OpenMed/multicare-articles huggingface dataset:
Rare case of aortic aneurysm with type A dissection (extending to right coronary artery) and severe AR in a nonhypertensive and non pregnant female
Authors: Natraj Setty H S, Rama Chikamuniswamy, Yeriswamy M C, Rahul Patil, Veeresh Patil, Sathwik Raj, Santhosh Jadav, Balraju D, Krishna Murthy B N, Babu Reddy, Srinivas B C, Raghu T R, Manjunath C N
Journal: Int J Surg Case Rep (2019)
Keywords: aneurysm, aortic dissection, bentall’s, ct aortogram

Introduction:
Typically a patient with acute aortic dissection presents with severe chest pain radiating to the back, tearing in nature. Rarely it can present as painless acute aortic dissection this is seen in iatrogenic cases or when associated with atherosclerosis, diabetes, or aortic aneurysm.
Case presentation:
We hereby present a case of a 32-year aged female who presented with dyspnoea & palpitations (NYHA III) from last 6 months, diagnosed to have Aortic Aneurysm with Type A dissection & Severe AR. She eventually underwent BENTALL'S procedure with CABG and had an uneventful recovery.
Discussion:
Clinical manifestation of Aortic dissection can be variable, therefore its diagnosis is challenging. 25% of cases, may have associated ECG changes suggestive of acute coronary syndrome leading to a possible misdiagnosis especially if associated ST elevation in ECG. Aorto arteritis is a non-atherosclerotic chronic inflammatory vascular disease of unknown etiology that affects the aorta, proximal parts of its major branches. In this case, there is a possibility that there was underlying spontaneous coronary artery dissection which in turn could be cause for silent ischemia in young women.
Conclusion:
Acute aortic dissection is a life-threatening disease with a high rate of cardiovascular morbidity and mortality. The most important and common risk factor is systemic hypertension which has been reported in the 70% of the patients with aortic dissection. Most of the aortic dissection observed in young women has been reported to be related to pregnancy. Dissection should be suspected during any acute coronary syndrome, particularly Inferior wall MI.
A Rare Case Report: A Malignant Histiocytic Tumor in the Form of Ovarian Mass
Authors: Emsal Pinar Topdagi Yilmaz, Yakup Kumtepe, Yunus Emre Topdagi, Seray Kaya Topdagi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Histiocytic cell malignancies are very rare. Hence, the information about this disease in hematology is limited. In this case report, we present a case of malignant histiocytic tumor affecting the ovary of a 40-year-old virgin female. Primary ovarian malignancy was not considered for the patient who was approached as if she had ovarian malignancy, since there was an indication of a mass in the ovary. Therefore, an aggressive surgery was not performed. Since our patient was in the reproductive age, fertility-preserving surgery was performed. Our patient was then treated systemically by medical oncology. In conclusion, the rare malignancy group was investigated in the present study along with an evaluation of the current literature.
Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review
Authors: Caleb W Grote, Paul C Cowan, David W Anderson, Kimberly J Templeton
Journal: Biores Open Access (2018)
Keywords: metal-on-metal total hip arthroplasty, pseudotumor, unilateral leg edema, women's health
MeSH terms: Review

Metal-on-metal (MoM) total hip arthroplasty (THA) can be associated with adverse metal reactions, including pseudotumors. This case report describes a 58-year-old female with an MoM THA-related pseudotumor that caused unilateral leg edema from compression of her external iliac vein. After thorough preoperative workup to rule out infection and deep vein thrombosis and consultation with a vascular surgeon, the patient underwent revision THA and excision of her pseudotumor. She had complete resolution of her swelling at 4 years after surgery. Review of all available case reports for this rare complication revealed that almost all patients were female. All patients underwent revision THA, with resolution of their symptoms. Literature review demonstrates that women are disproportionally affected by complications associated with MoM THA. We recommend close monitoring of patients with MoM THA, particularly women, for development of adverse metal reactions.
Nocardial Infection in the Early Period after Kidney Transplantation
Authors: Sudeendra Gupta, Ammar Abdulbaki, Sandra El Hajj, Ahmad Nusair, Mohamad Mooty, Nizar Attallah
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Patients with solid organ transplant have weaker immune system and can develop opportunistic infections. Prophylactic antimicrobials can help lower that risk but do not prevent it completely. High index of suspicion increases the chance of diagnosing rare opportunistic infections in immunocompromised patients and helps early and effective treatment. We present a unique case of a patient who developed pneumonia from Nocardia early after kidney transplant despite being on trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis. He was diagnosed and treated early which helped improving his outcome. We discuss incidence, risk factors, and treatment of nocardiosis post kidney transplant.
Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
Authors: Chen Li, Jing-Yong Xu, Yuan Liu
Journal: Open Med (Wars) (2021)
Keywords: cd68, kupffer cell, sonazoid, enhanced ultrasonography, perivascular epithelioid cell tumor
MeSH terms: Case Reports

Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor rarely described in the liver. Sonazoid is a new ultrasound contrast with both vascular and post-vascular phases due to the uptake of Kupffer cell. CD68 is a defined immunohistorical staining marker for macrophage including Kupffer cell. No previous cases have been reported to reveal Kupffer images in the post-vascular phase by using Sonazoid and pathologic characters of CD68 positive cell in PEComa. Herein, we describe the first case to present Sonazoid contrast-enhanced ultrasonography (CEUS) findings in Kupffer images and CD68 positive cell in hepatic PEComa which may lead to rethink of the phagocytic properties of macrophages.
Azygos vein aneurysm as a posterior mediastinal mass discovered after minor chest trauma
Authors: Gholamreza Mohajeri, Ali Hekmatnia, Hossein Ahrar, Farzane Hekmatnia, Reza Basiratnia
Journal: Iran J Radiol (2014)
Keywords: aneurysm, azygos vein, magnetic resonance angiography, mediastinum, tomography, x-ray computed
MeSH terms: Case Reports

Azygos vein aneurysm is a rare cause of a posterior or paratracheal mediastinal mass. Trauma or conditions causing elevated ﬂow or pressure in the azygos system, such as cardiac failure or cirrhosis of the liver are secondary causes of aneurysm of the azygos vein. We report a case of asymptomatic saccular aneurysm of the azygos vein in a 45-year-old man with blunt minor chest trauma. The azygos vein aneurysm was managed by conservative treatment.
A Case of Acute Massive Bioprosthetic Mitral Valve Thrombosis Leading to Fulminant Heart Failure
Authors: Zeid Nesheiwat, Pinang Shastri, Rohit Vyas, Cameron Burmeister, Robert Grande, Hazem Malas
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Bioprosthetic valve thrombosis has been considered to be extremely unlikely, typically freeing patients from the potential complications of long-term anticoagulation. However, there have been several documented cases of bioprosthetic valve thrombosis and there are concerns that its incidence may be underreported. Experience with diagnosis and management of this condition is limited. Here, we present a case of acute massive bioprosthetic mitral thrombosis manifesting as fulminant heart failure.
Two Cases of Congenital Chylethorax: A Successful Story of Medical Management
Authors: I Kankananarachchi, K K S Priyankara, K K K Lakman, K Withanaarachchi, P K G Gunathilaka
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Congenital chylothorax (CC) is one of the most common causes of pleural effusions in neonates. Associated ipsilateral pulmonary aplasia in CC results in neonatal respiratory distress. Here, we report 2 cases of CC who were managed in the Teaching Hospital Karapitiya, Sri Lanka, between 2017 and 2019. Both babies were males who presented with respiratory distress within a few hours of birth. Their antenatal ultrasound scans failed to detect CC. Chest radiographs showed left-sided pleural effusions. Pleural fluid was milky yellowish suggestive of chylothorax, and the analysis revealed elevated triglycerides, high lymphocyte counts, and low cholesterol levels compatible with CC. They were managed in the neonatal intensive care unit and kept nil by mouth for initial 48 hours. Intravenous octeotride infusion was started on day one and was continued for 7 and 10 days, respectively. The maximum dose of octeotride was 2 μg/kg/hour. Both babies needed intercostal tube placement for 5 and 6 days, respectively. None of them required invasive ventilation. They were started on a medium-chain fatty acid formula, which was continued for about one week. Both babies were commenced on breast milk by day 7 of life and continued with exclusive breastfeeding. Within two weeks, they were discharged home and followed up in the paediatric respiratory clinic for another year. None of them was found to have long-term respiratory complications during the follow-up.
Brooke-Spiegler Syndrome: Familial Cylindromatosis, a Rare Variant of a Rare Familial Syndrome
Authors: Harsh Patel, William Naber, Austin Cusick, Craig Oser
Journal: Case Rep Dermatol Med (2021)
MeSH terms: Case Reports

