Notwithstanding, further cohort studies should be approached clinically to insight the light on this disease with special regard to the prognosis after this approach.
Gonioscopically Guided Nonpenetrating Cyclodialysis Cleft Repair: A Novel Surgical Technique
Authors: Ian As Rodrigues, Brinda Shah, Saurabh Goyal, K Sheng Lim
Journal: J Curr Glaucoma Pract (2017)
Keywords: cyclodialysis cleft, direct gonioscope, hypotony, ocular trauma
MeSH terms: Case Reports

Aim:
We present a novel surgical technique for repair of persistent and symptomatic cyclodialysis clefts refractory to conservative or minimally invasive treatment.
Background:
Numerous surgical techniques have been described to close cyclodialysis clefts. The current standard approach involves intraocular repair of cyclodialysis clefts underneath a full-thickness scleral flap.
Technique:
Our technique employs intraoperative use of a direct gonioscope to guide a nonpenetrating surgical repair. Subsequently, a significantly less invasive, nonpenetrating technique utilizing a partial-thickness scleral flap can be performed that reduces potential risks associated with intraocular surgery. The direct gonioscope is also used for confirmation of adequate surgical closure of the cyclodialysis cleft prior to completion of surgery. This technique has been successfully carried out to repair traumatic chronic cyclodialysis clefts associated with hypotony in two patients. There were no significant adverse events as a result of using this technique.
Conclusion:
The novel technique described increases the likelihood of successful and permanent repair of cyclodialysis clefts with resolution of symptoms associated with hypotony, through direct intraoperative visualization of the cleft.
Clinical significance:
Gonioscopically guided nonpenetrating cyclodialysis cleft repair offers significant benefits over previously described techniques. Advantages of our technique include gonioscopic cleft visualization, enabling accurate localization of the area requiring repair, and subsequent confirmation of adequate closure of the cleft. Using a partial-thickness scleral flap is also less invasive and reduces risks associated with treatment of this potentially challenging complication of ocular trauma.
How to cite this article:
Rodrigues IAS, Shah B, Goyal S, Lim S. Gonioscopically Guided Nonpenetrating Cyclodialysis Cleft Repair: A Novel Surgical Technique. J Curr Glaucoma Pract 2017;11(1):31-34.
Sudden-Onset Paraplegia: A Unique Presentation of Acute Aortic Dissection (AD)
Authors: Monica R Campa, Brook Danboise, John D Cambron
Journal: Cureus (2023)
Keywords: aortic dissection, cardiovascular injury, emergency diagnosis, emergency medicine, resuscitation
MeSH terms: Case Reports

Aortic dissection (AD) is a rare but deadly diagnosis that emergency medicine physicians must consider in a wide variety of patient presentations. This case report describes a 42-year-old male bull rider who developed acute-onset bilateral lower extremity paralysis and loss of sensation. He was later found to have a type A Stanford AD during his emergency department evaluation.
Localized Bone Loss Resulted from an Unlikely Cause in an 11-Year-Old Child
Authors: Bianca Tozi Portaluppe Bergantin, Daniela Rios, Daniela Silva Barroso Oliveira, Edmêr Silvestre Pereira Júnior, João Adolfo Costa Hanemann, Heitor Marques Honório
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Periodontal diseases have several causes, amongst them, by foreign bodies. In this case report, an 11-year-old child who lived in a rural area and has never been treated by a dentist presented an extensive horizontal bone loss and edema on the region of tooth 44. The diagnosis of foreign body was obtained after biopsy, since an elastic band around the middle of the root tooth was found. The elastic band was not radiopaque, and the patient did not inform that she found the elastic band on the floor of the school and introduced the tooth by herself. Based on the case reported, it is concluded that anamnesis and clinical and radiographic examination are fundamental strategies to obtain the diagnosis, but sometimes, especially in children, there may be inconsistencies that can be elucidated by a biopsy.
Use of Ceftolozane/Tazobactam in a Case of Septic Shock by Puerperal Sepsis
Authors: Mario Pezzi, Anna Maria Scozzafava, Anna Maria Giglio, Renata Vozzo, Patrizia Dina Casella, Simona Paola Tiburzi, Lucio Cosco, Mario Verre
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Multiresistant bacteria infections cause widespread morbidity and mortality and lead to an increase in expenses for hospital stays and complications. We describe the case of a 27-year-old patient with puerperal sepsis after cesarean section due to Escherichia coli complicated by multiresistant Klebsiella ESBL-producing superinfection with septic shock and multiple organ dysfunction syndrome, successfully treated with ceftolozane/tazobactam.
Hemorrhagic Shock as Complication of Intramural Intestinal Bleeding
Authors: Asma Ben Ali, Mohamed Ali Cherif, Walid Mhajba, Hamdi Hamdène Doghri, Malek Hassouna, Youssef Zied El Hechmi, Zouheir Jerbi, Ines Ben Hassen, Mohamed Habib Daghfous
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma. Medical treatment was sufficient and there was no need for surgery. Conclusion. Gastrointestinal bleeding associated with shock in patients treated by oral anticoagulant should alert physicians to research a probable MIH. Urgent diagnosis and appropriate medical treatment can avoid surgical interventions.
Fournier's Gangrene and Intravenous Drug Abuse: an Unusual Case Report and Review of The Literature
Authors: Michele Del Zingaro, Andrea Boni, Jacopo Adolfo Rossi De Vermandois, Alessio Paladini, Emanuele Lepri, Pietro Ursi, Roberto Cirocchi, Morena Turco, Gianluca Gaudio, Andrea Nogara, Ettore Mearini
Journal: Open Med (Wars) (2019)
Keywords: fournier's gangrene, infection, necrotizing fasciitis, surgery

