OpenMed/multicare-articles huggingface dataset:
Corynebacterium striatum thrombophlebitis: a nosocomial multidrug-resistant disease?
Authors: Julie Tang, Dimitri Kornblum, Nagisa Godefroy, Gentiane Monsel, Jérome Robert, Eric Caumes, Valérie Pourcher, Elise Klement-Frutos
Journal: Access Microbiol (2021)
Keywords: corynebacterium, multidrug resistance, septic thrombophlebitis
MeSH terms: Case Reports

Introduction:

Corynebacterium striatum is a non-Diphteriae commensal bacterium with a wide range of pathogenicity. The identification of multidrug-resistant (MDR) C. striatum is concerning because drug susceptibility testing is not usually performed in microbiology laboratories. There is no consensus yet on the treatment of septic thrombophlebitis in this situation.
Case report:
We report here the first case of a quinquagenarian patient with a history of AIDS and fungic endocarditis, who was diagnosed with a nosocomial thrombophlebitis in the right jugular vein caused by C. striatum . Bitherapy with daptomycin for 12 days and linezolid for 23 days was combined with a therapeutic anticoagulant. The follow-up included weekly cervical ultrasound controls. The efficiency of the treatment and the stability of the lesions allowed us to alleviate the medication with a prophylactic dose of anticoagulant. The patient was discharged from hospital and showed no signs of recurrence after 12 months.
Conclusion:
The lack of consensus relative to the management of septic thrombophlebitis precludes the validation of a specific treatment for the condition. Our results suggest that a combination that includes removal of the medical device is needed. A total of 6 weeks of antibiotherapy should be applied, starting with 2 weeks of vancomycin or a combination of antibiotitherapy with daptomycin in order to reduce the bacterial load and avoid resistance. Six weeks of anticoagulation therapy is effective.
Postmortem Evaluation of Left Flank Laparoscopic Access in an Adult Female Giraffe (Giraffa camelopardalis)
Authors: R Pizzi, J Cracknell, L Dalrymple
Journal: Vet Med Int (2010)
MeSH terms: Case Reports

There are still few reports of laparoscopy in megavertebrates. The giraffe (Giraffa camelopardalis) is the tallest land mammal, and the largest ruminant species. An 18-year-old multiparous female hybrid giraffe, weighing 650 kg, was euthanized for chronic health problems, and left flank laparoscopy was performed less than 30 minutes after death. Safe primary access was achieved under visualisation using an optical bladed trocar (Visiport Plus, Tyco healthcare UK Ltd) without prior abdominal insufflation. A left paralumbar fossa approach allowed access to the spleen, rumen, left kidney, and intestines, but did not allow access to the reproductive tract which in nongravid females is intrapelvic in nature.
Case Report: Composite pheochromocytoma with ganglioneuroma component: A report of three cases
Authors: Paula B Araujo, Mirna S Carvallo, Ana P Vidal, João B Nascimento, Julia M Wo, Erika O Naliato, Silvio H Cunha Neto, Flavia L Conceição, Rosita Fontes, Vinicius V de Lima, Denise P Carvalho, Paula Soares, Jorge Lima, Delmar M Lourenço Jr, Alice Helena D Violante
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: composite pheocromocytoma, ganglioneuroma, molecular study, paraganglioma, pathology, pheocromocytoma
MeSH terms: Adrenal Gland Neoplasms / diagnosis, Adrenal Gland Neoplasms / genetics, Adrenal Gland Neoplasms / surgery, Ganglioneuroma / diagnosis, Ganglioneuroma / genetics, Ganglioneuroma / surgery, Paraganglioma / pathology, Pheochromocytoma / diagnosis, Pheochromocytoma / genetics, Pheochromocytoma / surgery, Case Reports, Research Support, Non-U.S. Gov't, Brazil, Humans

