OpenMed/multicare-articles huggingface dataset:
Basal ganglia infarction and COVID-19 infection in an elderly patient: A case report
Authors: Manar Ahmed Kamal
Journal: Transl Neurosci (2021)
Keywords: covid-19, basal ganglia infarction, case report, hematological characters, neurological manifestation
MeSH terms: Case Reports

Background:
Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since the first cases were observed in Wuhan, China. Patients with COVID-19 develop multiple neurological symptoms, including headache, disturbed consciousness, and paresthesia, in addition to systemic and respiratory symptoms.
Case presentation:
We presented a 57-year-old woman admitted to the emergency department - in December 2020 - with complaints of slurred speech, confusion, and left upper limb weakness after one week of positive nasopharyngeal swab sample SARS-CoV-2.
Conclusions:
While the patient had previous comorbidities like hypertension and diabetes, she had no prior history of ischemic stroke or thrombosis, so we conclude that unilateral acute basal ganglia infarction may be a unique neurological manifestation after COVID-19 infection in an elderly patient with previous comorbidities.
Pressure pain sensitivity map of multifocal nummular headache: a case report
Authors: Cristina Rodríguez, Sonia Herrero-Velázquez, Marina Ruiz, Johanna Barón, Alicia Carreres, Edert Rodríguez-Valencia, Angel Luis Guerrero, Pascal Madeleine, María Luz Cuadrado, César Fernández-de-Las-Peñas
Journal: J Headache Pain (2015)
MeSH terms: Headache / diagnosis, Hyperalgesia / diagnosis, Case Reports, Adolescent, Amines / therapeutic use, Analgesics / therapeutic use, Cyclohexanecarboxylic Acids / therapeutic use, Female, Gabapentin, Headache / drug therapy, Headache / physiopathology, Humans, Hyperalgesia / drug therapy, Hyperalgesia / physiopathology, Neurologic Examination, Pain Threshold / physiology, Pressure, Treatment Outcome, gamma-Aminobutyric Acid / therapeutic use, Amines, Analgesics, Cyclohexanecarboxylic Acids, gamma-Aminobutyric Acid, Gabapentin

Background:
Nummular headache (NH) is most commonly a localized unifocal headache; however, some patients infrequently exhibit multifocal symptomatic painful head areas retaining all features of NH. We present the pressure pain sensitivity map of an adolescent with multifocal NH.
Case presentation:
We describe a case of a 14 year-old-girl with a 3-year history of continuous pain in four rounded areas, all of them with the same size and shape. Pressure pain thresholds (PPT) were assessed on 21 points over the scalp and over the symptomatic areas. A pressure pain sensitivity map of the head was constructed. The neurological exam was unremarkable, with neither sensory symptoms nor trophic changes within the painful areas. As previously shown, symptomatic points exhibited lower PPTs compared to the surrounding areas. The map reflected 4 restricted areas of mechanical hyperalgesia confined just to the painful areas. Treatment with gabapentin achieved complete remission.
Conclusion:
This is the first pain sensitivity map of a patient with multifocal NH. Our results support peripheral mechanisms are maintained in multifocal NH.
Metastatic Cecal Adenocarcinoma to the Gallbladder Presenting with Acute Cholecystitis
Authors: Nedal Bukhari, Marwah Abdulkader
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Colorectal cancer (CRC) is one of the most common cancers and the second highest cause of cancer-related deaths (Jemal et al., 2011). Common presentations of CRC include alterations in bowel habit, weight loss, and lower gastrointestinal bleeding. We report a case of a 74-year-old male who presented with fever and right upper quadrant pain, with positive Murphy's sign on examination. The case was initially managed with a routine cholecystectomy. Histological examination revealed a moderately differentiated adenocarcinoma with a superimposed histologically proven acute acalculous cholecystitis. CT scan done postsurgery showed a cecal mass with retroperitoneal lymphadenopathy. Biopsy result of cecal mass was remarkable for colon adenocarcinoma. We are not aware of any similar prior cases reported in English literature.
Neurosyphilis with Concomitant Cryptococcal and Tuberculous Meningitis in a Patient with AIDS: Report of a Unique Case
Authors: Jose Armando Gonzales Zamora, Luis Alberto Espinoza, Rita N Nwanyanwu
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Meningitis in individuals living with acquired immunodeficiency syndrome (AIDS) is most frequently infectious in origin and usually due to opportunistic infections. The most common pathogens are Cryptococcus neoformans and Mycobacterium tuberculosis. Treponema pallidum causes neurosyphilis and can complicate HIV infections at any time after the initial infection. Simultaneous infections of the central nervous system caused by these pathogens are very uncommon even in the setting of severe immunosuppression. We report the case of a newly diagnosed HIV/AIDS young man who was found to have neurosyphilis with Cryptococcus meningitis. After a few weeks of treatment and initiation of antiretroviral therapy, he was also diagnosed with tuberculous meningitis, which was probably unmasked by the development of immune reconstitution inflammatory syndrome (IRIS). To the best of our knowledge, this is the only case of reported neurosyphilis and meningitis caused concomitantly by Cryptococcus and Mycobacterium tuberculosis.
The role of laparoscopic nephrectomy in pediatric xanthogranulomatous pyelonephritis: a case report
Authors: James F Brown, Jennifer C Chamberlain, Christopher C Roth
Journal: Case Rep Urol (2013)

