OpenMed/multicare-articles huggingface dataset:
Rifampin-associated tubulointersititial nephritis and Fanconi syndrome presenting as hypokalemic paralysis
Authors: Hong Ki Min, Eun Oh Kim, Sang Ju Lee, Yoon Kyung Chang, Kwang Sun Suh, Chul Woo Yang, Suk Young Kim, Hyeon Seok Hwang
Journal: BMC Nephrol (2013)
MeSH terms: Fanconi Syndrome / chemically induced, Hypokalemia / chemically induced, Hypokalemia / diagnosis, Nephritis, Interstitial / chemically induced, Paralysis / chemically induced, Rifampin / administration & dosage, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antibiotics, Antitubercular / administration & dosage, Diagnosis, Differential, Fanconi Syndrome / diagnosis, Humans, Male, Nephritis, Interstitial / diagnosis, Paralysis / diagnosis, Antibiotics, Antitubercular, Rifampin

Background:
Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN) is a frequent histological finding. We describe for the first time a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis, associated with the use of rifampin.
Case presentation:
A 42-year-old man was admitted with sudden-onset lower extremity paralysis and mild renal insufficiency. He had been treated for pulmonary tuberculosis with isoniazid, rifampin, and ethambutol for 2 months. Laboratory tests revealed proteinuria, profound hypokalemia, hyperchloremic metabolic acidosis with a normal anion gap, positive urine anion gap, hypophosphatemia with hyperphosphaturia, hypouricemia with hyperuricosuria, glycosuria with normal serum glucose level, generalized aminoaciduria, and β2-microglobulinuria. A kidney biopsy revealed findings typical of ATIN and focal granular deposits of immunoglubulin A and complement 3 in the glomeruli and tubules. Electron microscopy showed epithelial foot process effacement and electron-dense deposits in the subendothelial and mesangial spaces. Cessation of rifampin resolved the patient's clinical presentation of Fanconi syndrome, and improved his renal function and proteinuria.
Conclusion:
This case demonstrates that rifampin therapy can be associated with Fanconi syndrome presenting as hypokalemic paralysis, which is a manifestation of ATIN. Kidney function and the markers of proximal tubular injury should be carefully monitored in patients receiving rifampin.
A novel modified hanging maneuver in laparoscopic left hemihepatectomy
Authors: Kosei Takagi, Yuzo Umeda, Takashi Kuise, Ryuichi Yoshida, Kazuhiro Yoshida, Kazuya Yasui, Yuma Tani, Takahito Yagi, Toshiyoshi Fujiwara
Journal: Int J Surg Case Rep (2020)
Keywords: hanging maneuver, laparoscopic, liver resection
MeSH terms: Case Reports

Introduction:
The liver hanging maneuver is an essential technique for controlling bleeding in hepatectomy, however it is often difficult in laparoscopic major hepatectomy. The present study describes a novel modified hanging maneuver in laparoscopic left hemihepatectomy.
Presentation of case:
A 29-year-old female underwent laparoscopic left hemihepatectomy for mucinous cystic neoplasm. After mobilizing the left lobe, the liver parenchyma was dissected along the demarcation line. For the hanging technique, the upper edge of the hanging tape was placed on the lateral side of the left hepatic vein, and fixed with the Falciform ligament. The lower edge of the tape was extracted outside the abdomen. Accordingly the hanging tape can be controlled extraperitoneally during the liver parenchyma dissection.
Discussion:
This technique includes several advantages including no need of assistance using forceps, easy control of the hanging tape extraperitoneally, outflow control, better exposure of surgical field, and helpful guide of the liver dissection line toward the root of the left hepatic vein.
Conclusion:
Our novel modified hanging maneuver is easy and reproducible to use in laparoscopic left hemihepatectomy. Moreover, this technique can be applied to other laparoscopic hepatectomy.
The role of pre-reduction MRI in the management of complex cervical spine fracture-dislocations: an ongoing controversy?
Authors: Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
Journal: Patient Saf Surg (2017)
Keywords: cervical spine trauma, fracture-dislocation, intervertebral disc herniation, patient safety, perched facet, spinal cord injury, timing of surgery
MeSH terms: Case Reports

