OpenMed/multicare-articles huggingface dataset:
The Rationale for Using Corticosteroids in COVID-19 Encephalopathy: Lessons From a Case Report With Evidence From Literature
Authors: Muhammad Atif Ameer, Haroon Chaudhry, Maham Babar, Nimi Patel, Monata Song, Mathew Mathew
Journal: Cureus (2023)
Keywords: corticosteroids in covid-19, covid treatment, covid-19 cns involvement, covid-19 management, covid-19 pandemic, covid-19-related encephalopathy, hospitalization in covid-19, neurological manifestation of covid, remdesivir
MeSH terms: Case Reports

The coronavirus disease 2019 (COVID-19) virus primarily affects the pulmonary system, but neurological manifestations and complication of COVID-19 has been reported in abundance in the literature. We present a case of a middle-aged Caucasian male who was brought to the emergency department for altered mental status. His chief complaints were neurological rather than respiratory. A positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) nasal swab confirmed the diagnosis. Brain imaging showed mildly dilated ventricles with no other acute findings. As the patient did not require oxygen, he was treated with remdesivir alone without corticosteroids, which is also a precipitating factor of psychosis but, unfortunately, thickly used in practice. That led to remarkable results in full recovery without exposing the patient to steroid therapy. We strongly believe that remdesivir alone is sufficient in treating COVID-19-induced encephalopathy in a patient who does not require oxygen, and evidence supports this practice.
Sinus pericranii presenting with macrocephaly and mental retardation
Authors: R B Kamble, N K Venkataramana, L Naik, Shailesh, R Shetty
Journal: J Pediatr Neurosci (2010)
Keywords: digital subtraction angiography, macrocephaly, magnetic resonance imaging, sinus pericranii
MeSH terms: Case Reports

We present a rare case of right parietal sinus pericranii in a 2-year-old female child who presented with a compressible swelling on the right side of the scalp since 3 months of age, with a large head. Magnetic resonance imaging along with venography and conventional angiogram was performed, which confirmed the diagnosis.
Segmental resection with primary anastomosis is not always safe in splenic flexure perforation
Authors: Elroy P Weledji, Martin D Mokake, Motaze Sinju
Journal: BMC Res Notes (2016)
MeSH terms: Adenomatous Polyposis Coli / surgery, Anastomosis, Surgical / methods, Colectomy / methods, Colon, Transverse / surgery, Intestinal Perforation / diagnosis, Case Reports, Adenomatous Polyposis Coli / pathology, Adult, Colon, Transverse / pathology, Colonoscopy / adverse effects, Delayed Diagnosis, Humans, Ileum / surgery, Intestinal Perforation / etiology, Intestinal Perforation / pathology, Intestinal Perforation / surgery, Male, Rectum / surgery

Background:
Familial adenomatous polyposis (FAP) is caused by a rare mutation of the adenomatous polyposis coli gene on Chromosome 5q. The risk of colorectal cancer in patients with FAP is nearly 100% and intensive endoscopic surveillance or prophylactic colectomy are mandatory. If extensive endoscopic surveillance is chosen, there is a cumulative risk of perforation and bleeding especially after polypectomy. We discussed the problems and options in the management of the late diagnosis of an iatrogenic perforation of the splenic flexure complicating endoscopic surveillance in FAP.
Case presentation:
We present a 35-year-old black African man with FAP who sustained a splenic flexure perforation following a colonoscopic polypectomy of a suspicious lesion. He underwent a splenic flexure resection and primary anastomosis that dehisced and the patient benefited from an emergency definitive colectomy and ileorectal anastomosis.
Conclusions:
Resection with primary anastomosis following iatrogenic perforation of the splenic flexure is not safe because of a high chance of anastomotic dehiscence. Following a late diagnosis in an unstable patient exteriorization of the perforation as a stoma is a better option prior to a definitive prophylactic colectomy.
Case report: A rare occurrence of triple malignancy of the stomach, rectum and liver in a single patient
Authors: Cancan Jin, Jiangnan Hu, Kirthikaa Balapattabi, Brian Wang, Sizhe Hu, Kangyi Wang, Liangbin Fu, Xiaokang Zhao, Feng Qian, Zhen Wang
Journal: Front Oncol (2022)
Keywords: gastric carcinoma, hepatocellular carcinoma, immune checkpoint inhibitors, rectal carcinoma, surgery
MeSH terms: Case Reports