Xanthogranulomatous pyelonephritis (XGP) is a rare chronic renal infection characterized by the destruction of renal parenchyma. Traditional treatment involves open radical nephrectomy, which is challenging due to the inflammatory process associated with XGP. More recently, laparoscopic nephrectomy has been employed successfully in adult XGP. We present a case of a six-year-old female child with XGP who was successfully treated by laparoscopic nephrectomy with minor complications. Our case demonstrates the safety and feasibility of laparoscopic nephrectomy for childhood XGP, indicating that it should be considered a management option in such cases.
Massive Chondrolysis and Joint Destruction after Artificial Anterior Cruciate Ligament Repair
Authors: Jack Carlson, Olivia Fox, Peter Kilby
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The Ligament Augmentation Reconstruction System (LARS) is an artificial ligament made of polyethylene terephthalate (PET) used for anterior cruciate ligament (ACL) reconstruction in Australia. Poor results with previous generations of synthetic grafts causing synovitis, graft failure, and premature osteoarthritis have encouraged the production of the newer LARS ligament with good results. We present a case of massive chondrolysis and joint destruction after LARS implantation requiring total knee replacement in a 23-year-old male. This case documents a rare and severe complication to the LARS ligament as caution for the implementation of this device in young athlete.
Resolution of Giant Coronary Aneurisms in a Child With Refractory Kawasaki Disease Treated With Anakinra
Authors: Alessandro Gambacorta, Danilo Buonsenso, Gabriella De Rosa, Ilaria Lazzareschi, Antonio Gatto, Federica Brancato, Davide Pata, Piero Valentini
Journal: Front Pediatr (2020)
Keywords: coronary aneurysms, il-1 receptor antagonist, anakinra, kawasaki disease, paediatrics 2, personalized medicine, precision medicine
MeSH terms: Case Reports

Kawasaki disease (KD) is an acute, febrile illness of unknown etiology that mainly affects children under 5 years of age. intravenous immunoglobulin (IVIG), the standard treatment, has reduced coronary involvement to <5%. Patients who do not improve after an initial IVIG have a higher risk of developing coronary arteries aneurysms, and its optimal treatment remains controversial. We present a case of IVIG, steroids, and infliximab-resistant KD in a 9-month-old child, which developed giant aneurysms and was successfully treated with anakinra, a recombinant antagonist of the IL-1 receptor. In our case, the introduction of IL-1 receptor antagonist therapy seems to have blocked the disease from both a clinical and a laboratory point of view. We also noted a very rapid regression of coronary aneurysms passed from giant aneurysms to small ones, or, as in the case of the anterior descending artery, the complete disappearance of the aneurysm formation. We think that our case adds more evidences to the potential role of IL-1RA as therapy in some selected cases of refractory KD, in particular with severe involvement of coronary arteries, although new efficacy trials are needed to better understand the role of Anakinra in these patients.
Sunitinib-Induced Acute Interstitial Nephritis in a Thrombocytopenic Renal Cell Cancer Patient
Authors: Ibrahim Azar, Saghi Esfandiarifard, Pedram Sinai, Ali Wazir, Llewellyn Foulke, Syed Mehdi
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Sunitinib, a multitargeted tyrosine kinase inhibitor (TKI), is currently the standard of care for patients with metastatic renal cell carcinoma. Renal adverse events associated with sunitinib include proteinuria, renal insufficiency secondary to focal segmental glomerulosclerosis (FSGS), and thrombotic microangiopathy. We describe the second reported instance of biopsy-proven sunitinib-induced acute interstitial nephritis (AIN), in a challenging case complicated by thrombocytopenia. The case illustrates the importance of early diagnosis and intervention in ensuring long-term recovery from renal complications. Four other cases of AIN reported along with inhibition of the vascular endothelial growth factor (VEGF) by either TKI (sunitinib and sorafenib) or antibodies (bevacizumab) suggest a possible class effect. Given our experience, we recommend monitoring renal function with VEGF inhibition, and in the case of renal failure in the setting of an unclear diagnosis, we recommend prompt biopsy.
Case of a CD3 Negative Hepatosplenic T-Cell Lymphoma: Diagnostic and Therapeutic Challenges
Authors: Laura Alder, Scott Graupner, Guanhua Lai, Victor Yazbeck
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Hepatosplenic T-cell lymphomas (TCLs) are a rare, aggressive subset of TCLs, accounting for less than 5% of all peripheral T-cell and natural killer (NK) cell lymphomas. We report the case of a CD3 negative hepatosplenic T-cell lymphoma in a 42-year-old female, who presented with left-sided abdominal pain. She underwent a liver biopsy that showed marked abnormal sinusoidal lymphoid infiltration. PET scan revealed increased splenic and pharyngeal lymph node uptake. Immunophenotype was remarkable for negative CD3, gamma delta T-cell receptor, and alpha beta-T-cell receptor expression. She received 6 cycles of DA-EPOCH, had primary refractory disease and then underwent palliative splenectomy secondary to painful necrosis. Then, she was started on pralatrexate as a single agent and then in combination with romidepsin as a potential bridge to an allogeneic stem cell transplantation from her sibling.
Tuboovarian abscess as primary presentation for imperforate hymen
Authors: Jeh Wen Ho, D Angstetra, R Loong, T Fleming
Journal: Case Rep Obstet Gynecol (2014)