Background:
Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated.
Case presentation:
A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck. He was neurologically intact on presentation. Initial CT imaging revealed a complex multisegmental cervical spine injury with a left-sided C6/C7 perched facet, a right sided C7/T1 fracture-dislocation, and a right-sided C6 and C7 traumatic laminotomy. The initial management consisted of temporary external Halo fixator application without closed reduction maneuver, to mitigate the risk of a delayed spinal cord injury. Subsequent advanced imaging by MRI revealed an acute traumatic C7/T1 disc herniation, with the intervertebral disc completely extruded into the spinal canal. Definitive surgical management was then accomplished by employing a three-stage anterior-posterior-anterior spinal decompression, realignment, fixation and fusion C4-T2 in one operative session. The patient recovered well and retained full neurological function. He resumed bicycle street racing within 10 months of the injury following successful spinal reconstruction.
Conclusions:
The diagnostic evaluation of cervical fracture-dislocations should include advanced imaging by MRI in order to fully understand the injury pattern prior to proceeding with spinal reduction maneuvers which may impose the imminent threat of a devastating iatrogenic injury to the spinal cord. The presented staged management by initial Halo fixation without attempts for spinal reduction, followed by a surgical decompression and multilevel fusion, appears to represent a feasible and safe strategy for patients at risk of a delayed neurological injury.
Bacteremia due to clostridium difficile: case report and review of the literature
Authors: Cherag Daruwala, Giancarlo Mercogliano, Gary Newman, Mark J Ingerman
Journal: Clin Med Case Rep (2009)
Keywords: clostridium difficile, crohn’s disease, bacteremia
MeSH terms: Case Reports

Objective:
The purpose of this study is to report a case of C. difficile bacteremia in a Crohn's disease patient and to review the literature on previously reported cases.
Methods:
Searches of MEDLINE and PubMed databases were made.
Results:
We report the first case of C. difficile bacteremia in a Crohn's disease patient. There are 15 other reported cases of C. difficile bacteremia reported in the literature. We found that the majority of patients (10 of 15 patients) had polymicrobial bacteremia and that the overall mortality rate is significant, with 6 of 15 reported patients dying.
Conclusion:
In conclusion, we find that C. difficile bacteremia is associated with a significant mortality rate and it would seem prudent to consider aggressive antibiotic therapy.
Case report: Treatment of persistent atypical odontalgia with attention deficit hyperactivity disorder and autism spectrum disorder with risperidone and atomoxetine
Authors: Satoshi Kasahara, Chihiro Takao, Ko Matsudaira, Naoko Sato, Trang Thi Huyen Tu, Shin-Ichi Niwa, Kanji Uchida, Akira Toyofuku
Journal: Front Pain Res (Lausanne) (2022)
Keywords: anger, atomoxetine, attention deficit hyperactivity disorder, atypical odontalgia, autism spectrum disorder, chronic primary pain, irritability, risperidone
MeSH terms: Case Reports

