OpenMed/multicare-articles huggingface dataset:
Staphylococcus aureus Myocarditis with Associated Left Ventricular Apical Thrombus
Authors: Michael McGee, Emily Shiel, Stephen Brienesse, Stuart Murch, Robert Pickles, James Leitch
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Staphylococcus aureus myocarditis is a rare diagnosis with a high mortality rate, usually seen in people who are immunocompromised. Here, we report a case of a 44-year-old man on methotrexate for rheumatoid arthritis who presented in septic shock and was diagnosed with staphylococcus aureus myocarditis. The myocarditis was associated with a left ventricular apical thrombus, with normal systolic function. The myocarditis and associated thrombus were characterised on transthoracic echocardiogram and subsequently on cardiac magnetic resonance imaging. Cardiac magnetic resonance (CMR) imaging showed oedema in the endomyocardium, consistent with acute myocarditis, associated with an apical mural thrombus. Repeat CMR 3 weeks following discharge from hospital showed marked improvement in endomyocardial oedema and complete resolution of the apical mural thrombus. He was treated with a 12-week course of antibiotics and anticoagulated with apixaban. The patient was successfully managed with intravenous antibiotics and anticoagulation with complete recovery.
Case report: Vulval sebaceous carcinoma: a report of two cases and literature review focus on treatment and survival
Authors: Xiaoxue Wang, Xin Wei
Journal: Pathol Oncol Res (2023)
Keywords: adjuvant therapy, extraocular sebaceous carcinoma, prognosis, surgery, vulval sebaceous carcinoma
MeSH terms: Carcinoma / pathology, Vulvar Neoplasms / pathology, Vulvar Neoplasms / surgery, Review, Case Reports, Female, Humans, Lymph Node Excision, Lymph Nodes / pathology, Middle Aged, Neoplasm Recurrence, Local / pathology, Neoplasm Staging

Background: Extraocular sebaceous carcinoma (SC) arising in the vulva is extremely rare that no treatment consensus has been well-defined. Case presentation: We here presented two cases of vulval SC in a 31-year-old and a 62-year-old woman, respectively. Radical wide local excision was performed with free margin and they received no postoperative adjuvant therapy. No evidence of disease was detected after follow-ups for 12 months and 49 months, respectively. A comprehensive literature review of vulval SC was further conducted and other ten cases were included. The mean age was 55.9 years, nine patients were diagnosed with FIGO stage I diseases while the remaining three patients had metastatic lesions at initial diagnosis. Surgery was the mainstay treatment option that 11 (91.7%) underwent surgical resection, of which 5 patients received inguinal lymphadenectomy and 2 patients showed lymph nodes involved. Radiotherapy and chemotherapy were given in 2 and 1 patient, respectively. Two patients experienced recurrence within 1 year after initial therapy. At the final follow-up, ten patients had no evidence of disease, one patient was alive with the disease, and only one died of the disease. Conclusion: Radical wide local excision may be preferred in early-stage vulval SC and utilization of sentinel lymph node sampling should be recommended. Postoperative adjuvant therapy may be spared in patients with negative surgical margin and absence of lymph node involvement. Treatment of vulval SC referring to the guidelines of vulvar cancer should be administered in case of positive margins or metastatic disease.
Case report: Somatic mutations in microtubule dynamics-associated genes in patients with WNT-medulloblastoma tumors
Authors: Rostislav Skitchenko, Yulia Dinikina, Sergey Smirnov, Mikhail Krapivin, Anna Smirnova, Daria Morgacheva, Mykyta Artomov
Journal: Front Oncol (2023)
Keywords: wnt, exome sequence data, medulloblastoma, microtubule - associated proteins, somatic mutation analysis
MeSH terms: Case Reports

