OpenMed/multicare-articles huggingface dataset:
Next Generation Sequencing for Diagnosis of Leptospirosis Combined With Multiple Organ Failure: A Case Report and Literature Review
Authors: Juan Lu, Juan Hu, Shanshan Yu, Lanjuan Li
Journal: Front Med (Lausanne) (2022)
Keywords: clinical treatment, diagnosis, leptospirosis, multiple organ failure, next generation sequencing
MeSH terms: Case Reports

Introduction:
Leptospirosis poses a major threat to human life. The disease spectrum ranges from a nearly undetectable presentation to severe multi-organ dysfunction and death. Leptospirosis is difficult to diagnose by traditional antibody and culture tests. We here present a case of multiple organ failure associated with leptospirosis.
Material and methods:
A 64-year-old woman presented with fatigue and arthralgia, which developed rapidly into multiple organ injuries, and she eventually died of cerebral hemorrhage. Serum antibody test and cultures of blood, sputum, urine, and feces samples were all negative. The patient was diagnosed with leptospirosis by the next-generation sequencing (NGS).
Conclusion:
We conclude that leptospirosis is a neglected zoonosis caused by pathogenic Leptospira species. New techniques such as NGS are highlighted for early diagnosis. Surveillance for pathogens during diagnosis can provide guidance for clinical treatment and improves prognosis.
A boy with developmental delay and mosaic supernumerary inv dup(5)(p15.33p15.1) leading to distal 5p tetrasomy - case report and review of the literature
Authors: Pavel Tesner, Jana Drabova, Miroslav Stolfa, Martin Kudr, Martin Kyncl, Veronika Moslerova, Drahuse Novotna, Radka Kremlikova Pourova, Eduard Kocarek, Tereza Rasplickova, Zdenek Sedlacek, Marketa Vlckova
Journal: Mol Cytogenet (2018)
Keywords: 5p tetrasomy, intellectual disability, marker chromosome, mosaicism
MeSH terms: Case Reports

Background:
With only 11 patients reported, 5p tetrasomy belongs to rare postnatal findings. Most cases are due to small supernumerary marker chromosomes (sSMCs) or isochromosomes. The patients share common but unspecific symptoms such as developmental delay, seizures, ventriculomegaly, hypotonia, and fifth finger clinodactyly. Simple interstitial duplications leading to trisomies of parts of 5p are much more frequent and better described. Duplications encompassing 5p13.2 cause a defined syndrome with macrocephaly, distinct facial phenotype, heart defects, talipes equinovarus, feeding difficulties, respiratory distress and anomalies of the central nervous system, developmental delay and hypotonia.
Case presentation:
We present a boy with dysmorphic features, developmental delay, intellectual disability and congenital anomalies, and a mosaic sSMC inv dup(5)(p15.33p15.1). He is the fourth and the oldest reported patient with distal 5p tetrasomy. His level of mosaicism was significantly different in lymphocytes (13.2%) and buccal cells (64.7%). The amplification in our patient is smaller than that in the three previously published patients but the only phenotype difference is the absence of seizures in our patient.
Conclusions:
Our observations indicate that for the assessment of prognosis, especially with respect to intellectual functioning, the level of mosaicism could be more important than the extent of amplification and the number of extra copies. Evaluation of the phenotypical effect of rare chromosomal aberrations is challenging and each additional case is valuable for refinement of the genotype-phenotype correlation. Moreover, our patient demonstrates that if the phenotype is severe and if the level of sSMC mosaicism is low in lymphocytes, other tissues should be tested.
Extraskeletal chondroma of the preauricular region: a case report and literature review
Authors: Futoshi Watanabe, Tadahiko Saiki, Yoshihisa Ochochi
Journal: Case Rep Med (2012)