Objective. Imperforate hymen represents the extreme in the spectrum of hymenal embryological variations. The archetypal presentation in the adolescent patient is that of cyclical abdominopelvic pain in the presence of amenorrhoea. We reported a rare event of imperforate hymen presenting as a cause of tuboovarian abscess (TOA). Case Study. A 14-year-old girl presented to the emergency department complaining of severe left iliac fossa pain. It was her first episode of heavy bleeding per vagina, and she had a history of cyclical pelvic pain. She was clinically unwell, and an external genital examination demonstrated a partially perforated hymen. A transabdominal ultrasound showed grossly dilated serpiginous fallopian tubes. The upper part of the vagina was filled with homogeneous echogenic substance. Magnetic resonance imaging (MRI) demonstrated complex right adnexa mass with bilateral pyo-haemato-salpinges, haematometra, and haematocolpos. In theatre, the imperforate hymen was opened via cruciate incision and blood was drained from the vagina. At laparoscopy, dense purulent material was evacuated prior to an incision and drainage of the persistent right TOA. Conclusion. Ideally identification of imperforate hymen should occur during neonatal examination to prevent symptomatic presentation. Our case highlights the risks of late recognition resulting in the development of sepsis and TOA.
Immunomodulatory Therapies for COVID-19 in Solid Organ Transplant Recipients
Authors: Mario Fernández-Ruiz, José María Aguado
Journal: Curr Transplant Rep (2020)
Keywords: covid-19, canakinumab, colchicine, immunomodulatory therapy, solid organ transplantation, tocilizumab
MeSH terms: Review

Purpose of review:
Severe coronavirus disease 2019 (COVID-19) is characterized by the development of a deleterious hyperinflammatory response, in which the pleiotropic cytokine interleukin (IL)-6 plays a pivotal role. The administration of immunomodulatory therapies has been proposed to revert the tissue damage induced by COVID-19-related cytokine release syndrome (CRS). The present review summarizes the biological rationale and available clinical experience with this therapeutic strategy in the specific scenario solid organ transplantation (SOT).
Recent findings:
A number of case reports, case series, and non-controlled cohort studies have assessed the efficacy and safety of the anti-IL-6-receptor monoclonal tocilizumab in SOT (namely kidney transplantation) recipients with COVID-19 pneumonia and CRS. Although the heterogeneity in patient management and the lack of a control group limit the interpretation of these results, tocilizumab therapy appears to provide some clinical benefit in post-transplant COVID-19 and to be reasonably safe in terms of bacterial superinfection. A large randomized clinical trial (RCT) has shown survival benefit with adjuvant corticosteroids in non-transplant patients, but supporting evidence is scarce for SOT recipients and confounded by the variable adjustment of baseline immunosuppression. Anecdotal experiences have been reported with the use of the anti-IL-1 agent anakinra and the NLRP3 inflammasome inhibitor colchicine in this population.
Summary:
Immunomodulation has emerged as a promising option for SOT recipients with COVID-19-related CRS, with available experience mainly restricted to the anti-IL-6 agent tocilizumab. However, the supporting evidence is scarce and of low quality. In the absence of RCT, observational studies including well-matched control groups should be designed in future.
Ocrelizumab-Induced Severe Colitis
Authors: Hsing Hwa Lee, Naveen Sritharan, Daniel Bermingham, Gabriela Strey
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

