OpenMed/multicare-articles huggingface dataset:
Crohn's disease and schistosomiasis: a rare association
Authors: Faten Limaiem, Asma Sassi, Sabeh Mzabi
Journal: Pan Afr Med J (2016)
Keywords: crohn´s disease, intestine, pathology, schistosomiasis
MeSH terms: Constriction, Pathologic / pathology, Crohn Disease / physiopathology, Schistosomiasis / diagnosis, Case Reports, Abdominal Pain / etiology, Colonoscopy, Crohn Disease / parasitology, Humans, Ileal Diseases / parasitology, Ileal Diseases / pathology, Ileal Diseases / surgery, Ileum / diagnostic imaging, Ileum / pathology, Ileum / surgery, Intestinal Fistula / etiology, Male, Schistosomiasis / pathology, Tomography, X-Ray Computed, Vomiting / etiology, Young Adult

Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. Coexistence of schistosomiasis with Crohn's disease is very rare. To the best of our knowledge, this association has been described in literature only once. A 20-year-old male patient with a past medical history of appendectomy and ileocecal Crohn's disease, presented with abdominal pain and vomiting. Ileocolonoscopy showed an ulcerated and congested appearance of the upper rectum and sigmoid. Computed tomography scan revealed a circumferential thickening of the terminal ileum with luminal stenosis. Histopathological examination of the biopsy specimens revealed a focally ulcerated colonic epithelium. The lamina propria was fibrous harbouring a polymorphic inflammatory infiltrate including lymphocytes and plasma cells organized in lymphoid follicles admixed with eosinophils and neutrophils. In the submucosa, there were two well-preserved schistosoma eggs surrounded by a thick shell with a barely visible terminal spine. The final pathological diagnosis was colonic schistosomiasis associated with Crohn's disease. The patient underwent an ileocecal resection for stenosis of the terminal ileum complicated with enterocutaneous fistula. The postoperative course was uneventful. A stool examination and serology tests were planned for this patient who was lost to follow-up.
Pemphigus vulgaris confined to the gingiva: a case report
Authors: Mitsuhiro Ohta, Seiko Osawa, Hiroyasu Endo, Kayo Kuyama, Hirotsugu Yamamoto, Takanori Ito
Journal: Int J Dent (2011)
MeSH terms: Case Reports

Pemphigus Vulgaris (PV) is an autoimmune intraepithelial blistering disease involving the skin and mucous membranes. Oral mucosa is frequently affected in patients with PV, and oral lesions may be the first sign of the disease in majority of patients. In some patients, oral lesions may also be followed by skin involvement. Therefore, timely recognition and therapy of oral lesions is critical as it may prevent skin involvement. Early oral lesions of PV are, however, often regarded as difficult to diagnose, since the initial oral lesions may be relatively nonspecific, manifesting as superficial erosions or ulcerations, and rarely presenting with the formation of intact bullae. Lesions may occur anywhere on the oral mucosa including gingiva; however; desquamtive gingivitis is less common with PV than other mucocutaneous conditions such as pemphigoid or lichen planus. This paper describes the case of a patient presenting with a one-year history of painful gingival, who is finally diagnosed as having PV.
Forefoot plantar multilobular noninfiltrating angiolipoma: a case report and review of the literature
Authors: Theodoros B Grivas, Olga D Savvidou, Spyridon A Psarakis, Georgia Liapi, George Triantafyllopoulos, Ioannis Kovanis, Panagiotis Alexandropoulos, Vasiliki Katsiva
Journal: World J Surg Oncol (2008)
MeSH terms: Angiolipoma / pathology, Forefoot, Human / pathology, Soft Tissue Neoplasms / pathology, Case Reports, Angiolipoma / surgery, Forefoot, Human / surgery, Humans, Male, Middle Aged, Soft Tissue Neoplasms / surgery