An extraskeletal chondroma is a rare benign cartilaginous tumor that develops in soft tissue. Histologically, it is a lobulated nodule surrounded by a fibrous capsule; the inside consists of mature hyaline cartilage containing a few normal chondrocytes. We present a rare case of extraskeletal chondroma in the preauricular region. A 43-year-old man presented with a 2-cm-diameter right preauricular tumor that had been developing for 1 year. Magnetic resonance imaging showed a solid lobulated tumor in the right preauricular region, which was proximate to the capsule of the right temporomandibular joint (TMJ). This was subsequently resected under general anesthesia. The tumor was not in contact with the TMJ capsule and had not invaded the surrounding tissue, facilitating en bloc excision. Histopathologically, the tumor comprised mainly of hyaline cartilage containing chondrocytes with chondrocytic lacunae and was diagnosed as a chondroma. The postoperative period was uneventful, and there was no evidence of recurrence at the 2-year followup. We describe the clinical characteristics of our case and review the literature, emphasizing the differential diagnosis.
A Case of Spondylodiscitis Fistulating Into the Vagina 15 Years after Promontofixation
Authors: Thomas Saliba, Iulia Mocanu, Sanjiva Pather
Journal: J Belg Soc Radiol (2022)
Keywords: s constellatus, hysterectomy, infection, promontofixation, spondylodiscitis
MeSH terms: Case Reports

Promontofixations can be a rare cause of spondylodiscitis due to the material used getting infected. We present here a case of a 75-year-old woman who underwent a subtotal hysterectomy, followed by a trachelectomy, and presented 15 years later with lumbago and fever. After thorough examination, haemocultures and imaging were performed. This led to the diagnosis of spondylodiscitis of L5-S1, likely due to S. constellatus, with a fistula into the vagina. The patient received surgical treatment. This case is unusual due to the time lapse between the hysterectomy and the infection as well as the probable pathogen. Teaching Point: Promontofixation material can remain despite hysterectomy and can be a source of infection many years after the operation has taken place.
Robot-Assisted Infratrigonal Vesicovaginal Fistula Repair
Authors: João Pádua Manzano, Fábio da Silva Crochik, Felipe Guimarães Pugliesi, Renato Vasconcelos Souza de Almeida, Petronio Augusto de Souza Melo, Ricardo Luís Vita Nunes
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Background:
Although relatively rare, vesicovaginal fistula is the most common genitourinary fistula, causing a significant decrease in patients' quality of life. Location of fistula is major supratrigonal, with some cases located in the trigone and rarely below it. Disease treatment is surgical, and repair can be performed by several techniques, including robot-assisted.
Case presentation:
We present a case of a patient who developed an infratrigonal vesicovaginal fistula after treatment of a cervical cancer. The patient was submitted to robotic repair of the vesicovaginal fistula.
Conclusion:
The use of robot-assisted laparoscopy is expanding over all areas of urology and its applicability to repair vesicovaginal fistulas brings good results.
Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
Authors: Yan Wan, Guoqing Jiang, Ying Jin, Zengping Hao
Journal: Open Med (Wars) (2021)
Keywords: giant hydatidiform mole, hyperthyroidism, perimenopausal, preeclampsia
MeSH terms: Case Reports

Gestational trophoblastic disease (GTD) commonly occurs in reproductive females, but is extremely rare in perimenopausal females. In this study, we reported a case of hydatidiform mole in a 48-year-old perimenopausal female admitted due to a giant uterine mass of 28 weeks' gestational size. The serum human chorionic gonadotropin (HCG) level ranged from 944 to 1,286 mIU/mL before treatments. The signs of preeclampsia and hyperthyroidism were relatively prominent. Hysterectomy was performed and chemotherapy was scheduled when the serum HCG level remained at a plateau, about 528 mIU/mL. The symptoms of preeclampsia and hyperthyroidism were relieved after treatment. Accordingly, we concluded that GTD could occur in perimenopausal woman and hysterectomy usually is the optimal treatment.
Faster Recovery of Internal Ophthalmoplegia than External Ophthalmoplegia in a Miller Fisher Variant of Guillain-Barre Syndrome
Authors: Golla Abhinav, Jorge Gamez Jr, Michael C Yang, Tetyana Vaysman, Michelle von Gunten, Antonio Liu
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