We report a case of severe ocrelizumab (anti-CD20 monoclonal antibody) induced colitis in a 43-year-old woman with multiple sclerosis leading to total colectomy after failing medical therapy. Histology of the colectomy was consistent with medication-induced colitis.
Case report: Anti-GAD65 antibody-associated autoimmune encephalitis following HPV vaccination
Authors: Aonan Li, Ying Hu, Jialu Li, Xingui Chen, Yubao Jiang, Chengjuan Xie
Journal: Front Neurol (2022)
Keywords: anti-glutamic acid decarboxylase 65 (anti-gad65) antibody, autoimmune encephalitis (ae), cervical cancer, human papillomavirus, seizure, vaccination
MeSH terms: Case Reports

Human papillomavirus (HPV) infection is a sexually transmitted disease that may lead to cervical cancer. HPV vaccines have been implemented widely to prevent this. While generally few complications of vaccination are reported, there have been occasional reports of adverse reactions post-vaccination. The safety profile of the HPV vaccine is reassuring. However, since its introduction, several serious post-vaccination central nervous system complications have been reported; however, causality has not been established. Herein, we describe a 39-year-old woman who developed seizures and experienced a rapid decline in memory shortly after her first dose of the HPV vaccine. Cranial magnetic resonance imaging and cerebrospinal fluid analysis were performed, and the patient was diagnosed with anti-glutamic acid decarboxylase 65 (anti-GAD65) antibody-associated autoimmune encephalitis. She responded well to high-dose glucocorticoids. Four-month follow-up revealed full recovery and absence of recurrence. Since the HPV vaccine is administered worldwide, this case should raise clinicians' awareness regarding the possible CNS complications related to vaccinations, such as anti-GAD65 antibody-associated AE.
Secondary Squamous Cell Carcinoma of the Tongue Complicated with Bronchiolitis Obliterans as a Manifestation of Graft-versus-Host Disease following Peripheral Blood Stem Cell Transplantation
Authors: Kengo Hashimoto, Toru Nagao, Shin Koie, Satoru Miyabe, Terumi Saito
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Peripheral blood stem cell transplantation (PBSCT) has increasingly been used for hematologic cancer therapy, resulting in improved survival rates. However, risks include graft-versus-host disease (GVHD) and secondary solid tumors. Here, we describe a case of tongue squamous cell carcinoma (SCC) complicated by bronchiolitis obliterans (BO) following PBSCT. A 42-year-old man with a history of acute lymphocytic leukemia treated with PBSCT presented with multiple white lesions and erosions on the tongue and buccal mucosa that are compatible with oral chronic GVHD (NIH criteria: score 2). The lesions were presented for 8 years. The patient had a history of BO manifested as GVHD. During follow-up, an exophytic mass was rapidly developed on the left dorsum of the tongue. Biopsy of this lesion confirmed SCC (cT2N0M0). Pulmonary function testing for general anesthesia was almost normal. Hemiglossectomy, supraomohyoid neck dissection, and tongue reconstruction were performed. Thirteen months after surgery, the patient showed neither recurrence of tumor nor progression of oral GVHD. However, the patient died of respiratory failure due to repeated pneumothoraxes and deterioration of BO.
A Rare Case of Disseminated Mycobacterium avium-intracellulare Presenting as Proctitis
Authors: Chukwunonso Chime, Peter Bhandari, Masooma Niazi, Harish Patel
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Mycobacterium avium intracellulare (MAI) infections are common in Human Immuno-deficiency Virus (HIV) positive patients. MAI infection can have localized or disseminated presentation, patients with low CD4 count presenting with disseminated infection. Fever, abdominal pain, diarrhea, and weight loss are generally the presenting symptoms of disseminated MAI. We present a rare case of a patient with HIV and low CD4 count presenting with proctitis as manifestation of disseminated MAI infection. A 25 year-old-man with HIV came to the emergency room (ER) with complaints of intermittent rectal bleeding for two months. His CD4 count was less than 20 cells/µL. He was MSM (men having sex with men) and has receptive anal intercourse with men. His stool work-up was unrevealing for infectious etiology. Swabs for gonorrhea and chlamydia were negative. Colonoscopy revealed erythematous, congested, friable rectal mucosa with two superficial ulcers. Biopsies of the ulcer were positive for acid fast staining bacteria and the culture grew MAI. His blood culture was negative for growth of acid-fast bacteria (AFB). However, liver biopsy performed for elevated alkaline phosphatase of 958 units/L revealed noncaseating granuloma. Gastro-duodenoscopy with duodenal biopsy did not reveal any mucosal abnormality. He was managed as with disseminated MAI infection using clarithromycin, ethambutol, and rifabutin in addition to HAART therapy. Interval Colonoscopy in 20 months showed resolution of rectal ulcer. The gut is often involved in patients with disseminated MAI infection, with the duodenum being the most common site. MAI infection should be suspected as possible etiology for proctitis in HIV positive patient with low CD4 count, as proctitis, though infrequent can be the sole presentation for disseminated MAI infection in patients with HIV and low CD4 count.
Lacrimal Sac Malignant Melanoma in 15 Japanese Patients: Case Report and Literature Review
Authors: Toshihiko Matsuo, Takehiro Tanaka, Osamu Yamasaki
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: braf inhibitor, braf mutation, mek inhibitor, pet/ct, dabrafenib, lacrimal sac, malignant melanoma, trametinib
MeSH terms: Eye Neoplasms / diagnosis, Melanoma / diagnosis, Nasolacrimal Duct / pathology, Protein Kinase Inhibitors / therapeutic use, Proto-Oncogene Proteins B-raf / genetics, Case Reports, Review, Aged, Antineoplastic Combined Chemotherapy Protocols, Eye Neoplasms / drug therapy, Eye Neoplasms / genetics, Humans, Imidazoles, Male, Melanoma / drug therapy, Melanoma / genetics, Mutation, Oximes, Positron-Emission Tomography, Proto-Oncogene Proteins B-raf / antagonists & inhibitors, Pyridones, Pyrimidinones, Imidazoles, Oximes, Protein Kinase Inhibitors, Pyridones, Pyrimidinones, trametinib, BRAF protein, human, Proto-Oncogene Proteins B-raf, dabrafenib