Composite pheochromocytoma (CP) is a very rare tumor originating from neural crest cells, predominantly composed of pheochromocytoma (PCC), a chromaffin cell tumor arising in adrenal medulla, and ganglioneuroma, a tumor derived from autonomic ganglion cells of the nervous system. Moreover, CP may be present in the hereditary syndromes of which pheochromocytoma is part. Literature offers scarce data on this subject, and particularly about its biological behavior, clinical evolution, and molecular profile. We report the phenotype and outcome of three cases of CP (PCC and ganglioneuroma components), followed up at the Endocrine Service of the Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil. Two nonsyndromic patients (cases 1 and 2) were negative to germline mutations in genes VHL, SDHB, SDHC, SDHD, SDHAF2, TMEM127, and MAX, while the third case (case 3) had clinical diagnosis of neurofibromatosis syndrome. Cases 1, 2, and 3 were diagnosed at 29, 39, and 47 years old, respectively, and were followed up for 3, 17, and 9 years without no CP recurrence. All cases had apparent symptoms of catecholaminergic excess secreted by PCC. Ganglioneuroma, the neurogenic component present in all three cases, had a percentage representation ranging from 5% to 15%. Tumors were unilateral and large, measuring 7.0 cm × 6.0 cm × 6.0 cm, 6.0 cm × 4.0 cm × 3.2 cm, and 7.5 cm × 6.0 cm × 4.5 cm, respectively. All cases underwent adrenalectomy with no recurrence, metastasis, or development of contralateral tumor during follow-up. Genetic testing has been scarcely offered to CP cases. However, a similar frequency of genetic background is found when compared with classic PCC, mainly by the overrepresentation of NF1 cases in the CP subset. By literature review, we identified a notorious increase in cases reported with CP in the last decade, especially in the last 3 years, indicating a recent improvement in the diagnosis of this rare disorder in clinical practice.
Immediate Reversal of Dabigatran by Idarucizumab Prior to Laboratory and Imaging Results in Acute Stroke
Authors: Maren Hieber, Juergen Bardutzky
Journal: Front Neurol (2019)
Keywords: case report, dabigatran, door-to-needle time, idarucizumab, intravenous thrombolysis
MeSH terms: Case Reports

We report a case of intravenous thrombolysis in acute ischemic stroke of anterior choroidal artery following the antagonization of dabigatran with idarucizumab. No secondary complication, like hemorrhagic or thrombotic/thrombembolic event, of neither idarucizumab nor subsequent intravenous thrombolysis emerged. The recent approval of idarucizumab enables intravenous thrombolysis despite preexisiting oral anticoagulation with dabigatran, but raises the question of the optimal management and work flow of patients under medication with dabigatran and with acute neurological deficit, highly suspicious for an acute cerebrovascular event. In contrast to hitherto case reports and series, here, we explicitly refrained from awaiting the results of the thrombin time, as a marker for present anticoagulation by dabigatran, as well as the results of cerebral imaging before administration of idarucizumab. Based on the presented case we propose this approach to minimize door-to-needle time of intravenous thrombolysis in acute ischemic stroke and thus to enhance the chance for a good outcome.
A case of xenon inhalation therapy for respiratory failure and neuropsychiatric disorders associated with COVID-19
Authors: Vladimir Vasil'evich Udut, Sergei Alexandrovich Naumov, Diana Nikolaevna Evtushenko, Elena Vladimirovna Udut, Sergei Sergeevich Naumov, Gleb Nikolaevich Zyuz'kov
Journal: EXCLI J (2021)
Keywords: sars-cov-2, molecular modeling, neuropsychiatric disorders, respiratory failure, surfactant, xenon
MeSH terms: Case Reports