Chronic pain has recently been associated with developmental disorders [autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD)]. Regarding chronic pain in adulthood, fibromyalgia, migraine, and chronic low back pain have been associated with ADHD. The ICD-11 disease classification categorizes these pain diseases as chronic primary pain, suggesting high comorbidity with developmental disorders in chronic primary pain. Atypical odontalgia (AO) is a persistent tooth pain that occurs in the absence of any of the usual dental causes, most of which are triggered by dental treatment. Conditions characterized by tooth pain with no apparent cause are also classified as chronic primary pain. Approximately half the patients with AO are diagnosed with psychiatric disorders; the most common are depression (15.4%) and anxiety disorders (10.1%). However, there are no reports on neurodevelopmental disorders comorbid with AO. In the present study, we report a case of a 46-year-old man with numerous complaints (e.g., occlusal instability, difficulty eating, difficulty speaking), who took work leave due to worsening of his symptoms after periodontal scaling ("gingival recession" and "aggressive periodontal treatment") and frequently expressed dissatisfaction and anger at the hospital, making the dental treatment difficult. After a referral to a psychiatrist specializing in chronic pain, AO and previously undiagnosed comorbidity of ASD and ADHD were confirmed. Atypical antipsychotic risperidone for ASD irritability and an ADHD medication, atomoxetine dramatically reduced anger, pain, anxiety, depression, and pain catastrophizing thoughts, leading to reduced obsession with his symptoms and less frequent complaints. After risperidone (1 mg/day) + atomoxetine (120 mg/day) were ultimately prescribed after adjustment, he was able to return to work 226 days after initiation of psychiatric treatment. Recent studies show that comorbidity of developmental disorders in patients with chronic pain is likely to be undetected. Clinicians should include screening for ASD and ADHD not only in cases of fibromyalgia, migraine, and chronic low back pain, but also in orofacial pain such as AO and other treatments for chronic primary pain. For patients diagnosed with ASD or ADHD, an effective drug therapy for ASD and ADHD should be considered.
Familial aggregation of urinary tract and bone tumors: searching for a syndrome
Authors: Andreas Frings, Jochen B Geigl, Bernadette Liegl-Atzwanger, Andreas Leithner
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Positive family anamnesis is an important risk factor for cancer, and therefore further investigations need to be done if familial aggregation of cancer is observed. Due to a rare combination of urinary tract and bone tumors occurring in the family presented herein we hypothesized a hereditary predisposition and thus, Li-Fraumeni syndrome was considered to be the most likely differential diagnosis. To confirm Li-Fraumeni syndrome, we set out to investigate this case by analyzing the tumor suppressor gene p53. However, taking into account all the diagnostic results obtained, Li-Fraumeni syndrome could not be confirmed, but there is still uncertainty regarding a definitive diagnosis.
Pharmacokinetic Interactions of Clinical Interest Between Direct Oral Anticoagulants and Antiepileptic Drugs
Authors: Alessandro Galgani, Caterina Palleria, Luigi Francesco Iannone, Giovambattista De Sarro, Filippo Sean Giorgi, Marta Maschio, Emilio Russo
Journal: Front Neurol (2018)
Keywords: aeds, cyp, doacs, p-gp, antiepileptics, dabigatran, interactions, rivaroxaban
MeSH terms: Review

Direct oral anticoagulants (DOACs), namely apixaban, dabigatran, edoxaban, and rivaroxaban are being increasingly prescribed among the general population, as they are considered to be associated to lower bleeding risk than classical anticoagulants, and do not require coagulation monitoring. Likewise, DOACs are increasingly concomitantly prescribed in patients with epilepsy taking, therefore, antiepileptic drugs (AEDs), above all among the elderly. As a result, potential interactions may cause an increased risk of DOAC-related bleeding or a reduced antithrombotic efficacy. The objective of the present review is to describe the pharmacokinetic interactions between AEDs and DOACs of clinical relevance. We observed that there are only few clinical reports in which such interactions have been described in patients. More data are available on the pharmacokinetics of both drugs classes which allow speculating on their potential interactions. Older AEDs, acting on cytochrome P450 isoenzymes, and especially on CYP3A4, such as phenobarbital, phenytoin, and carbamazepine are more likely to significantly reduce the anticoagulant effect of DOACs (especially rivaroxaban, apixaban, and edoxaban). Newer AEDs not affecting significantly CYP or P-gp, such as lamotrigine, or pregabalin are not likely to affect DOACs efficacy. Zonisamide and lacosamide, which do not affect significantly CYP activity in vitro, might have a quite safe profile, even though their effects on P-gp are not well-known, yet. Levetiracetam exerts only a potential effect on P-gp activity, and thus it might be safe, as well. In conclusion, there are only few case reports and limited evidence on interactions between DOACs and AEDs in patients. However, the overall evidence suggests that the interaction between these drug classes might be of high clinical relevance and therefore further studies in larger patients' cohorts are warranted for the future in order to better clarify their pharmacokinetic and define the most appropriate clinical behavior.
Radical treatment of Sister Mary-Joseph nodule: case report and literature review
Authors: Amine Majdoubi, Tarek Bouhout, Marouan Harhar, Achraf Mirry, Serji Badr, Tijani El Harroudi
Journal: Pan Afr Med J (2021)
Keywords: sister mary-joseph nodule, umbilical skin metastasis, case report, radical surgery, stages of the tumor
MeSH terms: Adenocarcinoma, Sister Mary Joseph's Nodule, Skin Neoplasms, Case Reports, Review, Humans, Male, Middle Aged, Tomography, X-Ray Computed, Umbilicus