We present a case of classic Miller Fisher Syndrome (MFS) variant of Guillain-Barre Syndrome (GBS) with detailed description in the difference between the internal and external ophthalmoplegia. They are different in their onset, duration, and recovery.
Insights into secular trends of respiratory tuberculosis: The 20th century Maltese experience
Authors: Lianne Tripp, Larry A Sawchuk
Journal: PLoS One (2017)
MeSH terms: Tuberculosis, Pulmonary / epidemiology, Historical Article, Female, History, 20th Century, Humans, Male, Malta / epidemiology, Sex Factors, Tuberculosis, Pulmonary / history, Tuberculosis, Pulmonary / mortality

Over half a century ago, McKeown and colleagues proposed that economics was a major contributor to the decline of infectious diseases, including respiratory tuberculosis, during the 19th and 20th centuries. Since then, there is no consensus among researchers as to the factors responsible for the mortality decline. Using the case study of the islands of Malta and Gozo, we examine the relationship of economics, in particular, the cost of living (Fisher index) and its relationship to the secular trends of tuberculosis mortality. Notwithstanding the criticism that has been directed at McKeown, we present results that improvement in economics is the most parsimonious explanation for the decline of tuberculosis mortality. We reaffirmed that the reproductively aged individuals were most at risk of dying of tuberculosis, seeing that 70 to 90% of all deaths due to tuberculosis occurred between the ages of 15 and 45. There was a clear sex differential in deaths in that, prior to 1930, rates in females were generally higher than males. During times of extreme hardship, the sex differential was exacerbated. Over the course of World War I, the sex gap in tuberculosis rates increased until peaking in 1918 when there was also the influenza pandemic. The heightened differential was most likely a result of gendered roles as opposed to biological differences since female tuberculosis rates again surpassed male rates in 1945 during World War II. Respiratory tuberculosis in both urban and rural settlements (in Malta proper) was significantly influenced by the Fisher index, which explains approximately 61% of the variation in TB death rates (R = 0.78; p<0.0001). In Gozo, there was no significant impact on respiratory tuberculosis (R = 0.23; p = 0.25), most likely a consequence of the island's isolation, a self-sufficient economy and limited exposure to tuberculosis.
Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique: A Case Report and Literature Review
Authors: Michal Waszczykowski, Kryspin Niedzielski, Maciej Radek, Jaroslaw Fabis
Journal: Medicine (Baltimore) (2016)
MeSH terms: Arthrodesis / methods, Arthroscopy / methods, Ilizarov Technique, Knee Joint / surgery, Case Reports, Review, Adolescent, Humans, Knee Injuries / diagnostic imaging, Knee Injuries / surgery, Knee Joint / diagnostic imaging, Male, Radiography

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.
Case Report: Co-occurrence of Myocarditis and Thrombotic Microangiopathy Limited to the Heart in a COVID-19 Patient
Authors: Thomas Menter, Nadine Cueni, Eva Caroline Gebhard, Alexandar Tzankov
Journal: Front Cardiovasc Med (2021)
Keywords: covid-19, heart, myocarditis acute and fulminant, thromboinflammation, thrombus
MeSH terms: Case Reports

We report on an impressive case of a previously healthy 47-year-old female Caucasian SARS-CoV-2 positive patient who died within 48 h after initial cardiac symptoms. Autopsy revealed necrotizing myocarditis and extensive microthrombosis as the cause of death. The interesting feature of this case is the combination of both myocarditis and extensive localized microthrombosis of cardiac capillaries. Microthrombosis was not present in other organs, and the patient did not show typical features of diffuse alveolar damage in the lungs. Taken together, our morphologic findings illustrate the angiocentric, microangiopathic, thromboinflammatory disease with significant thrombotic diathesis prevalent in COVID-19, which has been previously described in the literature, likely warranting thromboprophylaxis even in oligosymptomatic circumstances. This case also delineates several potential etiologies for microthrombosis, i.e., inflammatory reactions and primary hypercoagulative states. Further systematic analyses on risk stratification for receipt of prophylactic anticoagulation in COVID-19 are urgently required.
Osteomyelitis in Cat-Scratch Disease: A Never-Ending Dilemma-A Case Report and Literature Review
Authors: D Donà, L Nai Fovino, E Mozzo, G Cabrelle, G Bordin, R Lundin, C Giaquinto, T Zangardi, O Rampon
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Background:
We performed a review of published case studies of osteomyelitis associated with cat-scratch disease to consolidate existing information on clinical presentation, diagnostic tools, therapy, and outcome, as well as presenting a case of disseminated cat-scratch disease in a 12-year-old female with skull osteomyelitis and spleen involvement.
Methods:
A search for articles indexed in PubMed, Embase, and Google Scholar was performed with the search terms "Bartonella," "bone," "osteomyelitis," "osteolytic," and "cat-scratch disease" limited to the immunocompetent pediatric population and articles in English.
Results:
51 cases were identified. The average age was 7.8 years with equal sex distribution. Fever (84.3%), often with a prolonged course (64.7%), and osteoarticular pain (88.2%) were the most common clinical findings. Lymphadenopathy was present in 64.7% of patients. Vertebral body was mainly involved (51.9%). MRI (50%) and bone scintigraphy (48.1%) were favored to confirm osteomyelitis, while serology was the preferred microbiological diagnostic. Various antibiotics were prescribed in combined or sequential regimens, with median duration of therapy of 23 days. About 12.5% of patients did not receive any treatment. Most patients had excellent prognosis; in particular, all patients not receiving any therapy showed complete recovery and no recurrence of symptoms.
Conclusions:

