OpenMed/multicare-articles huggingface dataset:
Primary progressive apraxia: an unusual ideomotor syndrome
Authors: Yeva M Fernandez, Steven J Frucht
Journal: J Clin Mov Disord (2017)
Keywords: apraxia, ideomotor, tauopathy
MeSH terms: Case Reports

Background:
Primary progressive apraxia is a rare form of apraxia in the absence of dementia which develops insidiously and is slowly progressive. Most reports of patients with apraxia also describe coexisting aphasias or involve additional apraxias with affected speech, usually in the setting of neurodegenerative diseases such as corticobasal degeneration, Alzheimer's disease or frontotemporal dementia. The aim of this report is to describe and demonstrate by video two cases of isolated primary progressive ideomotor apraxia seen in our clinic.
Case presentation:
We describe two patients with 2-5 years of progressive difficulty using their hands, despite having intact cognition and lack of correlating lesions on imaging.
Conclusion:
We report two cases of primary progressive apraxia that may be early presentations of taupathic disease in both patients. In both cases, there is isolated profound ideomotor apraxia of the hands, with preserved cognition, language skills, muscle power and tone, and gait. There are no correlating lesions on imaging.
Imaging Findings of Small Bowel Diverticulitis: A Case Report
Authors: Albert Zhou, Sarah Bella, Amy Patwa
Journal: J Educ Teach Emerg Med (2023)

Small bowel diverticulitis is an uncommon subset of acute diverticulitis and can mimic many other intra-abdominal processes. As a result, imaging modalities such as ultrasound and computed tomography (CT) scan are especially important for timely recognition of diverticulitis and can expedite diagnosis and treatment and reduce complications. In the case described in this report, an 81-year-old male with history of esophageal cancer and recurrent diverticulitis with history of multiple bowel resections presented to the emergency department (ED) with right lower quadrant abdominal pain and constipation. Findings on ultrasound were suggestive of diverticulitis, and findings on CT of the abdomen and pelvis showed ileitis with phlegmon and micro-abscess suspicious for small bowel diverticulitis. ED providers should familiarize themselves with ultrasound findings of diverticulitis and be aware that diverticulitis can also present in the small bowel. Treatment of small bowel diverticulitis is similar to colonic diverticulitis.
Topics:
Ileitis, small bowel diverticulitis, abdominal ultrasound.
Huge Primary Parasitic Leiomyoma in a Postmenopausal Lady: A Rare Presentation
Authors: Nkencho Osegi, E Yilaiba Oku, C Stanley Uwaezuoke, K Timothy Alawode, S Adeniyi Afolabi
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Although uterine myomas are the most common benign tumours of the female pelvis in the reproductive age group, they rarely grow in menopausal women. Parasitic fibroids without prior history of laparoscopic myomectomy are even a rarer presentation particularly in menopausal women. The case presented is a 58-year-old grand-multiparous, menopausal lady with progressive abdominal swelling of three-year duration. She had excision of a huge parasitic fibroid attached to omentum. She had partial omentectomy, total abdominal hysterectomy, and bilateral salpingo-oophorectomy. The parasitic fibroid mass weighed 5.2kg and histopathology confirmed leiomyoma uteri with cystic degeneration and lymph nodes with reactive lymphoid hyperplasia. She had uneventful postoperative recovery and follow-up has so far been uneventful.
An operative case of hepatic pseudolymphoma difficult to differentiate from primary hepatic marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
Authors: Michihiro Hayashi, Noboru Yonetani, Fumitoshi Hirokawa, Mitsuhiro Asakuma, Katsuhiko Miyaji, Atsushi Takeshita, Kazuhiro Yamamoto, Hironori Haga, Takayuki Takubo, Nobuhiko Tanigawa
Journal: World J Surg Oncol (2011)
MeSH terms: Liver Diseases / pathology, Liver Neoplasms / pathology, Lymphoma, B-Cell, Marginal Zone / pathology, Pseudolymphoma / pathology, Case Reports, Diagnosis, Differential, Female, Humans, Liver Diseases / surgery, Liver Neoplasms / surgery, Lymphoma, B-Cell, Marginal Zone / surgery, Middle Aged, Pseudolymphoma / surgery