Sister Mary-Joseph nodule (NSMJ) is a cutaneous metastasis of the umbilicus, rare and accounts for 2-3% of the patients with advanced stages of colorectal adenocarcinoma. Here we report the observation of a 48-year-old Moroccan man, referred to our hospital to manage a painful ulcero-budding nodule of the umbilicus; computed tomography revealed that the processes infiltrated the urachus and the bladder. Laboratory parameters were normal and radical surgery was performed to remove the tumor and embryological remnant of the umbilicus. The histological assessment confirmed the sigmoidal origin of the umbilical nodule. This kind of disease always poses a problem of treatment. It was considered for a long time as an outdated stage of tumor disease that deserves just palliative treatment. Several cases published in the international literature with radical treatment had good survival and evolution, which gives hope to patients with this disease.
A Patient Presenting with Cardiac Tamponade and the Challenges of Finding Its Cause: A Cardiac Angiosarcoma
Authors: Roshanak Habibi, Negar Faramarzi, Alvaro J Altamirano, Shahriar Dadkhah
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Primary malignancies of the heart are so rare that most of the available data come from case reports or large single-center-based studies, with the overall incidence of 0.02% in the United States. Diagnosis in case of an isolated pericardial effusion as presentation is challenging, and determining that an angiosarcoma is even more challenging. Here, we presented a rare case of pericardial angiosarcoma which presented to us with tamponade. The patient eventually was diagnosed through pericardiectomy. A multimodality approach was attempted to treat the cancer. The clinical details of such a unique disease entity inspired us to present it as a case report.
Thyrotoxicosis-Induced Cardiomyopathy With Systolic Dysfunction
Authors: Yusuf Khalil, Michael D Dube, Larry Woods
Journal: Cureus (2023)
Keywords: congestive heart failure, dilated cardiomyopathy, hyperthyroidism, systolic dysfunction, thyrotoxicosis
MeSH terms: Case Reports

Thyrotoxicosis-induced dilated cardiomyopathy is a rare but potentially life-threatening complication of thyrotoxicosis, with an incidence of <1%. This condition is characterized by a dilatation of the ventricular chamber and a decrease in cardiac contractility. Untreated, it can lead to irreversible changes in cardiac structure and function, including dilated ventricular chamber, a decrease in ejection fraction (EF), and an increased risk of atrial fibrillation. We present a case of a 39-year-old patient with a diagnosis of thyrotoxicosis-induced acute heart failure. A two-dimensional (2D) echocardiogram disclosed an ejection fraction of 36%, with diffuse mild dilation of the atria and ventricles with trace mitral and tricuspid regurgitation. The anti-thyroid-stimulating hormone (TSH) receptor was positive, and Grave's disease was diagnosed. The patient eventually returned to baseline functional status and could return to basic activities of daily living without limitations. The patient was encouraged to follow up with outpatient cardiology. Early diagnosis of cardiac involvement in patients with thyrotoxicosis is critical. Promptly delivered intensive treatment with the rapid achievement of euthyroid state can potentially reverse cardiac dysfunction and improve patient outcomes.
Postpartum-Isolated Native Pulmonic Valve Methicillin-Resistant Staphylococcus aureus Infective Endocarditis Complicated by Pelvic Abscess, Clavicle Osteomyelitis, and Polyarticular Septic Arthritis
Authors: Daniela Navarrete, David Hannibal, Sachin M Patil, Tarang Pankaj Patel, William Roland
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Isolated native pulmonic valve infective endocarditis (IE) is a rare occurrence. The most commonly involved valves in injection drug users are the tricuspid valve followed by mitral and then aortic valves. Most reported cases of methicillin-resistant Staphylococcus aureus (MRSA) IE involve multiple valves. Isolated involvement of the pulmonic valve in IE is infrequent, especially in intravenous drug users or patients with indwelling catheters, prosthetic valves, or implantable cardiac devices. Here, we report a young postpartum female patient with isolated native pulmonic valve MRSA IE with MRSA bacteremia and history of active injection drug use. A PubMed literature review revealed a single described prior case report in a postpartum female. The patient's clinical course was complicated by a large native pulmonic valve vegetation, septic pulmonary emboli, pelvic abscess, polyarticular septic arthritis, and clavicular osteomyelitis. The patient underwent bioprosthetic pulmonic valve replacement and finished six weeks of intravenous vancomycin for complete recovery.
Volvulus caused by a free intraperitoneal staple after laparoscopic appendectomy: A case report
Authors: Rachel Kim, Ryan Moore, Lauren Schmidt, Katherine Martin, Lars Ola Sjoholm, Leonard Mason, Jessica Beard
Journal: Int J Surg Case Rep (2019)
Keywords: bowel resection, case report, closed loop obstruction, laparoscopic appendectomy, staple, volvulus