Brooke-Spiegler Syndrome (BSS) is a rare autosomal dominant familial disorder resulting in dermatologic neoplasms of copious nodular appendages. Here, we report a case of Familial Cylindromatosis (FC), a subtype of BSS, in a patient with the largest cylindroma of 7.4 × 5.6 × 3.8 cm on the scalp. The patient had undiagnosed cylindromas growing for 36 years at presentation; however, he did not seek out healthcare evaluation. Excision and pathologic investigation of three large masses from different body sites determined a shared phenotype of cylindromas. Subsequent evaluation of the patient's son separately, after primary patient excision, confirmed cylindroma development as well. The pathologic evidence of cylindromas in the patient with a new history of family incidence confirmed the diagnosis of the FC variant of BSS.
Cannabidiol (CBD) for the treatment of subcutaneous treprostinil (Remodulin®) site pain: a case report
Authors: Jacqueline Brewer, Amy Kimber
Journal: Front Med (Lausanne) (2023)
Keywords: cannabinoids, injection site reaction, pain, pain management (mesh), pulmonary arterial hypertension, subcutaneous infusion, treprostinil
MeSH terms: Case Reports

Background:
Pulmonary arterial hypertension occurs as a result of vascular remodeling and dysregulation of endothelial cells that narrows small pulmonary arteries and raises precapillary pressures. Pulmonary arterial hypertension is a rare and progressive disease characterized by dyspnea, chest pain, and syncope. Parenteral treprostinil is indicated for the treatment of pulmonary arterial hypertension to diminish symptoms associated with exercise. Up to 92% of patients treated with treprostinil via subcutaneous delivery experienced infusion site pain and approximately 23% discontinued treatment due to site pain. Cannabidiol salve may have analgesic and anti-inflammatory properties and could be an additional option for patients with infusion site pain.
Case report:
Two patients with pulmonary arterial hypertension were treated with cannabidiol salve. Both patients reported a reduction in infusion site pain without the need for narcotics.
Conclusion:
These two cases suggest that cannabidiol salve may help to minimize redness and alleviate pain at the infusion site. Additional studies are required to test the effectiveness of cannabidiol in a larger group of patients with infusion site pain.
Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study
Authors: Milos R Popovic, Vera Zivanovic, Taufik A Valiante
Journal: Front Neurol (2016)
Keywords: functional electrical stimulation, grasping, myelopathy, spinal cord disorders, upper extremity rehabilitation
MeSH terms: Case Reports

Non-traumatic spinal cord pathology is responsible for 25-52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16-21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials, showing that functional electrical stimulation therapy (FEST) can restore voluntary reaching and/or grasping function, in people with stroke and traumatic SCI. Motivated by this success, we decided to examine changes in the upper limb function following FEST in a patient who suffered loss of hand function due to myelopathy secondary to cervical spondylosis. The participant was a 61-year-old male who had C3-C7 posterior laminectomy and instrumented fusion for cervical myelopathy. The participant presented with progressive right hand weakness that resulted in his inability to voluntarily open and close the hand and to manipulate objects unilaterally with his right hand. The participant was enrolled in the study ~22 months following initial surgical intervention. Participant was assessed using Toronto Rehabilitation Institute's Hand Function Test (TRI-HFT), Action Research Arm Test (ARAT), Functional Independence Measure (FIM), and Spinal Cord Independence Measure (SCIM). The pre-post differences in scores on all measures clearly demonstrated improvement in voluntary hand function following 15 1-h FEST sessions. The changes observed were meaningful and have resulted in substantial improvement in performance of activities of daily living. These results provide preliminary evidence that FEST has a potential to improve upper limb function in patients with non-traumatic SCI, such as myelopathy secondary to cervical spondylosis.
Chronic recurrent multifocal osteomyelitis: a case report
Authors: E Sadeghi, M R Kadivar, A K Ghadimi Moghadam, Gh R Pooladfar, N Sadeghi
Journal: Iran Red Crescent Med J (2011)
Keywords: crmo, chronic osteomyelitis, nsaid, recurrent osteomyelitis
MeSH terms: Case Reports