Hepatic pseudolymphoma (HPL) and primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) are rare diseases and the differential diagnosis between these two entities is sometimes difficult. We herein report a 56-year-old Japanese woman who was pointed out to have a space occupying lesion in the left lateral segment of the liver. Hepatitis viral-associated antigen/antibody was negative and liver function tests including lactic dehydrogenase, peripheral blood count, tumor markers and soluble interleukin-2 receptor were all within normal limit. Imaging study using computed tomography and magnetic resonance imaging were not typical for hepatocellular carcinoma, cholangiocarcinoma, or other metastatic cancer. Fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning showed high standardized uptake value in the solitary lesion in the liver. Under a diagnosis of primary liver neoplasm, laparoscopic-assisted lateral segmentectomy was performed. Liver tumor of maximal 1.0 cm in diameter was consisted of aggregation of lymphocytes of predominantly B-cell, containing multiple lymphocyte follicles positive for CD10 and bcl-2, consistent with a diagnosis of HPL rather than MALT lymphoma, although a definitive differentiation was pending. The background liver showed non-alcoholic fatty liver disease/early non-alcoholic steatohepatitis. The patient is currently doing well with no sign of relapse 13 months after the surgery. Since the accurate diagnosis is difficult, laparoscopic approach would provide a reasonable procedure of diagnostic and therapeutic advantage with minimal invasiveness for patients. Considering that the real nature of this entity remains unclear, vigilant follow-up of patient is essential.
Combination of dura turning-over and decompressive craniectomy: a new pattern of surgery for cerebral infarction caused by craniocerebral gunshot injury
Authors: Qi-Yong Mei, Yao Li, Chao He, Hong-Wei Shan, Yun-Kun Wang, Yan Dong, Ming-Kun Yu, Li-Jun Hou
Journal: Mil Med Res (2017)
Keywords: decompressive craniectomy, dura turning-over, gunshot cerebral injury, infarction
MeSH terms: Cerebral Infarction / surgery, Craniotomy / methods, Decompression, Surgical / methods, Dura Mater / surgery, Wounds, Gunshot / complications, Case Reports, Accidents, Brain / physiopathology, China, Craniotomy / standards, Decompression, Surgical / standards, Dura Mater / pathology, Dura Mater / physiopathology, Humans, Male, Tomography, X-Ray Computed / methods, Wounds, Gunshot / surgery, Young Adult

Background:
Craniocerebral gunshot injury refers to a wound caused by a bullet passing through or lodged in brain tissue, resulting in the loss of function of a certain area or other fatal damage to the human brain. Craniocerebral gunshot injury is usually life-threatening and is very common in modern warfare, accounting for the majority of battle casualties. Most of the patients suffer from acute cerebral infarction caused by vascular injury. Lack of early and solid battlefield emergency medical interference adds to the risk of death among the wounded.
Case presentation:
We present a 24-year-old man who was shot with a shotgun from a distance of 15 m in an accidental injury. Forty-seven grapeshots were found on his body surface by physical examination. A computed tomography (CT) scan demonstrated large areas of low-density shadows in his right parietal lobe and right temporal lobe with the midline shifting to the left side 2 days later. Afterwards, the patient was transferred to our emergency medical center at Changzheng Hospital in Shanghai. Cranial computed tomography angiography (CTA) showed a high-density shadow in the initial part of the right middle cerebral artery. The branches after the initial part were obliterated. Prompt medical attention and decompressive craniotomy (DC) surgery contributed to the final recovery from cerebral infarction of this patient.
Conclusion:
Bullets can penetrate or be lodged in the brain, causing intracranial hypertension. The bullets lodged in the brain can result in stenosis and embolism of a cerebral artery, causing acute cerebral infarction. Combining dura turning-over surgery with DC surgery can not only decrease intracranial pressure, which can increase the blood supply for hypertension-induced vessel stenosis, but also help vessels outside the dura mater grow into ischemic areas of the cerebral cortex. However, this new pattern of surgery needs further support from evidence-based medicine.
Disseminate fungal infection after acute pancreatitis in a simultaneous pancreas-kidney recipient
Authors: Anna Rossetto, Umberto Baccarani, Dario Lorenzin, Andrea Risaliti, Pierluigi Viale, Vittorio Bresadola, Gian Luigi Adani
Journal: J Transplant (2010)
MeSH terms: Case Reports