Background:
Soft tissue tumors of the feet are uncommon and there have been very few reports of large series in the literature. These tumors continue to present the clinician with one of the most difficult problems in medicine.
Case presentation:
We present a case of a large multilobular noninfiltrating angiolipoma at the plantar surface of the forefoot. Only three cases occurring at the foot have been previously described. We report this new case due to unusual location of the tumor, the long duration (25 years) of its existence and the unique surgical approach for the tumor excision.
Conclusion:
Surgical excision is the treatment of choice and adjuvant radiotherapy is indicated in select cases.
Sclerema Neonatorum in a Term Infant: A Case Report and Literature Review
Authors: Gloria Nakalema, Walufu Ivan Egesa, Patrick Kumbowi Kumbakulu, Martin Nduwimana, Amnia Diaz Anaya, Mirembe Stephen Kizito, Daniel Kavuma
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Sclerema neonatorum (SN) is a rare form of panniculitides with an obscure incidence, aetiology, and pathogenesis. This condition is peculiar to preterm neonates, especially those with comorbidities such as sepsis, congenital anomalies, congenital heart disease, and gastrointestinal and respiratory diseases. Usually, it presents within the first seven days of life, but may develop a few weeks later. Typically, SN manifests with diffuse hardening of the skin and subcutaneous tissues that subsequently bind to the underlying muscle and bone, often beginning in the buttocks, thighs, or trunk, and progressing to other body parts, but sparing the soles, palms, and genitalia. Diagnosis is based on clinical characteristics. It has been associated with a high mortality, despite aggressive use of various treatment modalities such as antibiotics, steroids, fresh blood transfusion, exchange blood transfusion, and intravenous immunoglobins. This is a report of a macrosomic term neonate who presented with typical clinical and histopathological features of SN.
Histoplasma tympanomastoiditis: Case report and literature review
Authors: Terrence Park, Gordon Love, Victoria Burke
Journal: IDCases (2023)
Keywords: fungal otomastoiditis, histoplasmosis
MeSH terms: Case Reports

Histoplasma is a dimorphic fungus capable of producing a diverse array of clinical pathology in humans dependent upon the host immune status. Acute symptomatic infection typically presents as an isolated pulmonary or nodal disease in immunocompetent patients with extra-thoracic manifestations rarely seen in this population. In this report, we describe a novel case of Histoplasma capsulatum tympanomastoiditis in an immunocompetent patient who presented with progressively worsening purulent otorrhea, vertigo, and facial nerve palsy. He was successfully managed with surgical debridement and a prolonged antifungal course.
Esmolol Use in Dual Axis Defibrillation Resistant Ventricular Fibrillation
Authors: Ankit Agrawal, Maria Cardinale, Douglas Frenia, Tarun Dalia, Chirag Shah
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Cardiac arrest in an event of acute myocardial infarction most commonly results in life-threatening ventricular tachycardia or ventricular fibrillation (VF). Patients who remain in VF despite optimal epinephrine, amiodarone, and three or more attempts at 200 joules of biphasic current defibrillation are known to be in an electrical storm. Here, we describe a case of defibrillation refractory VF responding to intravenous esmolol resulting in a successful return of spontaneous circulation. Learning objective. This case reinforces the growing body of evidence supporting esmolol as a novel treatment approach for refractory VF before the cessation of resuscitative efforts.
MDCT cystography using vaginal tampon for imaging lower urogenital tract fistulas: two case reports
Authors: Martin Ian Kamanda
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Multidetector CT (MDCT) cystography combines the established technique of excretory cystography with the high spatial resolution of MDCT. MDCT cystography with the use of vaginal tampon helps in increasing the sensitivity and specificity of detecting the presence or absence of urogenital fistulas. Vaginal tampons act as both negative and positive contrast agents. Until recently, urogenital fistulas were investigated by excretory urography/intravenous urography, retrograde ureterography, or retrograde voiding cystography/micturating urography. Scintigraphy with 99mTc diethylenetriaminepentaacetic acid has also been used to help elucidate these pathologic abnormalities. All these modalities are useful in the detection of obvious fistulous tracts but are deficient in providing anatomic detail and have a low specificity.
Surgical Management of Giant L2 Adrenal Neuroblastoma in Adult Male
Authors: Bikash Bikram Thapa, Sanjay Yadav, Sujit Pant, Pratik Rajkarnikar, Pankaj Mandal
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Neuroblastoma is an embryonal malignancy that arises from neural crest cells. Adult adrenal neuroblastoma is a rare disease, and less than 100 cases were reported in the literature. Adult neuroblastoma commonly presents with abdominal (retroperitoneal) lump and pain. A 35-year-old male patient presented with a giant (20 cm × 17 cm × 12 cm) nonfunctional left adrenal mass. He underwent en-bloc surgical excision of the left adrenal gland along with the left kidney. Histopathological examination revealed adrenal neuroblastoma (stage 2B, L2). We present here the surgical management of the rare adult adrenal neuroblastoma.
Executive and language control in the multilingual brain
Authors: Anthony Pak-Hin Kong, Jubin Abutalebi, Karen Sze-Yan Lam, Brendan Weekes
Journal: Behav Neurol (2014)
MeSH terms: Aphasia / psychology, Brain Injuries / psychology, Executive Function / physiology, Language, Multilingualism, Case Reports, Aged, Aphasia / etiology, Aphasia / pathology, Brain / pathology, Brain Injuries / complications, Brain Injuries / pathology, Female, Humans, Language Tests, Magnetic Resonance Imaging, Neuropsychological Tests

