OpenMed/multicare-articles huggingface dataset:
Arthroscopic Treatment of a Posterior Labral Interposition after a Pediatric Hip Dislocation-A Case Report
Authors: Christiane Kruppa, Marcel Dudda, Thomas A Schildhauer, Dominik Seybold
Journal: European J Pediatr Surg Rep (2018)
Keywords: arthroscopy, hip dislocation, labral tear, loose body
MeSH terms: Case Reports

We report the case of a 13-year-old boy, who suffered a posterior hip dislocation from playing soccer. Closed reduction was performed urgently. Because of a nonconcentric hip after closed reduction, further imaging was done. An intra-articular bony fragment was identified. Arthroscopic treatment was performed. Through an anterior portal we were able to locate the intra-articular bony fragment, which was located within the region of the fovea. After lifting of the caudal enfolded labral complex, we were able to remove the fragment. Evidence of a grade 3 cartilage defect was present at the femoral head. We were able to reduce the enfolded posterior labral complex, which was stable afterwards without the necessity of additional suture fixations. The concentric hip reduction was confirmed on an anteroposterior view of the hip postoperatively. The patient was instructed to toe tip weight-bearing for 6 weeks with limited range of motion to 60° of hip flexion. Eight weeks after surgery, he was free of pain and discomforts. From our experience, the arthroscopic intervention after pediatric hip dislocation associated with intra-articular bony fragments or posterior labral complex injuries, represents to be a preferred minimally invasive method in contrast to open surgical procedures.
Case report: Pain in anti-DPPX encephalitis
Authors: Tale L Bjerknes, Ole Martin Steihaug, Mette Haugen, Ina Elen Hjelland, Christian Alexander Vedeler
Journal: Front Neurol (2022)
Keywords: anti-dipeptidyl-peptidase-like protein 6 (dppx), autoimmune encephalitis, extremity pain, rituximab, weight loss
MeSH terms: Case Reports

Encephalitis due to antibodies targeting dipeptidyl-peptidase-like protein 6 (DPPX), a potassium channel subunit, is rare. The illness is typically characterized by a triad of weight loss, CNS hyperexcitability and cognitive symptoms, but recent reports suggest that the clinical picture may be more heterogeneous. Here, we describe the case of a 63-year-old female who was admitted to the hospital with severe extremity pain, which had been preceded by diarrhea and weight loss. She later developed cognitive changes, and her general condition rapidly deteriorated. Extensive workup did not reveal gastrointestinal illness or underlying malignancies. MRI of the brain was normal. Analyses of blood and cerebrospinal fluid showed normal cell counts but high titres of DPPX antibodies in blood and cerebrospinal fluid. The patient was treated with intravenous methylprednisolone followed by rituximab. At 1-year follow-up, she was without pain and had completely recovered. In this case, DPPX-associated autoimmune encephalitis was dominated by severe extremity pain, illustrating that sensory symptoms may be one of the main complaints in these patients. It is important for clinicians to be aware of the heterogeneous clinical picture in this serious condition, since correct diagnosis and treatment with immunosuppressants are associated with favorable prognosis.
Recurrent stroke in an African female with idiopathic thrombotic thrombocytopenic purpura: A case report
Authors: Kwabena Oteng Agyapong, Aba Folson, Roland Wonkyi, Kelvin Amenyedor, Jeffrey J Boateng, Kate Fiador
Journal: Clin Case Rep (2023)
Keywords: adamts 13, maha, platelet, thrombotic thrombocytopenic purpura
MeSH terms: Case Reports

We report on a young Ghanaian female who was diagnosed with thrombotic thrombocytopenic purpura (TTP) but had an ischemic stroke as the initial presentation. She was successfully treated with therapeutic plasma exchange. This case illustrates how TTP can masquerade as ischemic stroke and the application of PLASMIC score without ADAMTS-13 assay in risk prediction.
A Rare Presentation of Tuberculosis: Multifocal Skeletal and Multisystemic Disease Evaluated with Imaging Findings
Authors: Burak Günay, Büşra Özdemir, Fethi Emre Ustabaşioğlu
Journal: J Belg Soc Radiol (2022)
MeSH terms: Case Reports