Fungal infections after kidney transplantation are a major cause of morbidity and mortality, and Candida infection of the pancreas is considered an infrequent but important agent in necrotizing pancreatitis. We report the case of a 43-year-old Caucasian patient who underwent simultaneous pancreas-kidney transplantation because of diabetes type I, and chronic renal failure with peritoneal dialysis. The postoperative course was complicated by acute pancreatitis due to the thrombosis of the splenic artery of the graft, the subsequent acute rupture of the external iliac artery caused by fungal arteritis (Candida glabrata), and peritonitis a few days later caused by sigmoid perforation with detection of Candida glabrata infection of the resected intestinal tract. The present case remarks that awareness and prevention of fungal infection are major issues in the transplant field. Important information can be added by systematic culture of conservation perfusates but, probably, the best way for early recognition of a critical level of infectious risk remains the routine application of the colonization index screening. In cases of positive results, preemptive antifungal therapy could be warranted.
Seizures following Intoxication with a Common Antituberculosis Drug
Authors: Adnane Lahlou, Saïd Benlamkaddem, Mohamed Adnane Berdai, Mustapha Harandou
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Isoniazid is an antimycobacterial agent commonly prescribed in most tuberculosis chemotherapy regimens. Its side effects are widely known including mainly liver toxicity and peripheral neuropathy. The toxic effects of isoniazid are dose-related. Toxic doses are estimated at 35-40 mg/kg and fatal doses at 150 mg/kg. Treatment consists primarily of basic life support, antiepileptic drugs, and pyridoxine. The case is of one of the children with intentional isoniazid poisoning, the drug belonging to an uncle currently under antituberculosis treatment, resulting in tonic-clonic seizures. During her hospitalization in the paediatric intensive care unit, her neurological status as well as her lab values was closely monitored, and despite initial deterioration, the patient was discharged from critical care a week after full recovery.
Case Report: Causative De novo Variants of KCNT2 for Developmental and Epileptic Encephalopathy
Authors: Pan Gong, Xianru Jiao, Dan Yu, Zhixian Yang
Journal: Front Genet (2021)
Keywords: kcnt2, encephalopathy, epilepsy, genetic, seizures
MeSH terms: Case Reports

Objective: KCNT2 gene mutations had been described to cause developmental and epileptic encephalopathies (DEEs). In this study, we presented the detailed clinical features and genetic analysis of two unrelated patients carrying two de novo variants in KCNT2 and reviewed eight different cases available in publications. Methods: Likely pathogenic variants were identified by whole exome sequencing; clinical data of the patients were retrospectively collected and analyzed. Results: Our two unrelated patients were diagnosed with Ohtahara syndrome followed by infantile spasms (IS) and possibly the epilepsy of infancy with migrating focal seizures (EIMFS), respectively. They both manifested dysmorphic features with hirsute arms, thick hair, prominent eyebrows, long and thick eyelashes, a broad nasal tip, and short and smooth philtrum. In the eight patients reported previously, two was diagnosed with IS carrying a 'change-of-function' mutation and a gain-of-function mutation, respectively, two with EIMFS-like carrying a gain-of-function mutation and a loss-of-function mutation, respectively, one with EIMFS carrying a loss-of-function mutation, three with DEE without functional analysis. Among them, two patients with gain-of-function mutations both exhibited dysmorphic features and presented epilepsy phenotype, which was similar to our patients. Conclusion: Overall, the most common phenotypes associated with KCNT2 mutation were IS and EIMFS. Epilepsy phenotype associated with gain- and loss-of-function mutations could overlap. Additional KCNT2 cases will help to make genotype-phenotype correlations clearer.
Long-Term Survival of Cutaneous Malignant Melanoma with Metastasis to Paranasal Sinuses: A Case Report and Literature Review
Authors: Kazem Anvari, Mohammad Reza Majidi, Mahdi Razmara Ferezghi, Bahereh Parkam, Seyed Alireza Javadinia
Journal: Galen Med J (2018)
Keywords: cutaneous malignant, melanoma, paranasal sinuses, survival
MeSH terms: Case Reports