Introduction:
Laparoscopic appendectomies are routinely performed using linear staplers. Few case reports have discussed complications from free intraperitoneal staples after appendectomy. We present the first case of a volvulus caused by a free staple that subsequently required bowel resection.
Presentation of case:
A 27-year-old female underwent laparoscopic appendectomy for uncomplicated appendicitis. The base of the appendix was divided using a laparoscopic gastrointestinal anastomosis (GIA) stapler and the mesoappendix was divided using a LigaSure device. The patient was discharged the following day. Eight days later, the patient returned to the emergency department with severe abdominal pain, emesis, and peritoneal signs. Computed tomography (CT) showed significant pneumoperitoneum and nonspecific small bowel edema. Exploratory laparotomy was performed revealing a necrotic small bowel segment from a malformed, free staple caught on the peritoneum of the small bowel mesentery causing a closed loop obstruction. After reduction and detorsion, the small bowel segment was not viable and required resection. She was discharged on postoperative day four with no additional perioperative complications.
Discussion:
Mechanical staplers are commonly used in laparoscopic appendectomy and free intraperitoneal staples are generally considered inert. A high index of suspicion should be maintained for the early postoperative appendectomy patient with obstructive symptoms.
Conclusion:
Inspection of the staple line, choosing the appropriate staple size and cartridge, and removing free malformed staples if seen should be employed during appendectomy to prevent rare but devastating complications.
Acalculous cholecystitis associated with levodopa-carbidopa intestinal infusion therapy: A case report
Authors: Viviana Torres, Guillermo González-Ortega, Antoni Suárez, Alicia Garrido, Ana Cámara, Yaroslau Compta, Francesc Valldeoriola
Journal: Clin Park Relat Disord (2022)
MeSH terms: Case Reports

Continuous intra jejunal infusion of levodopa-carbidopa intestinal gel (LCIG) is one of the primary therapies for improving advanced Parkinson's disease symptoms. Placement of the jejunal catheter through the abdominal wall for drug administration requires a percutaneous interventional procedure called percutaneous endoscopic gastrostomy (PEG). PEG is considered a safe and straightforward procedure, and it is performed very commonly in clinical practice. In the context of LCIG treatment, severe adverse events have been identified, such as intestinal bleeding and acute abdomen [1], but acute acalculous cholecystitis (AAC) has never been reported.
Conservative management of a congenital seminal vesicle cyst associated with ipsilateral renal agenesis revealed by cystitis: one case report
Authors: Youness Ahallal, Mohammed Fadl Tazi, Abdelhak Khallouk, Jalaleddine Elammari, Mohammed Jamal Elfassi, Moulay Hassan Farih
Journal: Case Rep Urol (2011)
MeSH terms: Case Reports

Seminal vesicle cyst is an extremely rare disease. Its association with ipsilateral renal agenesis is even more exceptional. We present herein one case of a 16-year-old male who presented with a four-month history of lower urinary tract symptoms (LUTSs) and micturition pain. The digital rectal examination revealed a small mass arising from the prostate. The urine culture showed that E. coli is sensitive to all antibiotics tested. Transrectal ultrasound (TRUS) revealed a cystic mass in the outer prostate. Seminal vesicle cyst and left renal agenesis were confirmed by magnetic resonance imaging (MRI). Maximum flow (Q(max)) at uroflow was greater than 15 mL/sec. We therefore decided to manage this disease conservatively with alpha blockers and antibiotics. After 6-month' followup the patient did not report any complain and the uroflow test was similar to a normal urination. From one case report and literature review, the authors suggest a diagnostic and therapeutic strategy for the management of this rare condition.