Teaching point: Tuberculosis (TB) is a rare clinical disease in the musculoskeletal system. Multifocal bone involment and multisystemic spread of this disease is extremely uncommon and difficult to diagnose.
Low-intensity body building exercise induced rhabdomyolysis: a case report
Authors: Massimiliano Gagliano, Daniela Corona, Giuseppe Giuffrida, Alessia Giaquinta, Tiziano Tallarita, Domenico Zerbo, Massimiliano Sorbello, Annalaura Paratore, Carla Virgilio, Alessandro Cappellani, Pierfrancesco Veroux, Massimiliano Veroux
Journal: Cases J (2009)

Introduction:
Rhabdomyolysis is a severe and debilitating condition that promotes muscle breakdown and is a relatively rare, not always diagnosed cause of acute renal failure (ARF) with an 8-20% reported incidence. Exertional rhabdomyolysis only appears in adult patients 24-48 h after strenuous activities as military basic training, weight lifting, and marathon running.
Case presentation:
A 30-year-old man was admitted to our department because of weakness and painful swelling of the muscles as well as dark urine appearing 24 h after carrying out a body-building exercises of low intensity. The development of an acute exertional rhabdomyolysis was confirmed by the increased serum enzyme levels and myoglobinuria. The patient was treated with intravenous sodium chloride, and sodium bicarbonate. The nephrotoxicity of myoglobin was decreased by forced alkaline diuresis.
Conclusion:
The reported case emphasizes the occurrence of acute rhabdomyolysis even in those who underwent a low-intensity exercise. A proper treatment is mandatory to avoid a sudden worsening of clinical conditions eventually evolving to acute renal failure.
Central retinal vein occlusion with cerebral infarction secondary to anlotinib treatment: a case report and literature review
Authors: Yingying Chen, Yi Du, Lu Qiu, Jing Zheng
Journal: Front Pharmacol (2023)
Keywords: adverse drug (event), anlotinib, case report, cerebral infarction, retinal vein occlusion (rvo)
MeSH terms: Case Reports

Purpose: We present a rare case of an elderly man with minimal pre-existing thromboses risk, who experienced central retinal vein occlusion (CRVO) and cerebral infarction after oral intake of the anti-cancer drug anlotinib, likely due to a drug-related complication. Observations: A male, aged 65 years, sought care at the ophthalmology department because of acute painless 5-day vision loss in the right eye, in combination with cerebral infarction history, after oral intake of anlotinib for hepatocellular carcinoma (HCC) for over 16 months. Clinical assessment and ancillary examination verified a right eye central retinal vein occlusion diagnosis. Anlotinib is a multi-target tyrosine kinase inhibitors (TKIs) is reported to potently suppress vascular endothelial growth factor (VEGF) receptor, in order to exert strong antitumor angiogenesis and inhibit tumor occurrence. Although anlotinib is only regarded as a possible thrombosis risk factor, it is possible that anlotinib administration markedly enhanced vaso-occlusive risk within this patient. Conclusion and significance: Herein, we present the first report of anlotinib-induced CRVO and cerebral infarction to our knowledge. Given our evidences, anlotinib usage is intricately linked to sight- and life-threatening thrombotic effects even among patients with reduced thrombophilic risk. Hence, patients receiving this drug must be carefully monitored for possible drug-related complications.
A Case of Ignatzschineria indica Bacteremia following Maggot Colonization
Authors: Hugh Muse, Rachel L Jenkins, Meredith B Oliver, Soomin Kim, Richard L Grantier 3rd, Bharat K Malhotra, Jason J Parham, Kayla R Stover
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Ignatzschineria indica is a Gram-negative bacterium that is commonly associated with the larvae of flesh flies. I. indica is difficult to isolate in routine laboratory procedures but has been associated with neglected wounds infested with maggots, fever, elevated white blood count and C-reactive protein, and polymicrobial culture results. Other specific hematological/immunological changes are not known. We present a case of I. indica bacteremia and polymicrobial osteomyelitis resulting from infected decubitus ulcers. The patient improved after treatment with cefepime followed by levofloxacin.
Conjunctival lymphangioma in a 4-year-old girl revealed tuberous sclerosis complex
Authors: Florentina Joyce Freiberg, Erdmute Kunstmann, Thomas König, Juliane Matlach, Daniel Kampik
Journal: GMS Ophthalmol Cases (2016)
Keywords: conjunctival lymphangioma, genetic testing, ocular lymphangioma, tuberous sclerosis complex
MeSH terms: Case Reports