Background:
Malignant melanoma (MM) usually present with metastases to unexpected regions of the body. Metastatic MM is a highly lethal condition, and the median survival in this setting is 6 to 7.5 months; however, few reports rarely describe long-term after chemotherapy.
Case report:
We describe a 31-year-old man with MM, which got metastatic (to paranasal sinuses) after local and systemic therapy showed complete responses with long-term survival after endonasal endoscopic metastasectomy and radiotherapy of the nasal cavity, paranasal sinuses, and base of the skull.
Conclusion:
Although long-term survival is rare, few reports describe cases after chemotherapy. MM could be associated with metastasis to any regions and clinicians should be aware of its behavior and perform complete investigation in the presence of any suspicious symptoms, and this should be reinforced periodically. However, the survival is poor in the metastatic setting, and the treatment of choice is debatable, some patients may benefit from metastasectomy and local radiotherapy.
Guided Implant Surgery to Reduce Morbidity in Von Willebrand Disease Patients: A Case Report
Authors: Mathilde Fénelon, Sabine Castet, Jean-Christophe Fricain, Sylvain Catros
Journal: Open Dent J (2018)
Keywords: bleeding disorder, dental implant, guided surgery, hemostasis, oral surgery, von willebrand disease
MeSH terms: Case Reports

Introduction:
Von Willebrand Disease is the most common inherited bleeding disorder. In the general population, 1/8000 patients are affected. Primary hemostasis (platelet adhesion) and coagulation (protection of Factor VIII) are altered. Among several bleeding symptoms, these patients suffer from excessive bleeding of oral mucosa and dental management requires a close collaboration between haematologists and oral surgeons.
Materials & methods:
Guided implant surgery can be used to increase the accuracy of implant placement and to reduce the overall morbidity of this surgical procedure by using a flapless surgery technique.
Case report:
We report the case of a 49 years old woman having a Type 2A von Willebrand disease and who presented to replace tooth #.46 because of interradicular fracture and peri-apical infection. After planning the implant surgery using Codiagnostix® software, a surgical guide was prepared. The patient received 4 injections of von Willebrand factor (Willfactin®) for this particular surgical procedure. The implant was placed immediately after tooth removal and local haemostasis was performed.
Discussion:
The follow-up was uneventful and the implant was restored by a crown 4 months later. Two cases of implant placement in haemophiliac patients have been reported before in the literature.
Conclusion:
As far as we know, this is the first case report of implant placement in a patient having a von Willebrand disease. The use of guided surgery allowed to perform a mini-invasive procedure and thus contributed to prevent bleeding complications in this patient.
Orthodontic Management of Skeletal Class II Malocclusion with the Invisalign Mandibular Advancement Feature Appliance: A Case Report and Review of the Literature
Authors: Melina Koukou, George Damanakis, Apostolos I Tsolakis
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

The treatment of Class II malocclusion due to mandibular retrognathia is one of the most common challenges met in orthodontic practice. When it comes to a growing patient, functional appliances are the optimal way to achieve growth modification by enhancing mandibular growth. Clear aligners have been part of the orthodontic treatment for several decades but until recently they were only used to correct mild malocclusions. In 2017, Align Technology introduced the Invisalign with Mandibular Advancement Feature (IMAF) which replicates the action of functional appliances. As this device is new to clinical practice, there is limited literature on its clinical efficiency. This case report describes the orthodontic management of a 12-year-old male patient having skeletal Class II malocclusion due to mandibular retrognathia. As the patient was experiencing active growth, the IMAF appliance was chosen for his treatment. The IMAF appliance appears to be successful in the treatment of Class II malocclusion with mandibular retrognathism in a growing patient. As with all functional appliances, the correction of the malocclusion is a result of both skeletal and dental effects and the IMAF presents the advantage of producing less proclination of the lower incisors compared to other functional appliances.
Delusional parasitosis in dementia with Lewy bodies: a case report
Authors: Sho Ochiai, Hiroko Sugawara, Yusuke Kajio, Hibiki Tanaka, Tomohisa Ishikawa, Ryuji Fukuhara, Tadashi Jono, Mamoru Hashimoto
Journal: Ann Gen Psychiatry (2019)
Keywords: aripiprazole, dlb, delusional parasitosis, donepezil
MeSH terms: Case Reports