Bartonella henselae should be considered in differential diagnosis of localized lymphadentitis. Osteoarticular pain or limitation during cat-scratch disease in children should always be investigated for bone spreading. Owing to good prognosis, invasive procedures to obtain the bone material should be avoided. Serology is the gold standard diagnostic tool and MRI is the best radiographic technique to define bone and surrounding tissue involvement. Treatment represents a never-ending dilemma: surgical intervention or use of antibiotics is still controversial, and more studies are needed to define the best antimicrobial regimen.
Management of macular edema with branch retinal vein occlusion in a case of secondary polycythemia
Authors: Sumeer Singh, Srividya Neriyanuri, Rajiv Raman
Journal: GMS Ophthalmol Cases (2019)
Keywords: branch retinal vein occlusion, intravitreal injections, macular edema, polycythemia
MeSH terms: Case Reports

Purpose: We report a case of polycythemia with an ocular complication of branch retinal vein occlusion associated with macular edema that was managed by anti-vascular endothelial growth factor (VEGF) and systemic management. Methods: A 43-year-old, one-eyed male, a known case of polycythemia presented with complaints of decreased vision in the right eye. He underwent comprehensive eye evaluation, fundus photography and optical coherence tomography at the baseline visit and post intravitreal ranibizumab 1-, 3-, 4- and 11-month follow-up. Results: A patient with polycythaemia was diagnosed in the right eye with superotemporal branch retinal vein occlusion and macular edema, which clinically and on optical coherence tomography resolved after 1 intravitreal injection of ranibizumab. However, as he discontinued systemic management, macular edema reappeared and the edema resolved well after intravitreal ranibizumab. He then became more compliant to the systemic therapy and was asymptomatic for the last 7 months. Conclusion: In a case of retinal vein occlusion with macular edema of recognizable cause, the management of systemic disease and anti-VEGF can give satisfactory results.
Culture and group-functional punishment behaviour
Authors: Antonio M Espín, Pablo Brañas-Garza, Juan F Gamella, Benedikt Herrmann, Jesús Martín
Journal: Evol Hum Sci (2022)
Keywords: cooperation, gypsy/roma, culture, evolution, punishment