Medulloblastoma (MB) is the most common pediatric brain tumor which accounts for about 20% of all pediatric brain tumors and 63% of intracranial embryonal tumors. MB is considered to arise from precursor cell populations present during an early brain development. Most cases (~70%) of MB occur at the age of 1-4 and 5-9, but are also infrequently found in adults. Total annual frequency of pediatric tumors is about 5 cases per 1 million children. WNT-subtype of MB is characterized by a high probability of remission, with a long-term survival rate of about 90%. However, in some rare cases there may be increased metastatic activity, which dramatically reduces the likelihood of a favorable outcome. Here we report two cases of MB with a histological pattern consistent with desmoplastic/nodular (DP) and classic MB, and genetically classified as WNT-MB. Both cases showed putative causal somatic protein truncating mutations identified in microtubule-associated genes: ARID2, TUBB4A, and ANK3.
Intracavitary Irradiation as a Safe Alternative for Cystic Craniopharyngiomas: Case Report and Review of the Literature
Authors: Alejandro Enriquez-Marulanda, Melibea Sierra-Ruiz, Luz Maritza Pabón, Javier Lobato-Polo
Journal: Case Rep Med (2016)

Craniopharyngioma treatment remains a challenge for clinicians and patients. There are many treatment alternatives; however one of them (intracavitary irradiation) seeks to control this type of benign brain tumor using minimally invasive techniques, with the specific aim of avoiding causing significant damage to important structures surrounding the sellar/suprasellar region. We present the case of a 3-year-old patient with a predominantly cystic craniopharyngioma who underwent intracavitary irradiation by stereotactic placement. Using this approach, the patient showed a successful response with remission of headaches and hydrocephalus. A reduction in the size of the cyst was achieved, without deterioration of visual fields, with no hormonal supplementation being needed, and with no evidence of focal neurological signs.
A case of cutaneous toxigenic Corynebacterium ulcerans likely acquired from a domestic dog
Authors: Richard Othieno, Kate Mark, Michelle Etherson, Geoffrey Foster, Steven Murray, Pota Kalima, Norman K Fry, Claire Cameron, Jenni Strachan
Journal: Access Microbiol (2019)
Keywords: corynebacterium, public health, vaccination, wound infection, zoonoses
MeSH terms: Case Reports

Introduction:

Corynebacterium ulcerans can produce diphtheria toxin and although still rare, is now the predominant cause of toxigenic diphtheria infection in the UK, making this organism of great clinical and public health importance. Here we describe a cutaneous case, likely secondary to domestic animal contact.
Case presentation:
A 60-year-old female presented with a slow-healing finger-burn wound. A skin swab cultured Corynebacterium ulcerans, which was confirmed to be toxin producing. She resided with her partner and two dogs, one of which had a chronic skin lesion. Her most recent diphtheria vaccine was in 2009. Four close contacts were identified, two of whom were healthcare professionals, and nose and throat swabs were obtained. The patient was treated with clarithromycin (14 day course), diphtheria vaccine and excluded from work until completion of antibiotics and negative clearance swabs. Contacts were given erythromycin (7 day course), vaccinated and healthcare worker contacts excluded from work until swab negative. A veterinary practitioner swabbed the throats and a skin lesion of their dogs. One contact (partner of patient) and all dog swabs were positive. Partial allelic profiles from MLST supported an epidemiological link. The dogs were treated with antibiotics and antimicrobial skin wash. Repeat swabs for the index case, contact and both dogs were negative following treatment.
Conclusion:
This was a rare case of cutaneous diphtheria secondary to Corynebacterium ulcerans with domestic animals the most likely source, although human-to-human contact could not be excluded, with important human and animal public health implications.
Unusual complication and successful high-dose chemotherapy treatment of advanced Burkitt's lymphoma in an adult HIV-positive patient
Authors: Henrietta W H McGrath, Alexander Fitzhugh, Maria Javed, Neesha Rockwood, Farhat Kazmi
Journal: SA J Radiol (2017)
MeSH terms: Case Reports

Adult Burkitt's lymphoma emerged as an AIDS-defining condition in the 1980s. We describe a case of HIV-associated adult Burkitt's lymphoma diagnosed and treated with high-dose chemotherapy in our institution, complicated by unusual bilateral renal vein tumour thrombi and tumour lysis syndrome. We believe this unique case highlights the need for early recognition of current and potential complications on staging computed tomography imaging, as well as successful use of a high-dose chemotherapy regimen.
Evidence of acute Mycoplasma infection in a patient with incomplete and atypical kawasaki disease: a case report
Authors: M Ebrahim, M Gabay, R F Rivas-Chacon
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