Fournier's gangrene is a potentially fatal emergency condition characterized by necrotizing fasciitis and supported by an infection of the external genital, perineal and perianal region, with a rapid and progressive spread from subcutaneous fat tissue to fascial planes. In this case report, a 52-year-old man, with a history of hepatitis C-virus (HCV)-related chronic liver disease and cocaine use disorder for which he was receiving methadone maintenance therapy, was admitted to the Emergency Department with necrotic tissue involving the external genitalia. Fournier's gangrene is usually due to compromised host immunity, without a precise cause of bacterial infection; here it is linked to a loco-regional intravenous injection of cocaine. A multimodal approach, including a wide surgical debridement and a postponed skin graft, was needed. Here we report this case, with a narrative review of the literature.
Case report: Clinical and single-cell transcriptome sequencing analysis of a mixed gangliocytoma-adenoma presenting as acromegaly
Authors: Chao Li, Daqin Feng, Dabiao Zhou
Journal: Front Oncol (2022)
Keywords: acromegaly, case report, mixed gangliocytoma-adenoma, pituitary tumors, single-cell transcriptome sequencing
MeSH terms: Case Reports

Background:
Mixed gangliocytoma-adenoma (MGA) is a rare tumor of pituitary gland. It's difficult to distinguish it from pituitary adenoma by clinical manifestations, imaging features or serological testing. Thus, the histopathological examination is still the golden standard for diagnosis. Besides, studies on molecular level are still lacking.
Case information:
In this case report, we described a 28-year-old male with MGA presenting as acromegaly, who suffered staging operation and post-operation gamma knife radiosurgery, but finally died of secondary hyperglycemic hyperosmolar collapse. A complete data including clinical, histopathological, ultrastructural and single-cell transcriptome level information were collected and analyzed.
Conclusion:
This case report detailed the only clinical and molecular report of MGA following operation and radiotherapy. Complete clinical data enhanced the understanding of the diagnosis and treatment of this disease. Besides, the single-cell transcriptome sequencing analysis further disclosed the intra-tumoral heterogeneity and provided support for subsequent basic research.
Laser Interstitial Thermal Therapy for the Treatment of a Pineal Region Glioma Through an Infratentorial Approach: A Case Report
Authors: Omar Nabulsi, Mohamed Abouelleil, Sanjay Patra, Paul Mazaris
Journal: Cureus (2023)
Keywords: excision of tumor, infratentorial, laser interstitial thermal therapy, pineal region, pineal region glioma, pineal region tumor
MeSH terms: Case Reports