Malignant tumors of the digestive system are common worldwide; however, it is extremely rare for more than two malignancies to occur simultaneously. Here, we report a case with a triple malignancy of the digestive system, including gastric, rectal, and hepatic tumors. The patient underwent surgical resection of three tumors followed by chemotherapy. Negative image-based screenings and the absence of serum tumor biomarkers elevation were found at 2.5 years after the surgery, indicating the absence of recurrence and metastasis of cancers.
Monkeypox Virus Infection in 22-Year-Old Woman after Sexual Intercourse, New York, USA
Authors: Nawras Zayat, Shirley Huang, Jude Wafai, Melissa Philadelphia
Journal: Emerg Infect Dis (2023)
Keywords: new york, united states, monkeypox, sexually transmitted infections, viruses, zoonoses
MeSH terms: Monkeypox virus, Monkeypox, Case Reports, Letter, Adult, Coitus, Female, Humans, New York, Young Adult

We report a case of a 22-year-old woman in New York, USA, who had painful vulvar and intravaginal lesions after sexual intercourse and tested positive for monkeypox virus. Literature documenting the clinical manifestations of monkeypox in female genitalia remains insufficient.
A case report of intracranial hemorrhage after spinal anesthesia
Authors: Yuri Iwase, Manzo Suzuki, Hiroyasu Bito
Journal: JA Clin Rep (2017)
Keywords: aspirin, chronic subdural hematoma, combined spinal and epidural anesthesia, postdural puncture headache

Background:
Chronic subdural hematoma (CSDH) after spinal anesthesia is a rare complication. We experienced a patient who developed CSDH after postdural puncture headache (PDPH) following combined spinal and epidural anesthesia (CSE).
Case presentation:
A 38-week-gestation parturient with a history of previous cesarean delivery underwent elective cesarean section under CSE. She had been receiving aspirin therapy for Kawasaki disease for many years. She developed a symptom of PDPH 1 day after the surgery. Fluid administration and analgesics were started. Although the headache was relatively severe and persistent, it suddenly disappeared on the third postoperative day. Aspirin administration was restarted on the third postoperative day, and the patient was discharged 1 week after the surgery. 2 weeks after being discharged, she was readmitted to our hospital for severe headache and was diagnosed as having CSDH. An epidural blood patch was performed, resulting in resolution of the hematoma.
Conclusions:
We experienced a case of CSDH after PDPH in a patient who was receiving aspirin therapy. Aspirin therapy should be restarted after confirmation of the absence of headache. We should consider the possibility of unexpected disappearance of PDPH in the postoperative period may be due to the development of CSDH.
Two-Stage Mucogingival Surgery with Free Gingival Autograft and Biomend Membrane and Coronally Advanced Flap in Treatment of Class III Millers Recession
Authors: Avita Rath, Smrithi Varma, Renny Paul
Journal: Case Rep Dent (2016)

Introduction. Gingival recession is an apical shift of the gingival margin with exposure of the root surface. This migration of the marginal tissue leads to esthetic concerns, dentin hypersensitivity, root caries, and cervical wear. It is, paradoxically, a common finding in patients with a high standard of oral hygiene, as well as in periodontally untreated populations with poor oral hygiene. Changing the topography of the marginal soft tissue in order to facilitate plaque control is a common indication for root coverage procedures and forms a major aspect of periodontal plastic surgeries. The regeneration of a new connective tissue attachment to denuded root surface is by allowing the selective coronal regrowth of periodontal ligament cells while excluding the gingival tissues from the root during wound healing by means of a barrier membrane. Case Presentation. This case reports a two-stage surgical technique for treatment of Miller's class III defect using free gingival autograft and type I absorbable collagen membrane (BioMend®, Zimmer Dental, USA)(§). Conclusions. The 6-month follow-up of the case showed a significant increase in attached gingiva suggesting it as a predictable alternative in the treatment of Millers class III defects.
A Case of Recurrent Hemorrhagic Corpus Luteum with Elevated Follicle-Stimulating Hormone, Controlled by Estrogen/Gestagen Therapy
Authors: Yoshihide Inayama, Koji Yamanoi, Baku Nakakita, Shimpei Shitanaka, Jumpei Ogura, Tsutomu Ohara, Mie Sakai, Haruka Suzuki, Koji Yasumoto, Ichiro Kishimoto, Yusuke Sagae, Yoshimi Kitawaki, Koh Suginami
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