The etiology of Kawasaki disease remains unknown despite extensive studies. Some researchers suggest that it is caused by an infectious agent. This is a case report where a patient with incomplete Kawasaki disease was found to have evidence compatible with acute Mycoplasma pneumoniae infection. This is one of the several case reports linking Mycoplasma pneumoniae to Kawasaki disease as a possible trigger. This is perhaps due to a superantigen or is mediated by some other mechanism. Accurate and timely testing for Mycoplasma infections is difficult and has its limitations. Despite this, Mycoplasma pneumoniae should be considered in the differential and workup for Kawasaki disease.
Bilateral Hypoglossal Nerve Palsy due to Brainstem Infarction: A Rare Presentation of Presumed Pyogenic Meningitis
Authors: A G T A Kariyawasam, C L Fonseka, S D A L Singhapura, J S Hewavithana, H M M Herath, K D Pathirana
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Background:
Cranial nerve palsies are well-known complications of basal meningitis, especially in patients with tuberculous meningitis. However, a minority of bacterial meningitis gets complicated with cranial nerve palsies. Although cerebral infarctions are known to occur with acute bacterial meningitis, infarctions occurring in the brainstem are infrequently described.
Case presentation:
We report a 46-year-old healthy female who presented with dysarthria with fever, headache, and vomiting and was diagnosed to have acute pyogenic meningitis complicated with a brainstem infarction resulting in bilateral hypoglossal palsy. Her MRI revealed an infarction in the lower part of the medulla oblongata, probably involving the bilateral hypoglossal nuclei.
Conclusion:
Isolated bilateral hypoglossal nerve palsy is an extremely rare cranial nerve palsy, secondary to pyogenic meningitis. To our knowledge, this should be the first reported case of isolated bilateral hypoglossal nerve palsy due to a brainstem infarct in the background of pyogenic meningitis.
Suggestions on Relieving Physical Anxiety of Medical Workers and Improving Physical and Mental Health Under the COVID-19 Epidemic-A Case Study of Meizhou City
Authors: Zhi-Cheng Lu, Chien-Hsing Tseng, Hsiao-Hsien Lin, Yuan-Shing Perng, Yi-Han Tseng
Journal: Front Public Health (2022)
Keywords: sars-cov-2, body anxiety, environment risk, healthcare professionals, leisure satisfaction, physical and mental health
MeSH terms: COVID-19 / prevention & control, Mental Health, Anxiety, Anxiety Disorders, Humans, Male, Middle Aged, Reproducibility of Results

The study examined the effects of swimming pools on healthcare professionals' willingness to engage in recreational activities, physical anxiety, and physical and mental well-being in the context of COVID-19. The research adopted the mixed research method, used SPSS 26.0 statistical software to test the reliability of the questionnaire, and then collected 840 valid questionnaires; first analyzed the data with basic statistics, t-test, ANOVA, and PPMCC test methods, and then used the interview method to collect expert opinions. A multi-check approach assembled all data and discussions. The study found that the use of personnel dynamic tracking systems or measures, combined with sodium hypochlorite and repeated filtration to stabilize water quality, could maintain the confidence of most medical workers in the swimming pool sports environment for epidemic prevention and avoid violations. The government could formulate safety prevention and control mechanisms in traffic and establish appropriate traffic routes. Next, formulated a prescription for swimming or other physical activity mechanisms for men aged 31-50 and redesigned measures for medical staff over 51 years old to have tense head issues and physical fatigue, promote blood circulation and improve sleep quality. This will promote the purpose of relieving stress and regulating the physical and mental health of medical staff after engaging in swimming.
Acanthosis nigricans in a patient with lung cancer: a case report
Authors: Duru Serap, Sever Ozlem, Yüceege Melike, Dilli Alper, Albayrak Aynur, Arıkök Ata Türker, Sadik Ardıç
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Some skin lesions may accompany malignancies. Acanthosis nigricans, one such lesion, is a paraneoplastic dermatosis characterized by hyperpigmented and velvety verrucose plaques observed as symetric eruptions. With this report, we aim to present a rare case of concomitant lung cancer and acanthosis nigricans. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. A 65-year-old patient who had hyperpigmented, hypertrophic and symmetric verrucose lesions at the flexor surfaces of the lower and upper extremities, face, palms and the axillary region. Thoracic computed tomography demonstrated a hypodense mass lesion with a dimension of 5 x 5.5 cm at the center of basal segment bronchi of the left pulmonary lobe. Fiberoptic bronchoscopy showed that the access to the lower left lobe was almost completely obstructed by the endobronchial lesion. The result of the histopathologic examination of the endobronchial tissue biopsy was reported as non-small cell (adenocarcinoma) lung cancer. Result of the histopathologic analysis of the punch biopsy of the skin lesions was reported as acanthosis nigricans .There are no pathognomonic dermatological findings for lung cancer. In conclusion, there are skin lesions that accompany lung cancer and we believe that these should be considered for differential diagnosis.
Case Report: Severe back pain, epigastric distress and refractory nausea; an unusual presentation of mediastinal bronchogenic cyst
Authors: Saeed Ali, Abdul Rauf, Ling Bing Meng, Zeeshan Sattar, Sana Hussain, Umair Majeed
Journal: F1000Res (2018)
Keywords: back, bronchogenic, cyst, pain
MeSH terms: Back Pain / diagnostic imaging, Back Pain / physiopathology, Back Pain / surgery, Bronchogenic Cyst / diagnostic imaging, Bronchogenic Cyst / physiopathology, Bronchogenic Cyst / surgery, Dyspepsia / diagnostic imaging, Dyspepsia / physiopathology, Dyspepsia / surgery, Mediastinal Cyst / diagnostic imaging, Mediastinal Cyst / physiopathology, Mediastinal Cyst / surgery, Nausea / diagnostic imaging, Nausea / physiopathology, Nausea / surgery, Tomography, X-Ray Computed, Case Reports, Adult, Female, Humans