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory bone disease. It is a diagnosis of exclusion based on the clinical, radiological and pathological criteria. The awareness of the corresponding feature can help avoid of unnecessary diagnostic procedures and prolonged antibiotic therapy. We present a case of 4.5 year old girl, diagnosed with CRMO who were followed for 6 months as a case of chronic bacterial osteomyelitis and received long course of antibiotic therapy.
Wernicke's encephalopathy after acute pancreatitis with upper gastrointestinal obstruction: A case report and literature review
Authors: Zongding Wang, Lei Zhang, Xingzhen Deng, Zili Peng, Shaoyong Liang
Journal: Front Neurol (2023)
Keywords: wernicke's encephalopathy, acute pancreatitis, case report, gastrointestinal obstruction, vitamin b1
MeSH terms: Case Reports

A 42-year-old female was admitted with upper abdominal pain. Imaging studies and laboratory tests were performed to consider acute lipogenic pancreatitis. After symptomatic treatment, her abdominal pain was significantly relieved. However, the patient was accompanied by upper gastrointestinal obstruction, which was gradually relieved after long-term fasting, gastrointestinal decompression, and fluid rehydration. The patient developed dizziness and ataxia, which worsened. Cranial magnetic resonance imaging (MRI) indicated patchy abnormal signal shadows in the bilateral thalami and dorsal brainstem and suggested metabolic encephalopathy. Wernicke's encephalopathy (WE) was the initial diagnosis of suspicion, adequate vitamin B1 was immediately replenished until the complete resolution of symptoms, and the patient made a rapid and dramatic recovery.
Hair tourniquet syndrome of labia minora: case report
Authors: Ahmed El Mouloua, Elouafi Elaouni Kamili, Karima Fouraiji, Mohamed Oulad Saiad
Journal: Pan Afr Med J (2022)
Keywords: hair tourniquet syndrome, case report, child, labia minora
MeSH terms: Tourniquets, Vulva / pathology, Vulva / surgery, Case Reports, Child, Female, Hair, Humans, Syndrome

Hair Tourniquet Syndrome (HTS) is defined as strangulation by a hair thread of the appendage of the human body, especially in the children population, it rarely occurs in external genitalia (clitoris, labia majora and minora). Herein, we aimed to present a rare occurrence of HTS around the labia minora in a 12-year-old child treated by excision of the cystic lesion with an uneventful follow-up. Special care should be given to every swollen appendage in children to avoid severe consequences such as amputation and disfigurement.
[Enlarged vestibular aqueduct syndrome: report of 3 cases and literature review]
Authors: José A Pinto, Carlos Fernando Mello Jr, Ana Carla S Marqui, Delmer J Perfeito, Roberto D P Ferreira, Rubens H Silva
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Hearing Loss, Sensorineural / diagnosis, Vestibular Aqueduct / diagnostic imaging, Vestibular Diseases / diagnosis, Case Reports, Review, Adolescent, Adult, Age Factors, Child, Cochlear Implantation, Diagnosis, Differential, Female, Hearing Loss, Sensorineural / genetics, Hearing Loss, Sensorineural / therapy, Humans, Male, Syndrome, Tomography, X-Ray Computed, Vestibular Diseases / genetics, Vestibular Diseases / therapy

Enlarged Vestibular Aqueduct Syndrome is characterized by a widening of the vestibular aqueduct, associated with sensorineural hearing loss, or sometimes with mixed hearing loss, which may be congenital or acquired during childhood. The sensorineural hearing loss may be classified into mild, moderate and severe, associated with sudden periods of improvement or aggravation. The enlargement of the vestibular aqueduct is the most common inner ear anomaly. This syndrome is admitted as a result of a genetic abnormality of the vestibular aqueduct development, previous to the fifth week of gestation. The incidence of this syndrome ranges from 1% to 1.3%, with the possibility of getting up to 7%, depending on the examined population. The aim of this study was to analyze three cases of LVAS seen at the Otorhinolaryngology and Radiology Department of Sao Camilo Hospital - Sao Paulo. Two of these three cases were of brothers, from the same mother but from different fathers. Two were male and one was female and the ages ranged from 9 to 30 years old. The diagnostic method of election was CT - Computerized Tomography of the temporal bones. The recommended management of the cases was conservative, except for those of cranial trauma, barotrauma and, if necessary, the use of hearing aids.
A diagnostic dilemma: infectious versus noninfectious multifocal choroiditis with panuveitis
Authors: Sharel Ongchin, C Dirk Keene, Russell Van Gelder, Gurunadh Atma Vemulakonda
Journal: J Ophthalmic Inflamm Infect (2013)