Humans often 'altruistically' punish non-cooperators in one-shot interactions among genetically unrelated individuals. This poses an evolutionary puzzle because altruistic punishment enforces cooperation norms that benefit the whole group but is costly for the punisher. One key explanation is that punishment follows a social-benefits logic: it is eminently normative and group-functional (drawing on cultural group selection theories). In contrast, mismatch-based deterrence theory argues that punishment serves the individual-level function of deterring mistreatment of oneself and one's allies, hinging upon the evolved human coalitional psychology. We conducted multilateral-cooperation experiments with a sample of Spanish Romani people (Gitanos or Calé) and the non-Gitano majority. The Gitanos represent a unique case study because they rely heavily on close kin-based networks and display a strong ethnic identity. We find that Gitano non-cooperators were not punished by co-ethnics in only-Gitano (ethnically) homogeneous groups but were harshly punished by other Gitanos and by non-Gitanos in ethnically mixed groups. Our findings suggest the existence of culture-specific motives for punishment: Gitanos, especially males, appear to use punishment to protect their ethnic identity, whereas non-Gitanos use punishment to protect a norm of universal cooperation. Only theories that consider normative, group-functional forces underlying punishment behaviour can explain our data.
Native Valve Infective Endocarditis Caused by Histoplasma capsulatum in an Immunocompetent Host: The First Case in Asia and Literature Review in Asia and Australia
Authors: Kamalas Amnuay, Chayatat Sirinawin, Nonthikorn Theerasuwipakorn, Pairoj Chattranukulchai, Chusana Suankratay
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Background:
Infective endocarditis caused by the dimorphic fungus Histoplasma capsulatum is extremely rare, occurring predominantly in individuals with prosthetic heart valves and HIV infection. To our knowledge, no case of H. capsulatum native valve endocarditis has been reported in Asia. Methodology. A descriptive study was carried out at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, in 2020.
Results:
A previously healthy 34-year-old man developed fever, umbilicated skin lesions, oral ulcers, hoarseness of voice, severe weight loss, and progressive dyspnea over the course of one week. Facial umbilicated papules, nodular ulcers in his tongue and palate, a diastolic rumbling murmur at the mitral valve, diffuse fine crackles in both lungs, and engorged neck veins were detected during the examination. Skin scraping of the facial lesion revealed both extracellular and intracellular yeasts with buddings, 2-4 μm in size on Wright's stain. Transthoracic echocardiography demonstrated a left ventricular ejection fraction of 54 percent, severe rheumatic mitral stenosis, and multiple oscillating masses in the anterior mitral valve leaflet ranging in dimension from 1.5 to 2.4 cm. The HIV antibody test was negative. H. capsulatum endocarditis was diagnosed, and liposomal amphotericin B was administered. Due to cardiogenic shock, emergency open-heart surgery was conducted one day after admission. However, he died of multiorgan failure four days after the operation. The skin and vegetation cultures finally grew H. capsulatum after 1 week of incubation.
Conclusions:
To date, there has been handful of cases of H. capsulatum native valve endocarditis in non-HIV-infected patients. We report herein the first case in Thailand. Umbilicated skin lesions, especially combined with oral mucosal lesions, are a clinical clue that leads to the correct diagnosis of the causative organism.
Atypical presentation of currarino syndrome: A case report
Authors: Paul Hage, Cedric Kseib, Carmen Adem, Camil J Chouairy, Reva Matta
Journal: Int J Surg Case Rep (2019)
Keywords: case report, currarino syndrome, dysraphism, malignancy, neurosurgery, pediatric surgery

Introduction:
Currarino syndrome is a rare congenital disorder characterized by a triad of anorectal malformation, a sacral bone defect, and a presacral mass. It results of an abnormal separation of the ectoderm from the endoderm caused by HLXB9 mutation in chromosome 7q36 in 50% of cases. The disorder is mostly hereditary as it can also be sporadic with a variable expression spectrum.
Presentation of case:
The case of a previously healthy 3-month-old girl with abdominal distension, post-prandial vomiting, obstipation, and anuria of 5 days' history is presented in this article. Abdomino-pelvic magnetic resonance imaging (MRI) showed a large cystic multilobulated mass in the sacrococcygeal region with a dural communication evident of an anterior sacral meningocele. 1 year later, the child came back with constipation and was found to a have a malignant mixed germ cell tumor in the presacral area, a very rare presentation in Currarino syndrome.
Discussion:
In a child presenting with at least one of the features of Currarino syndrome's triad, a diagnosis should be suspected. After reviewing the literature, the syndrome is usually missed and hence is under diagnosed. MRI is the best imaging modality for diagnostics and follow-up for any mass, benign or malignant, can bring life saving measures. Most masses are benign but can undergo malignant transformation even after resection. De novo malignancy is very rare and is described in our case.
Conclusion:
Physicians treating patients with spinal dysraphism should suspect a diagnosis of Currarino syndrome by follow up imaging for any new benign or malignant growth.