Background: Bronchogenic cysts are congenital malformations from abnormal budding of embryonic foregut and tracheobronchial tree. We present a case of bronchogenic cyst with severe back pain, epigastric distress and refractory nausea and vomiting. Case Presentation: A 44-year-old Hispanic female presented with a 3-week history of recurrent sharp interscapular pain radiating to epigastrium with refractory nausea and vomiting. She underwent cholecystectomy 2-years ago. Computed tomography (CT) abdomen at that time showed a subcarinal mass measuring 5.4 X 5.0 cm. Subsequent endoscopic ultrasound diagnosed it as a bronchogenic cyst. Endobronchial ultrasound (EBUS) guided aspiration resulted in incomplete drainage and she was discharged after partial improvement. Current physical examination showed tachycardia and tachypnea with labs showing leukocytosis, elevated inflammatory markers, and hypokalemic metabolic alkalosis. CT chest showed an increased size of the bronchogenic cyst (9.64 X 7.7 cm) suggestive of possible partial cyst rupture or infected cyst. X-ray esophagram ruled out esophageal compression or contrast extravasation. Patient's symptoms were refractory to conservative management. The patient ultimately underwent right thoracotomy with cyst excision that resulted in complete resolution of symptoms. Conclusion: Bronchogenic cysts are the most common primary cysts of mediastinum with the prevalence of 6%. The most common symptoms are chest pain, dyspnea, cough, and stridor. Diagnosis is made by chest X-Ray and CT chest. Magnetic resonance imaging chest and EBUS are more sensitive and specific. Symptomatic cysts should be resected unless surgical risks are high. Asymptomatic cysts in younger patients should be removed due to low surgical risk and potential late complications. Watchful waiting has been recommended for asymptomatic adults or high-risk patients. This case presents mediastinal bronchogenic cyst as a cause of back, nausea and refractory vomiting. Immediate surgical excision in such cases should be attempted, which will lead to resolution of symptoms and avoidance of complications.
Loxapine in the Treatment of Manic and Psychotic Symptoms in an Individual Intolerant to Multiple Mood-Stabilizing and Antipsychotic Medications
Authors: David S Im, Marina Capitanov, Amy M VandenBerg
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