Background:
Dementia with Lewy bodies (DLB) is characterized by fluctuating cognitive impairments, recurrent visual hallucinations, the motor symptoms of parkinsonism and REM sleep behavior disorder. Various neuropsychiatric symptoms including hallucination and delusions occur frequently; however, delusional parasitosis is rare in DLB. Here, we report a case of DLB patient with delusional parasitosis.
Case presentation:
The patient was an 89-year-old woman. At the age of 88, she began to complain her oral cenesthopathy, and developed cognitive decline, delusional parasitosis and parkinsonism. As a result of examination, she was diagnosed as DLB and treated with combination of donepezil 5 mg/day and aripiprazole 1.5 mg/day, and her complaint was disappeared.
Conclusions:
Further studies are needed to investigate the association between delusional parasitosis and underlying pathophysiology of DLB, and the utility of antipsychotics for delusional parasitosis in DLB has to be examined through more cases.
Comminuted Fracture of the Body of the Trapezium and Thumb Carpometacarpal Dislocation: A Particular Pattern
Authors: Laura Alonso, José Couceiro
Journal: Surg J (N Y) (2018)
Keywords: carpometacarpal, fracture, joint dislocation, trapezium
MeSH terms: Case Reports

Trapezium fractures are uncommon injuries. Our case is that of a thumb carpometacarpal joint dislocation associated to a partly comminuted fracture of the body of the trapezium. To the best of the authors' knowledge, this particular variation has not been previously reported in the indexed literature.
Synchronous atrioventricular sequential pacing utilizing conventional and leadless pacemakers in an elderly patient: a case report
Authors: Neil Bodagh, Kevin Cheng, William Eysenck, Tom Wong
Journal: Eur Heart J Case Rep (2022)
Keywords: bradycardia, case report, lead failure, leadless pacemaker
MeSH terms: Case Reports

Background:
Leadless pacemakers present a viable alternative to conventional transvenous devices to mitigate the risk of lead- and/or pocket-related complications. In elderly patients who have encountered ventricular lead failures with transvenous pacemakers, this option may enable the delivery of atrioventricular synchronous pacing therapy, while obviating the requirement for lead extraction and lead-based pacemaker re-implantation.
Case summary:
This case report describes the successful implantation of a leadless pacemaker in a 90-year-old who had undergone two dual-chamber permanent pacemaker implantation procedures with a failure of three of four previously implanted leads. Atrioventricular synchronous pacing was achieved, as the leadless device was able to track the atrial-paced rhythm from the pre-existing right-sided device.
Discussion:
In elderly patients who have encountered issues with transvenous pacemakers, alternative approaches should be considered to mitigate the risk of future complications. Leadless pacemakers may offer a low-risk solution, enabling the delivery of atrioventricular synchronous pacing therapy in such patient groups. Future studies should be designed to delineate whether these devices could be utilized as a first-line approach in certain situations.
A Rare Congenital Perineal Groove
Authors: Enyew Abate
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Background:
Perineal groove is a rare congenital anomaly characterized by nonepithelialized mucous membrane that appears as an erythematous sulcus in the perineal midline, extending from the posterior vaginal fourchette to the anterior anal orifice. It is one of the uncommon anomalies of anogenital region that is unknown to many clinicians, and it is usually misdiagnosed as an anal fissure, perineal trauma, diaper dermatitis, infection, or sexual abuse. Case Presentation. Seven-day-old female neonate was brought by her parents after they observe reddish discoloration of her genitalia. Upon examination, there was a vertical perineal wet groove-like unkeratinized erythematous lesion with no bleeding, sign of infection, or inflammation that extends from the posterior vaginal fourchette to the anal rim. The newborn was sent home after counseling with a reassessment plan in case of complications.
Conclusions:
Recognition of the congenital perineal groove at birth is important for the health care providers to deliver an appropriate parental counseling and appropriate follow-up.
Marked mydriasis and neuritis nervi optici associated with galactorrhea following citalopram treatment: a case report and discussion
Authors: Horst J Koch, Heike Zellmer
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Moreover, abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophysiology. The ocular symptoms disappeared rapidly after the discontinuation of citalopram and pulse therapy with methyl-prednisolone. However, galactorrhea persisted for a few weeks necessitating treatment with bromocriptine.