Acute respiratory distress syndrome (ARDS) is the main danger to the life of patients with pneumonia caused by SARS-CoV-2. At the same time, respiratory failure (RF) after ARDS can persist for a long time despite intensive therapy. Therefore, it is important to develop new effective approaches for restoring the ventilation function of the lungs after COVID-19. Here, we present a case report of effective application of short-term inhalations of xenon-oxygen (Xe/O2) gas mixture for treatment of RF and neuropsychiatric disorders (NPD) associated with COVID-19. The patient inhaled a gas mixture of 70 % Xe and 30 % O2. We used multispiral computed tomography, evaluated psychometry, studied hematological and biochemical blood parameters, and applied some other methods of clinical studies to assess the therapeutic effectiveness of Xe inhalation. Also, we studied the mechanism of action of xenon with computer modeling. The clinical case showed the high efficacy of Xe/O2 mixture for treating severe RF and NPD after SARS-CoV-2 infection. Xenon inhalations dramatically increased oxygen saturation and the degree of pneumatization of the lungs. We found out that in coronavirus pneumonia, saturated phospholipids of surfactant are transferred to the solid-ordered phase, which disrupts the surface tension of the alveoli and alveolar gas exchange. Using molecular modeling methods, we demonstrated that the xenon atom increases the distance between the acyl chains of phospholipids due to the van der Waals dispersion interaction. These changes allow for the phase transition of phospholipids from the solid-ordered phase to the liquid phase and restore the functional activity of the surfactant. The findings suggest the feasibility of conducting studies on the effectiveness of Xe/O2 inhalations for treating ARDS in SARS-CoV-2 infection.
Complete resolution of recurrent piriformis syndrome after piriformis resection with 3 years' follow up: A case report
Authors: Achmad Fahmi, Mustaqim Apriyansa Rahmadhan, Dirga Rachmad Aprianto, Heri Subianto, Agus Turchan
Journal: Int J Surg Case Rep (2020)
Keywords: pain relief, piriformis resection, piriformis syndrome
MeSH terms: Case Reports

Introduction:
Piriformis syndrome (PS) is an uncommon neuromuscular condition characterized by buttock pain radiating to the leg. Although the goal of PS treatment is symptom relief, it is difficult in some patients using conservative treatment alone.
Presentation of case:
A 72-year-old male underwent piriformis resection after failed sequential steroid injection of the piriformis. The patient ultimately underwent surgery for resection of the piriformis muscle and experienced satisfactory pain relief (pain reduction > 75% according to visual analog scale for at least 12 months) following surgery and in the 3-year follow-up period.
Discussion:
Conservative treatment is first-choice treatment for managing PS. Surgery was indicated when the patient did not achieve satisfactory pain relief with conservative treatment. Surgical resection of the piriformis muscle has been shown to be effective and feasible.
Conclusion:
Piriformis resection is effective and can be a feasible option for the treatment of PS following failure of appropriate conservative treatment(s).
Liposarcoma of the spermatic cord: a case report
Authors: M S Papageorgiou, G Dadakas, K Donev
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Liposarcomas are malignant tumors derived embryologically from mesodermal tissues. An unusual site of presentation is the spermatic cord, presenting as an inguinal or scrotal mass. We report a rare case of a liposarcoma of the spermatic cord, mimicking a testicular tumor. The patient was operated, and an orchidectomy, including the tumor, was performed. To our knowledge, there are about 185 similar cases reported in the literature.
An Exceptional Case of Liver-Restricted High-Grade B-Cell Lymphoma in a Patient with Clinical History of HBV and HCV Coinfections
Authors: Connor R Zuraski, Vinit Patil, Katherine E Schwetye
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Primary hepatic lymphomas (PHLs) are exceedingly rare. Many reported cases are associated with various viral serologies, and some viruses may be implicated in lymphomagenesis through emerging, though as-of-yet uncertain, mechanisms. A review of the literature reveals previously reported cases of PHL, some of which support the potential roles of the hepatitis B and C viruses (HBV and HCV) in the development of PHL. We describe an exceptional case of primary hepatic high-grade B-cell lymphoma, discovered at autopsy, in a patient whose clinical history is significant for coinfection with both HBV and HCV. Additionally, attempts at cytogenetic testing of formalin-fixed, paraffin-embedded (FFPE) autopsy tissues, which we performed approximately ten years after the original autopsy, led us to question the utility of older tissue blocks in molecular and some immunohistochemical assays.
Rapid emergence of resistance to antiretroviral treatment after undisclosed prior exposure: A case report
Authors: Theresa M Rossouw, Gisela van Dyk, Gert van Zyl
Journal: South Afr J HIV Med (2019)
Keywords: antiretroviral therapy, hiv drug resistance, undisclosed prior treatment
MeSH terms: Case Reports