Background:
The objective of this study was to report a diagnostic dilemma in a patient with multifocal choroiditis. This is a case report study.
Findings:
A 68-year-old female presented with new onset of floaters in both eyes and diagnosed with bilateral panuveitis. Her visual acuity was 20/200 in both eyes. Slit-lamp examination showed 1+ anterior chamber cells in both eyes. Ophthalmoscopic examination of both eyes showed vitreous cells, optic disc edema, small amounts of subretinal hemorrhage, and punctate choroidal lesions throughout the fundus. Laboratory work-up revealed a positive QuantiFERON-TB Gold result, and the patient was started on antituberculosis medications. However, given the patient's intolerance to antituberculosis medications and progressive worsening of vision, she underwent a chorioretinal biopsy to assist with determining a definitive diagnosis. Biopsy results showed noncaseating granulomas and were negative for an infectious etiology. The patient was diagnosed with ocular sarcoidosis and started on immunomodulatory therapy for sarcoid-related multifocal choroiditis.
Conclusions:
Multifocal chorioretinal lesions of unknown etiology can present as a diagnostic and therapeutic dilemma. Laboratory work-up is useful in determining an etiology; however, more invasive procedures, such as chorioretinal biopsy, may be necessary to guide treatment.
Endometrial carcinoma presenting as vasculitic sensorimotor polyneuropathy
Authors: Marketa Vasku, Thomas Papathemelis, Nicolai Maass, Ivo Meinhold-Heerlein, Dirk Bauerschlag
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

Paraneoplastic syndromes (PNS) are a heterogeneous group of symptoms which are indirectly caused by primary or metastatic tumor. Paraneoplastic polyneuropathy (PNP) is mostly related to small cell lung cancer (5%), prostate, gastric, and breast cancer. Only sporadic cases have been reported to be associated with endometrial cancer. We present a case of a premenopausal woman with severe vasculitic, asymmetric sensorimotor polyneuropathy that developed in conjunction with an endometrial carcinoma responding to surgical therapy of primary tumor combined to steroid therapy. Neurological symptoms such as asymmetrical sensorimotor deficits and painful paresthesias are suspicious when they occur in otherwise healthy women with no medical history. The phenomenon of a paraneoplastic syndrome can point to an underlying malignancy and can be used as marker of progression or regression of the tumor. Due to the rarity of PNP, there is no standard treatment. Recommended therapy is stage-adjusted treatment of the primary tumor.
Case Report: Two Cases of Subacute Thyroiditis Following SARS-CoV-2 Vaccination
Authors: Catherine Bornemann, Katharina Woyk, Caroline Bouter
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, sars-cov-2 vaccination, coronavirus, subacute thyroiditis, thyroid
MeSH terms: Case Reports

Subacute thyroiditis is an inflammatory thyroid disorder associated with viral infections. Rare cases of subacute thyroiditis have also been described following vaccination. Recently, a few cases of subacute thyroiditis following SARS-CoV-2 vaccination have also been reported. Here, we present two cases of cytological proven subacute thyroiditis after receiving the first dose of a SARS-CoV-2 vaccination. We describe clinical, laboratory, imaging and cytological findings in two cases of subacute thyroiditis that presented in our department 2 weeks after SARS-CoV-2 vaccination with Spikevax (Moderna Biotech, Spain) and Vaxzevria (AstraZeneca; Sweden). Both cases did not have a previous history of thyroid disorders and presented with anterior and lateral neck pain. Clinical test results as well as cytological findings were consistent with subacute thyroiditis. Subacute thyroiditis may develop following a SARS-CoV-2 vaccination and should be considered as a possible side effect in cases that present with thyroid pain.