Background: To present a case of conjunctival lymphangioma in a 4-year-old girl with tuberous sclerosis complex. Methods/results: A 4-year-old girl presented with a relapsing cystic lesion of the bulbar conjunctiva in the right eye with string-of-pearl-like dilation of lymphatic vessels and right-sided facial swelling with mild pain. Best-corrected vision was not impaired. Examination of the skin revealed three hypomelanotic macules and a lumbal Shagreen patch. Magnetic resonance imaging (MRI) findings displayed minimal enhancement of buccal fat on the right side. Cranial and orbital MRI showed signal enhancement in the right cortical and subcortical areas. Genetic analysis revealed a heterozygous deletion encompassing exon 1 and 2 of the TSC1 gene (tuberous sclerosis complex 1 gene), confirming the diagnosis of tuberous sclerosis complex. Conclusion: In conjunctival lymphangioma, tuberous sclerosis complex should be considered as the primary disease.
Traumatic Takotsubo Cardiomyopathy in a Patient with Extensive Coronary Artery Disease
Authors: Abagayle E Renko, Warren C Doyle, Paul W Sokoloski
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Takotsubo Cardiomyopathy (TCM) should be considered in the differential diagnosis for patients with cardiovascular symptoms not only following emotional trauma but also following motor vehicle accidents. A 45-year-old woman presented with chest pain following a motor vehicle accident. While she had an elevated troponin level and an extensive history of cardiac disease, her electrocardiogram was normal. Echocardiogram, however, demonstrated transiently reduced left ventricular systolic function with mid to apical hypokinesis consistent with TCM. We emphasize the use of a diagnostic score and point of care focused cardiac ultrasound (FOCUS) to expedite the recognition, evaluation, and treatment of suspected TCM in an Emergency Department setting.
Case report: Expanding the phenotype of FOXP1-related intellectual disability syndrome and hyperkinetic movement disorder in differential diagnosis with epileptic seizures
Authors: Carlo Alberto Cesaroni, Marzia Pollazzon, Cecilia Mancini, Susanna Rizzi, Camilla Cappelletti, Simone Pizzi, Daniele Frattini, Carlotta Spagnoli, Stefano Giuseppe Caraffi, Roberta Zuntini, Gabriele Trimarchi, Marcello Niceta, Francesca Clementina Radio, Marco Tartaglia, Livia Garavelli, Carlo Fusco
Journal: Front Neurol (2023)
Keywords: foxp1, angiomas, autism, choanal atresia, epilepsy, movement disorder
MeSH terms: Case Reports

Objective:
We aimed to report on previously unappreciated clinical features associated with FOXP1-related intellectual disability (ID) syndrome, a rare neurodevelopmental disorder characterized by global developmental delay, intellectual disability, and language delay, with or without autistic features.
Methods:
We performed whole-exome sequencing (WES) to molecularly characterize an individual presenting with ID, epilepsy, autism spectrum disorder, behavioral problems, and facial dysmorphisms as major features.
Results:
WES allowed us to identify a previously unreported de novo splice site variant, c.1429-1G>T (NM_032682.6), in the FOXP1 gene (OMIM*605515) as the causative event underlying the phenotype. Clinical reassessment of the patient and revision of the literature allowed us to refine the phenotype associated with FOXP1 haploinsufficiency, including hyperkinetic movement disorder and flat angiomas as associated features. Interestingly, the patient also has an asymmetric face and choanal atresia and a novel de novo variant of the CHD7 gene.
Conclusion:
We suggest that FOXP1-related ID syndrome may also predispose to the development of hyperkinetic movement disorders and flat angiomas. These features could therefore require specific management of this condition.
Gender bias in clinical case reports: A cross-sectional study of the "big five" medical journals
Authors: Pascale Allotey, Caitlin Allotey-Reidpath, Daniel D Reidpath
Journal: PLoS One (2017)
MeSH terms: Journalism, Medical, Periodicals as Topic, Sexism, Cross-Sectional Studies, Female, Humans, Male