Introduction:
Patients who disengaged from care may present as therapy naïve for antiretroviral treatment (ART) initiation at a different site, without being recognised as being at an increased risk of rapid treatment failure and HIV drug resistance.
Patient presentation:
A 43-year-old woman, who gave no prior history of ART, was initiated on a standard first-line regimen of TDF, FTC and EFV. She had a poor response to treatment with evidence of treatment failure at 12 months.
Management and outcome:
HIV-1 drug resistance tests showed no pre-treatment HIVDR mutations, but revealed high-level drug resistance to all component drugs at 12 months. On investigation, viral load (VL) was recorded in 2012 and 2013, providing evidence of prior ART use.
Conclusion:
Linkage of patient therapy and laboratory information to unique patient identifiers may allow health-care workers to identify patients who previously received ART and disengaged from care. This will enable differentiated care when these patients reinitiate ART, which should involve expedited VL testing and more rapid transition to definitive second-line ART.
Endovascular Embolization of a Perforated Deep Femoral Artery in a 15-Year-Old Boy
Authors: Matthew H Bageris, Todd Chassee, Chris Benner
Journal: Cureus (2023)
Keywords: deep femoral, endovascular embolization, pediatric, penetrating stab wound, profunda femoris, trauma
MeSH terms: Case Reports

Trauma patients who are hemodynamically unstable or have certain signs of vascular injury should have immediate surgical exploration. For less severe signs of vascular injury, current literature states that endovascular intervention is optimal. This case presents the opportunity to review how signs of vascular injury were considered along with other diagnostic tools to inform decision-making after a penetrating stab wound injury to an extremity. A 15-year-old male presented to the emergency department (ED) as a trauma activation after being stabbed in the left thigh. The patient had an approximately 5 cm long laceration over the lateral superior aspect of his left thigh with visible subcutaneous tissue and biceps femoris muscle upon probing. He had an initial blood pressure of 101/61 mm Hg. Shortly after the tourniquet was removed, the patient developed brisk bleeding from the wound and his blood pressure decreased to 88/55 mm Hg. He was taken expediently to computed tomography (CT) for an angiogram of the lower extremity which showed active bleeding from a posterior peripheral branch arising from the deep femoral artery in the posterolateral thigh. Interventional radiology performed intravascular embolization, and hemostasis was achieved. The patient was admitted for observation and then discharged 17 hours after admission without ambulatory difficulty. We present a case of penetrating extremity trauma (PET) where the patient had a presentation with mixed hard signs and soft signs of vascular injury. The patient responded well to endovascular embolization. Early detection and intervention in PET are critical in minimizing blood loss and ischemia to distal structures. While following professional organization guidelines can help guide care, a collaborative approach by multiple specialty care teams is critical in providing optimal care in PET.
The dentato-rubro-olivary tract: clinical dimension of this anatomical pathway
Authors: Fadil Khoyratty, Thomas Wilson
Journal: Case Rep Otolaryngol (2013)

Symptomatic palatal tremor is potentially the result of a lesion in the triangle of Guillain-Mollaret (1931) and is associated with hypertrophic olivary degeneration (HOD) which has characteristic MR findings. The triangle is defined by dentate efferents ascending through the superior cerebellar peduncle and crossing in the decussation of the brachium conjunctivum inferior to the red nucleus, to finaliy reach the inferior olivary nucleus (ION) via the central tegmental tract. The triangle is completed by ION decussating efferents terminating on the original dentate nucleus via the inferior cerebellar peduncle. We can demonstrate the anatomy of this anatomical triangle using a clinical case of palatal tremor presenting with bilateral subjective pulsatile tinnitus along with the pathognomonic MR findings previously described. The hyperintense T2 signal in these patients may be permanent, but the hypertrophied olive normally regresses after 4 years. The temporal relationship between the evolution of the histopathology and the development of the palatal tremor remains unknown as does the natural history of the tremor. Botox injection at the level of tensor and levator veli palatini insertion have been used to treat patients with disabling tremor synchronous tinnitus. A lesion involving the triangle can have a quite varied clinical expression.
Stress fracture of the midshaft clavicle associated with sternocostoclavicular hyperostosis-Case report
Authors: Shuichi Miyamoto, Makoto Otsuka, Fumio Hasue, Takayuki Fujiyoshi, Koushirou Kamiya, Hitoshi Kiuchi, Tadashi Tanaka, Junichi Nakamura, Sumihisa Orita, Seiji Ohtori
Journal: Int J Surg Case Rep (2019)
Keywords: ankylosing spondylitis, midshaft of the clavicle, sapho syndrome, sternocostoclavicular hyperostosis, stress fracture