A high secretion of follicle-stimulating hormone (FSH) in reproductive-aged women is unusual. We report a case of recurrent corpus luteum hemorrhage and subsequent ovarian torsion with markedly elevated FSH levels in a reproductive-aged woman in the absence of functional gonadotroph adenoma (FGA) or premature ovarian failure (POF). A 22-year-old nulligravid woman with a history of bilateral hemorrhagic corpus luteum and subsequent ovarian torsion presented with acute abdominal pain. An emergency salpingo-oophorectomy of the right side was performed, and the right ovarian torsion due to hemorrhagic corpus luteum was diagnosed. Laboratory tests revealed markedly elevated FSH levels (77.6 mIU/mL). FGA was suspected, but no evidence of tumor was identified. The left ovary enlarged again at one-month follow-up. Estrogen/gestagen therapy (EGT) was started, which reduced the enlarged ovary to normal size. Two years later, her pituitary hormonal status was evaluated in detail. Besides markedly elevated FSH level, slightly elevated LH (31.2 mIU/mL), normal total inhibin B (35.3 pg/ml), abnormally low anti-Müllerian hormone (AMH) (<0.03 ng/mL), and poor FSH response to gonadotropin-releasing hormone stimulation test were found. In the absence of FGA, we conclude that certain disorders of inhibitory factors for FSH function, including inhibin and AMH may exist, which could attribute to the patient's symptoms. EGT was very effective in suppressing the ovarian hyperactivity.
Implantable cardioverter defibrillator related Actinomyces Odontolyticus endocarditis and bacteremia-First reported case
Authors: Mirai Farah Khoury, Shay Perek, Ayelet Raz-Pasteur
Journal: IDCases (2021)
Keywords: actinomyces, actinomyces odontolyticus, actinomyces endocarditis, actinomyces foreign body infection
MeSH terms: Case Reports

Actinomyces Odontolyticus is a gram-positive bacillus, usually found in the oropharynx, gastrointestinal and urogenital tracts, as commensal flora. Infections caused by this organism are rare but may occur, more commonly in immunocompromised patients. We report a case of a 54-year-old man, who presented to the emergency department (ED), with fever and chills. The patient had undergone an implantable cardioverter defibrillator (ICD) insertion, 5 months prior to his arrival, and was diagnosed with Actinomyces Odontolyticus bacteremia, during the hospitalization. Transesophageal echocardiogram (TEE) revealed vegetations on the tricuspid valve and the ICD electrode. This is the first reported case of ICD related Actinomyces endocarditis and bacteremia based on our literature review. This case emphasizes the importance of probing for the source of actinomyces infection, while considering the indolent properties of the disease.
Case report: Mild phenotype of a patient with vascular Ehlers-Danlos syndrome and COL3A1 duplication mutation without alteration in the [Gly-X-Y] repeat sequence
Authors: Shujiro Hayashi, Tomomi Yamaguchi, Tomoki Kosho, Ken Igawa
Journal: Front Genet (2022)
Keywords: col3a1, vascular ehlers–danlos syndrome, endoplasmic reticulum stress, in-frame mutation, triplet repeat sequence, unfolded protein response
MeSH terms: Case Reports