Laser interstitial thermal therapy (LITT) is a minimally invasive surgical option for the treatment of brain tumors introduced in 1983. The innovative technique was welcomed for its ability to access deep-seated supratentorial and posterior cranial fossa lesions. Surgical approaches to pineal region tumors are challenging and require a high degree of precision since the critical vasculature, such as the vein of Galen and precentral vein, in the area pose significant anatomical challenges to operating surgeons. To minimize the risk of damaging this key venous anatomy, an infratentorial approach may be more advantageous. We present a case where LITT was utilized through an infratentorial approach to a pineal region tumor. A 62-year-old male with no significant past medical history presented to his primary care physician complaining of ataxia and headaches for the past four weeks. An MRI was concerning for multicentric glioma within the cerebellar hemispheres, brainstem extending to the middle cerebellar peduncle, upper cervical spinal cord, and pineal region. An enhancing lesion of the midbrain tectum was concerning for a high-grade tumor. We decided to proceed with stereotactic biopsy and magnetic resonance-guided LITT via an infratentorial approach. Supratentorial trajectory planning did not allow for a safe corridor due to the venous anatomy; thus, it was decided to proceed with an infratentorial approach. The patient was positioned prone, had his bone fiducial CT fused with MRI, and the tumor was targeted using robotic guidance (ROSA, Zimmer Biomet, Warsaw, Indiana). Postoperatively, he suffered from transient diplopia due to cranial nerve VI palsy. Additionally, the postoperative MRI revealed a decrease in the size of the enhancing lesion and the hyperintense T2 signal within the brainstem. Open surgical approaches to tumors within the pineal region often pose an anatomic and neurovascular challenge. We describe the safe utilization of a novel, previously unreported infratentorial approach utilizing LITT with promising treatment, morbidity, and efficacy outcomes. A larger series will be necessary to ensure the safety and efficacy of this approach.
Prosthetic valve endocarditis caused by Pseudomonas luteola
Authors: Jean-Paul Casalta, Pierre-Edouard Fournier, Gilbert Habib, Alberto Riberi, Didier Raoult
Journal: BMC Infect Dis (2005)
MeSH terms: Endocarditis, Bacterial / microbiology, Heart Valve Prosthesis / microbiology, Pseudomonas / classification, Pseudomonas / isolation & purification, Pseudomonas Infections / microbiology, Case Reports, Anti-Bacterial Agents / therapeutic use, Endocarditis, Bacterial / drug therapy, Equipment Contamination, Humans, Male, Middle Aged, Pseudomonas Infections / drug therapy, Anti-Bacterial Agents

Background:
Pseudomonas luteola has been recognized as an uncommon cause of bacteremia and of infections in patients with underlying medical disorders.
Case presentation:
We isolated P. luteola from blood cultures in a patient with prosthetic valve endocarditis developed 16 months after cardiac surgery.
Conclusion:
P. luteola is a rare opportunistic agent, with a propensity of infecting valvular prostheses.
Intraoperative Pancreatic Ductoscopy for Ampullary Adenocarcinoma During Pancreatic Resection: A Case Report
Authors: Anthony Congiusta, Ariel Brown, Andrew M Brown, Charles J Yeo
Journal: J Pancreat Cancer (2019)
Keywords: intraoperative pancreatic ductoscopy, periampullary neoplasm, pylorus-preserving pancreaticoduodenectomy
MeSH terms: Case Reports

Background: Periampullary neoplasms can be challenging to work up and diagnose preoperatively. Herein, we report the case of a patient whose preoperative workup failed to detect a malignancy, yet, underwent a pylorus-preserving pancreaticoduodenectomy (PPPD) with intraoperative pancreatic ductoscopy (IPD) and was ultimately found to have an ampullary adenocarcinoma. Presentation: A 78-year-old woman presented with 4 weeks of nausea, weight loss, jaundice, and light-colored stools. She underwent outpatient diagnostic studies, including magnetic resonance cholangiopancreatography, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography with pancreatic duct (PD) stenting and papillotomy. These revealed common bile duct dilatation measuring 2 cm, PD dilatation measuring 7 mm, a 17 mm cyst in the head of the pancreas, and a firm nodule noted between the biliary and pancreatic orifices. Cytologic and pathologic analyses were initially nondiagnostic. A repeat ampullary biopsy was negative for dysplasia and malignancy. A computed tomography scan was then performed and showed cystic pancreatic lesions with pancreatic ductal dilation. Suspicion remained high for periampullary tumor or a main duct intraductal papillary mucinous neoplasm, and the patient underwent a PPPD with IPD and tolerated the procedure well. Her final specimen pathology revealed well-to-moderately differentiated ampullary adenocarcinoma, pancreaticobiliary type with positive nodal disease. Conclusions: Given the relatively poor prognosis of patients with node-positive pancreaticobiliary-type ampullary adenocarcinoma, clinical suspicion should remain high for malignancy in patients with lesions located in the periampullary region and a negative preoperative workup, as aggressive treatment approaches are warranted to maximize their chance for survival.
Perforated Duodenal Ulcer in a Young Nepalese Girl: An Infrequent Diagnosis for Age
Authors: Ashish Lal Shrestha, Anusha Shrestha
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Perforated duodenal ulcer (PDU) is exceedingly uncommon in children. In a child with acute abdomen and pneumoperitoneum, an appendiceal etiology is more often suspected as a likely cause. Failure or delay to diagnose a PDU can result in significant morbidity and even mortality. We report a case of acute abdomen in a girl with PDU with a successful outcome. A 12-year-old school girl presented to emergency room (ER) with acute generalized abdominal pain for 2 days. Clinical examination revealed florid peritonitis, and abdominal radiographs showed free peritoneal air. At emergency laparotomy, PDU was noted with general peritoneal contamination. Omental patch repair and continued supportive care resulted in gradual improvement. PDU is an uncommon cause of peritonitis in children and poses significant challenges in management. Strong suspicion and prompt appropriate intervention is necessary to avoid untoward outcomes.
Successful Use of Octreotide Therapy for Refractory Levofloxacin-Induced Hypoglycemia: A Case Report and Literature Review
Authors: Matthew R Watson, Ceressa T Ward, Amit Prabhakar, Babar Fiza, Vanessa Moll
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Fluoroquinolones are commonly prescribed antimicrobials that have been implicated in alterations of glucose metabolism. We report a case of refractory fluoroquinolone-induced hypoglycemia in a patient with type-2 diabetes mellitus on glipizide that was successfully treated with octreotide. A patient was admitted with hypoglycemia after having been initiated on levofloxacin therapy. Despite treating the hypoglycemia supportively with multiple boluses of 25 g of dextrose, a continuous dextrose infusion, and glucagon, the patient experienced repeated episodes of rebound hypoglycemia. The persistent hypoglycemia was eventually reversed with the administration of subcutaneous octreotide. Clinicians should be cognizant of this adverse effect of fluoroquinolones, as well as predisposing risk factors, and consider octreotide as an adjunctive therapy for refractory hypoglycemia cases.
Transient Musical Hallucinations in a Young Adult Male Associated with Alcohol Withdrawal
Authors: Graham Blackman, Mao Fong Lim, Fahmida Mannan, Anthony David
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