Introduction:
Stress fracture is generally a result of cumulative and repetitive stress in athletes, which accelerates the normal remodeling process of bones, and the most frequently involved areas are the tibia and metatarsal bones. Therefore, stress fractures of the midshaft of the clavicle are very rare.
Presentation of case:
A 58-year-old female was admitted to our hospital because of pain in the middle of the right clavicle. Based on laboratory and radiographic inspection, it was concluded that the stress fracture of the midshaft of the clavicle in this case was caused by sternocostoclavicular hyperostosis (SCCH). Because the clavicular fracture had no displacement or callus formation, conservative treatment with a clavicle band was undertaken. Shoulder function at the final follow-up visit was satisfactory.
Discussion:
SCCH is a rare chronic inflammatory disorder of the axial skeleton and ossifying diathesis associated with a predominantly osteogenic response. Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome and ankylosing spondylitis (AS) should be considered in the differential diagnosis of SCCH. If a patient with this type of fracture has no history of traumatic injury or sports activity, the differential diagnosis might be very difficult.
Conclusion:
We report the case of a female who had a stress fracture of the midshaft of the clavicle associated with SCCH in SAPHO or AS. Although the patient was treated conservatively, and the shoulder function was satisfactory at the final follow-up visit, re-fracture may occur in the future.
Interstitial Pregnancy: From Medical to Surgical Approach-Report of Three Cases
Authors: L Di Tizio, M R Spina, S Gustapane, F D'Antonio, M Liberati
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Background:
Interstitial pregnancy is a rare form of ectopic pregnancy that usually leads to uterine rupture resulting in sudden life-threatening haemorrhage, need for blood transfusion, and admission to intensive care unit. Mortality rate is 6-7 times higher than that in classical ectopic pregnancy. Uterine rupture has been typically reported to occur at more advanced gestational ages compared to tubal pregnancy although several recent reports have shown a high risk of rupture before 12 weeks of gestation.
Cases presentation:
We report three cases of women affected by interstitial pregnancy, with different clinical symptoms, and managed to be treated with surgery or medical therapy. An emergency laparotomy was performed in the first case by the general surgeon, while in the second case laparoscopy was made by a gynecologist; last case shows the success of systemic administration of methotrexate.
Conclusion:
Interstitial pregnancy is still a challenging condition to diagnose and treat; early diagnosis may help to choose the proper management.
Low-dose "metronomic chemotherapy" with oral cyclophosphamide and methotrexate in metastatic breast cancer: a case report of extraordinarily prolonged clinical benefit
Authors: G Masci, A Losurdo, C Gandini, I Garassino, L di Tommaso, R Torrisi, M Zuradelli, A Santoro
Journal: Ecancermedicalscience (2012)
MeSH terms: Case Reports

We report the case of a 34-year-old woman affected by breast cancer that had metastasized to the bone. She had been treated with oral cyclophosphamide and methotrexate (metronomic chemotherapy) and achieved 3.5 years of clinical remission. To our knowledge, this is the first description of such a prolonged response to therapy. This case report adds weight to known data on metronomic treatment and supports further investigation of this therapy.
Voluminous extracardiac adult rhabdomyoma of the neck: a case presentation
Authors: Riccardo Maglio, Scicchitano Francesco, Magistri Paolo, Valabrega Stefano, D'Angelo Francesco, Ramacciato Giovanni
Journal: Case Rep Surg (2012)

Introduction. Rhabdomyomas of the head and neck are exceptionally rare benign mesenchymal tumors. Rare cases have been reported to involve other sites of the body including the head and neck regions. Case Presentation. We report a case of voluminous extracardiac adult rhabdomyoma affecting adult patients and initially seen as slowly growing, indolent neoplasms. The patient is a seventy-year old male Italian patient. Conclusion. Adult extracardiac rhabdomyoma is a rare benign tumor that may present with symptoms that vary from aerodigestive tract obstruction to remaining asymptomatic for many years. Although histology is very characteristic, several differential diagnoses have to be considered. To our knowledge, this is the first case of voluminous adult-type symptomless rhabdomyoma.