Background. Primary malignant melanoma of the lacrimal sac is rare. A patient with lacrimal sac melanoma was presented, and 14 Japanese patients with lacrimal sac melanoma in the literature were reviewed. Case Presentation. A 78-year-old Japanese man was presented with painless swelling of the lacrimal sac on the left side. Dacryocystectomy revealed diffuse infiltration with large epithelioid cells, sometimes with pigments, which were positive for cocktail mix of antibodies to tyrosinase, melan A (MART-1), and HMB45, leading to pathological diagnosis of melanoma. One month later, positron emission tomography (PET) revealed 2 high-uptake sites (SUVmax = 10.29 and 15.38) at the levels of medial canthus and nasolacrimal duct, but no abnormal uptake in the other site of the body. The lesion had the BRAF V600E mutation. He began to take daily oral dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor), leading to no abnormal uptake on PET in half a year. He had stable disease in good physical status with small and weak uptake sites of lymph nodes on PET 1 year later. Results. In the review of 15 Japanese patients, including this patient, local recurrence was noted in 4 patients, regional lymph node metastasis only in 3, distant metastasis in 6, and no metastasis in 6. Five patients died within 2 years and the others were alive in short follow-up periods. Conclusions. Chemotherapy was the standard for local recurrence or metastasis. Emerging molecular target drugs, as shown in the present patient, would change the strategy for management of lacrimal sac melanoma.
Clinical and Histopathological Findings in a Patient of Darier-White Disease with Acrokertasosis Verruciformis of Hopf
Authors: Vikash Paudel, Manish Bhakta Pradhan, Brijesh Shrestha, Sumit Paudel
Journal: Case Rep Dermatol Med (2022)
MeSH terms: Case Reports

Darier disease (DD) is a rare genodermatoses characterized by greasy hyperkeratotic papules in seborrheic regions and nail and oral changes. Histologically, it presents as suprabasal clefts with acantholytic and dyskeratotic cells. Acrokertasosis verruciformis of Hopf (AKVH) is considered an allelic variant with clinical overlap where Church spires are seen histologically without dyskeratoses. Patients are susceptible to various viral and bacterial skin infections requiring prevention and treatment of infection. Nonspecific treatment includes patient counseling on exacerbating factors. Although there are no curative treatments for DD, topical corticosteroids and systemic retinoids may be used to control inflammation and hyperkeratosis. We are reporting a rare case with clinical and histological findings of DD with AKVH in a 17-year-old boy with keratotic papules, presented on the hands and feet, nose, and ears without mucosal involvement.