First-line treatments for schizophrenia and schizoaffective disorder include antipsychotics and mood stabilizers, but their use may at times be limited due to severe adverse events. This case describes a 41-year-old male with a history of schizoaffective disorder and polysubstance use who was admitted to an inpatient psychiatry unit for acute manic and psychotic symptoms in the setting of absconding from his residential home and noncompliance with prescribed psychiatric medications. During his inpatient psychiatric hospitalization, he experienced DRESS (drug reaction with eosinophilia and systemic symptoms) with valproate, nephrogenic diabetes insipidus with lithium, potential neuroleptic malignant syndrome with risperidone, and orthostasis/tachycardia with clozapine. He ultimately achieved stabilization of manic and psychotic symptoms with loxapine without experiencing adverse events. This report highlights the potential utility of loxapine in individuals with schizoaffective disorder intolerant to standard mood-stabilizing and antipsychotic medications.
Primary Cutaneous CD30-Positive Large T-Cell Lymphoma in an 80-Year-Old Man: A Case Report
Authors: Rehan Hussain, Amir Bajoghli
Journal: ISRN Dermatol (2011)
MeSH terms: Case Reports

Primary cutaneous CD30-positive large cell lymphoma (CD30+ PCLCL) is a rare subtype of cutaneous T-cell lymphoma (CTCL) that can present in a variety of ways. We report a patient with a three-month history of an enlarging, exophytic mass with two smaller satellite lesions on the left forearm. Biopsy of the skin stained positive for CD30, and, after thorough systemic evaluation, a diagnosis of CD30+ PCLCL was made. When PCLCL is suspected, it is important to perform immunohistological studies for CD30 types and conduct a thorough workup to rule out systemic LCL. These measures will reduce the use of unnecessarily aggressive chemotherapy regimens for CD30+ PCLCL, an indolent disease with a favorable prognosis.
Isolated gallbladder metastasis of melanoma: Case report
Authors: Gonzalo Guido D'Urso Vilar, Facundo Iriarte, Daniela Speisky, Mariano Luis Bregante, Sergio Damian Quildrian
Journal: Int J Surg Case Rep (2020)
Keywords: case report, gallbladder, isolated metastasis, laparoscopic cholecystectomy, melanoma
MeSH terms: Case Reports

Background:
Although metastatic melanoma is most frequently found in liver, lungs, and brain, most metastases found in the gallbladder are from melanoma. Here, we present a case of isolated metastatic melanoma found during cholecystectomy.
Presentation of case:
74-year-old male with a personal history of hypertension, diabetes mellitus, obesity, and arrhythmia. A skin lesion was found on the right malar region. An excisional biopsy was performed and histopathological examination showed an ulcerated nodular-type malignant melanoma, Breslow 7.6 mm, Clark IV. Surgical excision with margins of 2 cm and sentinel lymph-node biopsy was carried and were negative. Abdominal sonography at 6 months showed an 18 mm solid mass adhered to the wall of the gallbladder that was suggestive of a polyp. Thorax-abdomen-pelvis CT showed no abnormalities. The gallbladder lesion had increased in volume on the following sonography and therefore, cholecystectomy was performed. Histopathological study revealed melanoma infiltrating the mucosa and muscular layer. Written informed consent was previously obtained, and Institutional Review Board approval was not needed.
Discussion:
Isolated metastatic melanoma in the gallbladder is uncommon. Follow-up controls with images are important in the diagnosis. As most metastatic melanoma to the gallbladder are asymptomatic, surgeons should have high level of suspicion. Cholecystectomy could prolong survival in these patients.
Conclusion:
Isolated gallbladder metastasis of melanoma is an uncommon presentation of this disease. Laparoscopic cholecystectomy is an adequate procedure in this particular situation and may improve patient survival. The presentation of this case may help surgeons to maintain a high level of suspicion regarding the condition.
Emergence Delirium in a 29-Year-Old Man following an Uneventful Appendectomy
Authors: Zhi Wang, Yong Yang, Yang Chen, Kai Lu, Bing Chen
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Emergence delirium (ED) is defined as the delirium that occurs during the transition from the sleep state to full consciousness. ED increases the risk for injury, self-extubation, hemorrhages, and prolonged hospitalization and occurs in patients of any age but most often in children and elderly patients. However, ED in young adults is rarely reported. We presented a case of typical ED occurring in a young healthy man following an uneventful appendectomy. The causes of ED can be classified as either predisposing or precipitating factors. In this case, the unnoticeable mental stress may be the predisposing factor and the sevoflurane maintenance of anesthesia may be the precipitating factor. ED occurs at any age of patient and in any minor surgery, and anesthesiologists should do some work to prevent it from happening.