Background:
Gender bias in medical journals can affect the science and the benefit to patients. It has never been investigated in clinical case reports. The oversight is important because of the role clinical case reports play in hypothesis generation and medical education. We investigated contemporary gender bias in case reports for the highest ranked journals in general and internal medicine.
Methods:
PubMed case reports data from 2011 to 2016 were extracted for the Annals of Internal Medicine, British Medical Journal, the Journal of the American Medical Association, The Lancet, and New England Journal of Medicine. The gender of the patients were identified and a text analysis of the Medical Subject Headings conducted.
Results:
A total of 2,742 case reports were downloaded and 2,582 (95.6%) reports contributed to the final analysis. A pooled analysis showed a statistically significant gender bias against female case reports (0.45; 95%CI: 0.43-0.47). The Annals of Internal Medicine was the only journal with a point estimate (non significant) in the direction of a bias against male patients. The text analysis identified no substantive difference in the focus of the case reports and no obvious explanation for the bias.
Conclusion:
Gender bias, previously identified in clinical research and in clinical authorship, extends into the patients presented in clinical case reports. Whether it is driven by authors or editors is not clear, but it likely contributes to and supports an overall male bias of clinical medicine.
Case Report: High-Calorie Glucose Infusion and Tight Glycemic Control in Ameliorating Refractory Acidosis of Empagliflozin-Induced Euglycemic Diabetic Ketoacidosis
Authors: Siti Sanaa Wan Azman, Norlela Sukor, Muhammad Yusuf Abu Shamsi, Ilham Ismail, Nor Azmi Kamaruddin
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: sglt2 inhibitor, sglt2 inhibitor-induced diabetic ketoacidosis, diabetic ketoacidosis, euglycemic diabetic ketoacidosis, high-calorie glucose
MeSH terms: Diabetes Mellitus, Diabetic Ketoacidosis / chemically induced, Diabetic Ketoacidosis / drug therapy, Sodium-Glucose Transporter 2 Inhibitors / adverse effects, Case Reports, Benzhydryl Compounds, Glucose, Glucosides / therapeutic use, Glycemic Control, Humans, Benzhydryl Compounds, Glucosides, Sodium-Glucose Transporter 2 Inhibitors, empagliflozin, Glucose

The current widespread use of sodium-glucose co-transporter 2 (SGLT2) inhibitors has triggered an increase in reported cases of euglycemic diabetic ketoacidosis (EDKA), often characterized by a protracted metabolic acidosis that is resistant to conventional DKA treatment. We report a case of empagliflozin-induced EDKA with severe metabolic acidosis intractable to aggressive fluid resuscitation and boluses of bicarbonate infusion. Following the introduction of high-calorie glucose infusion coupled with tight glycemic control, the recalcitrant acidosis was successfully corrected. This is the first case report that adopts the above approach, representing a paradigm shift in the management of SGLT2 inhibitor-induced EDKA.
Osteochondral avulsion fracture of the femoral origin of the anterior cruciate ligament in an 11-year-old child
Authors: Sunil Kumar Pai, Nayef Aslam Pervez, Graham Radcliffe
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Although tibial end avulsions of the anterior cruciate ligament are relatively common in clinical practice, avulsions of the femoral end of this ligament are by comparison rare. We present the case of an 11-year-old boy with a bony avulsion injury, which was presumed to have arisen from the tibial insertion of the anterior cruciate ligament but turned out instead to be an osteochondral avulsion fracture of the femoral origin. This unexpected finding that was not detected during preoperative workup resulted in the first attempt at surgical fixation being aborted. The need for a second planned definitive fixation procedure emphasises the importance of combining a thorough history and examination in association with appropriate imaging in the patient workup. The patient's definitive operative treatment and outcome are described. Although rare, surgeons (and emergency room doctors) treating such patients should include femoral end avulsion injuries of the anterior cruciate ligament in the differential diagnosis of a child presenting with an acute haemarthrosis of the knee. Furthermore, once diagnosed, early onward referral to an experienced knee surgeon is advocated.
Case report: Anorexia nervosa and unspecified restricting-type eating disorder in Jewish ultra-orthodox religious males, leading to severe physical and psychological morbidity
Authors: Sofia Laufer, Estee Herman, David Serfaty, Yael Latzer, Rachel Ashkenazi, Orna Attias, Sinai Oren, Meirav Shimomi, Moria Uziel, Adi Enoch-Levy, Eliezer Witztum, Daniel Stein
Journal: Front Psychiatry (2023)
Keywords: jewish, anorexia nervosa, obsessive compulsive disorder, orthodox, religion
MeSH terms: Case Reports