Background: Vascular-type Ehlers-Danlos syndrome (vEDS) is an autosomal dominant inherited disorder caused by a deficit in collagen III as a result of heterogeneous mutations in the α1 type III collagen gene (COL3A1). Patients with vEDS often experience the first major complications in their early 20s and >80% have at least one complication by their 40s, reducing their average life expectancy to 48 years. Most commonly, vEDS variants are heterozygous missense substitutions of a base-pair encoding a glycine (Gly) residue of the [Gly-X-Y] repeat of the COL3A1 protein. When a peptide chain derived from a mutant allele is present in the procollagen triple helical structure, the helical structure cannot be maintained. Therefore, typically, the mutated collagen peptide induces a dominant negative effect on procollagen production. We reported the case of a patient with vEDS and a unique novel duplication mutation without alteration in the [Gly-X-Y] triplet repeat sequence. Case presentation: A 58-year-old man developed a sudden disorder of consciousness and abdominal pain and was consequently taken to a nearby hospital, where an intra-abdominal aneurysm was found, in addition to mild small joint hypermobility and acrogeria. There has been no history of spontaneous pneumothorax, dislocation, or subcutaneous hematoma. The analysis of genomic DNA from a blood sample identified a likely pathogenic in-frame duplication mutation in the COL3A1 gene coding region. Interestingly, this mutation is not expected to alter the [Gly-X-Y] triplet repeat sequence. We verified the mutation's pathogenicity by performing an analysis of synthetic procollagen from cultured skin fibroblasts, electron microscopy, and mRNA expression analysis of unfolded protein response sensors for endoplasmic reticulum (ER) stress. Conclusion: Although the clinical findings of the case were mild, when compared to typical vEDS, decreased α1 collagen III levels and morphological abnormalities of the collagenous bundles were observed in the patient samples when compared with the normal control samples. Our evidence supports the conclusion that this variant is pathogenic. However, unlike the common vEDS, ER stress was not observed, and the mild phenotype presentation was suggested to be due to the unique mutation, allowing the triple helical structure to be maintained to a certain extent.
Neuro-meningeal cryptococcal infection revealing a multiple myeloma
Authors: Sameh Sayhi, Sawsen Bouzidi, Imen Beji, Aman Allah Nasr, Souha Hannachi, Ines Bedoui, Samy Layouni, Najiba Fekih-Mrissa, Bassem Louzir, Brahim Nsiri, Rym Abid, Riadh Battikh
Journal: Pan Afr Med J (2020)
Keywords: cryptococcal-meningitis, hypogammaglobulinemia, lymphopenia, multiple myeloma
MeSH terms: Meningitis, Cryptococcal / diagnosis, Multiple Myeloma / diagnosis, Opportunistic Infections / diagnosis, Case Reports, Headache / etiology, Humans, Male, Meningitis, Cryptococcal / microbiology, Middle Aged, Multiple Myeloma / complications, Opportunistic Infections / microbiology, Vomiting / etiology

Rare cases of Cryptococcus have been documented in patients living with multiple myeloma. To date there has been no documented evidence of cryptococcosis revealing multiple myeloma. We reported a 63-year-old man who had a 2-months history continuous holocranial headaches, morning vomiting, complaining of blurred vision and fever. The biologic and the imaging showed a Cryptococcus meningoencephalitis. The search for a cause of immunodeficiency revealed a multiple myeloma. The diagnosis for Cryptococcus was confirmed according to an India ink stain, blood and cerebrospinal fluid culture. The patient's treatment for multiple myeloma was initiated with a chemotherapy regimen. The evolution was good without complication. Cryptococcosis, especially in the neuro-meningeal form, is a serious, deadly opportunistic infection. The search of an underlining immunodeficiency must be systematic. In this case, it was associated with early stage multiple myeloma.
Superficial siderosis and sudden sensorineural hearing loss: a case report and review of the literature
Authors: Kirsti S V Lee, Niranjan Sritharan, Allan Forrest
Journal: Case Rep Otolaryngol (2013)

This case report highlights an unusual case of sudden sensorineural hearing loss related to superficial siderosis (SS). Our patient had a craniotomy for medulloblastoma 23 years earlier, and this may represent a delayed complication related to this procedure. Magnetic resonance imaging (MRI) remains the key diagnostic investigation to illustrate the imaging features of superficial siderosis and exclude other pathologies. Increased awareness of progressive and sudden hearing complications caused by SS is important in the otolaryngologic community to expedite management and better counsel patients during the consent process.