We present the case of a 25-year-old male who presented to A&E with isolated musical hallucinations, in the absence of audiological or neurological disease. The patient had a history of recreational drug use and a family history of psychosis. Hallucinations, which were preceded by discontinuation of alcohol and reinitiation of citalopram for depression, resolved spontaneously after three days. Aetiological factors are discussed alongside the existing literature. Whilst the underlying mechanisms underpinning musical hallucinations remain elusive, the case illustrates the potential role of alcohol withdrawal, serotonin toxicity, recreational drug use, and genetic vulnerability.
Case report: Response to endocrine therapy in triple-negative breast cancer metastases with altered hormone receptors
Authors: Ruoyan Qin, Jie Qian, Mengjun Shan, Guangxin Ruan, Xiaofeng Yang, Yanwen Wang, Lingshuang Liu
Journal: Front Oncol (2023)
Keywords: altered hormone receptors, endocrine therapy, later-line treatment, metastases, triple-negative breast cancer
MeSH terms: Case Reports

Triple-negative breast cancer refers to breast cancer patients with negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2). Metastatic triple-negative breast cancer is predominantly treated with chemotherapy, but later-line treatment remains challenging. Breast cancer is highly heterogeneous, and the expression of hormone receptors is often inconsistent between primary and metastatic lesions. Here, we report a case of triple-negative breast cancer 17 years after surgery with lung metastases for 5 years that progressed to pleural metastases after multiple lines of chemotherapy. The pleural pathology suggested ER (+) and PR (+) and transformation to luminal A breast cancer. This patient received fifth-line letrozole endocrine therapy and achieved partial response (PR). The patient's cough and chest tightness improved after treatment, associated tumor markers decreased, and progression-free survival (PFS) exceeded 10 months. Our results may be of clinical relevance for patients with hormone receptor alterations in advanced triple-negative breast cancer and suggest that individualized regimens should be developed for breast cancer based on the molecular expression of tumor tissue at the primary and metastatic sites.
Fulminating Postcaesarean Necrotising Fasciitis: A Rare and Lethal Condition Successfully Managed in a Resource-Disadvantaged Setting in Sub-Saharan Africa
Authors: Carlson-Babila Sama, Conrad S Tankou, Fru F Angwafo Iii
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Necrotising fasciitis is a rare but potentially lethal condition in obstetrics which usually presents with fulminant tissue destruction and a resultant high mortality. We report a 19-year-old Sub-Saharan female diagnosed with a rapidly erosive necrotising fasciitis on day 5 after caesarean section in a resource-limited setting. Timely diagnosis, aggressive antibiotic therapy, and prompt surgical intervention via an extensive abdominal wall debridement were pivotal to her survival.