Background:
Young Jewish Ultra-Orthodox women usually show less disturbances in body image and eating in comparison to less religious communities. By contrast, problems with eating are highly unknown and unrecognized in Jewish Ultra-Orthodox males.
Aim:
To investigate whether in Ultra-Orthodox males, restricting-type AN (AN-R) with highly obsessional physical activity and unspecified restricting eating disorder (ED) in the context of obsessive-compulsive disorder (OCD) would lead to severe physical and emotional morbidity.
Results:
The study included two groups: the first, 3 adolescents with AN-R developing severely increased ritualized obsessional physical activity in addition to restricting eating, requiring inpatient treatment because of severe bradycardia. These youngsters ignored the severity of their obsessional physical activity, continuing with it in hospital despite their grave medical condition. One student began extensive training for triathlon, whereas another student, upon remitting from AN, developed severe muscle dysmorphia. These findings suggest that young Ultra-Orthodox males with AN may develop obsessional physical activity to increase their muscle mass rather than to lose weight Another four Jewish Ultra-Orthodox males developed malnutrition in the context of severe OCD, with no evidence of dieting or body-image disturbances. These individuals developed highly obsessional adherence to different Jewish religious rules, including prolonged praying, asceticism, and overvalued strict adherence to Jewish Kashrut rules of eating, leading in all cases to severe food restriction. They were highly unaware of their severe weight loss and required hospitalization because of severe physical disturbances associated with malnutrition. Moreover, most did not cooperate with their treatment, and their ED-related obsessionality was mostly resistant to psychopharmacotherapy.
Conclusion:
Owing to their highly ritualistic rigid way of life, combined with the need for excellency in studying, Jewish Ultra-Orthodox adolescent males with AN might be at a specific risk of developing severe physical disturbances if their illness is associated with highly perfectionistic obsessional physical activity. Second, Jewish Ultra-Orthodox religious males with OCD might be at a specific risk for severe undernutrition, as their rigid relentless observance of Jewish everyday laws might highly interfere with their eating.
Squamous Carcinoma of the Neovagina after Male-to-Female Reconstruction Surgery: A Case Report and Review of the Literature
Authors: Ronja Fierz, Gian-Piero Ghisu, Daniel Fink
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Squamous cell carcinoma (SCC) of the neovagina after genital reconstruction surgery is a rare occurrence with only very few cases published up to the present. We report a case of a 43-year-old transgender woman who developed neovaginal SCC 23 years after vaginoplasty. The patient tested positive for high-risk human papillomavirus (HPV). At the time of diagnosis, radiological investigations revealed already existing lymph node and osseous metastases. The treatment consisted of various cycles of chemotherapy and radiation therapy. Unfortunately, the formation of additional metastases, including cerebral, pulmonary, and hepatic metastases, could not be prevented. After comparing the literature on the topic, we conclude that neovaginal carcinoma often appears years and decades after genital reconstruction surgery. We therefore recommend the continuation of regular clinical follow-up for transgender women after postoperative follow-up is completed. With this approach, potential lesions may be detected at an earlier stage and a better outcome may be achieved. Follow-up should include neovaginal examination and cytological smear testing. At a later age, we recommend additional regular prostate-specific antigen (PSA) testing and digital rectal examination (DRE). Moreover, transgender women are advised to take part in mammography screening starting at the age of 50, especially when additional risk factors are present.
Case Report: Acute pyelonephritis and hearing loss in scrub typhus
Authors: Sivaranjini Venketesan, Dheeraj Jain, Stalin Viswanathan, Murugesan Sivagurunathan Gayathri
Journal: F1000Res (2019)
Keywords: acute pyelonephritis, hearing loss, scrub typhus, urinary tract infection
MeSH terms: Hearing Loss / etiology, Pyelonephritis / etiology, Scrub Typhus / complications, Scrub Typhus / drug therapy, Case Reports, Anti-Bacterial Agents / therapeutic use, Doxycycline, Female, Humans, Middle Aged, Anti-Bacterial Agents, Doxycycline

Acute pyelonephritis is a common renal manifestation in patients with diabetes. A 52-year-old diabetic lady presented with loin pain, dysuria, and fever and urinary incontinence that had begun seven and three days prior to presentation respectively. She was treated with escalating spectra of intravenous antibiotics without improvement. Urine and blood cultures were sterile, while radiological investigations were suggestive of pyelonephritis. Mild hepatic dysfunction prompted consideration of scrub typhus and she improved with empirical doxycycline. Scrub IgM was later confirmed to be positive. In conclusion, local prevalence of systemic infections such as rickettsioses should always be considered in diabetics with fever, even if symptoms and signs otherwise suggest typical diabetes-related infections. We, therefore report a case of acute pyelonephritis caused by scrub typhus which has not been previously described in English medical literature.