Neuroimaging studies suggest that the neural network involved in language control may not be specific to bi-/multilingualism but is part of a domain-general executive control system. We report a trilingual case of a Cantonese (L1), English (L2), and Mandarin (L3) speaker, Dr. T, who sustained a brain injury at the age of 77 causing lesions in the left frontal lobe and in the left temporo-parietal areas resulting in fluent aphasia. Dr. T's executive functions were impaired according to a modified version of the Stroop color-word test and the Wisconsin Card Sorting Test performance was characterized by frequent perseveration errors. Dr. T demonstrated pathological language switching and mixing across her three languages. Code switching in Cantonese was more prominent in discourse production than confrontation naming. Our case suggests that voluntary control of spoken word production in trilingual speakers shares neural substrata in the frontobasal ganglia system with domain-general executive control mechanisms. One prediction is that lesions to such a system would give rise to both pathological switching and impairments of executive functions in trilingual speakers.
Intravenous thrombolysis in acute ischemic stroke after antagonization of unfractionated heparin with protamine: case series and systematic review of literature
Authors: Katharina Kneer, Adedolapo Kamaldeen Adeyemi, Jennifer Sartor-Pfeiffer, Vera Wilke, Corinna Blum, Ulf Ziemann, Sven Poli, Annerose Mengel, Katharina Feil
Journal: Ther Adv Neurol Disord (2023)
Keywords: acute ischemic stroke, antagonization, heparin, intravenous thrombolysis, protamine, revascularization
MeSH terms: Case Reports

Background and aims:
Intravenous thrombolysis (IVT) is standard of care for disabling acute ischemic stroke (AIS) within a time window of ⩽ 4.5 h. Some AIS patients cannot be treated with IVT due to limiting contraindications, including heparin usage in an anticoagulating dose within the past 24 h or an elevated activated prothrombin time (aPTT) > 15 s. Protamine is a potent antidote to unfractionated heparin.
Objectives:
The objective of this study was to investigate the safety and efficacy of IVT in AIS patients after antagonization of unfractionated heparin with protamine.
Methods:
Patients from our stroke center (between January 2015 and September 2021) treated with IVT after heparin antagonization with protamine were analyzed. National Institutes of Health Stroke Scale (NIHSS) was used for stroke severity and modified Rankin Scale (mRS) for outcome assessment. Substantial neurological improvement was defined as the difference between admission and discharge NIHSS of ⩾8 or discharge NIHSS of ⩽1. Good outcome at follow-up after 3 months was defined as mRS 0-2. Safety data were obtained for mortality, symptomatic intracerebral hemorrhage (sICH), and for adverse events due to protamine. Second, a systematic review was performed searching PubMed and Scopus for studies and case reviews presenting AIS patients treated with IVT after heparin antagonization with protamine. The search was limited from January 1, 2011 to September 29, 2021. Furthermore, we conducted a propensity score matching comparing protamine-treated patients to a control IVT group without protamine (ratio 2:1, match tolerance 0.2).
Results:
A total of 16 patients, 5 treated in our hospital and 11 from literature, [65.2 ± 13.1 years, 37.5% female, median premorbid mRS (pmRS) 1 (IQR 1, 4)] treated with IVT after heparin antagonization using protamine were included and compared to 31 IVT patients [76.2 ± 10.9 years, 45% female, median pmRS 1 (IQR 0, 2)]. Substantial neurological improvement was evident in 68.8% of protamine-treated patients versus 38.7% of control patients (p = 0.028). Good clinical outcome at follow-up was observed in 56.3% versus 58.1% of patients (p = 0.576). No adverse events due to protamine were reported, one patient suffered sICH after secondary endovascular thrombectomy of large vessel occlusion. Mortality was 6.3% versus 22.6% (p = 0.236).
Conclusion:
IVT after heparin antagonization with protamine seems to be safe and, prospectively, may extend the number of AIS patients who can benefit from reperfusion treatment using IVT. Further prospective registry trials would be helpful to further investigate the clinical applicability of heparin antagonization.
Traumatic superior orbital fissure syndrome
Authors: Sait Coskun Özcan, Feyza Önder, Nedime Demir, Deniz Özarslan Özcan
Journal: GMS Ophthalmol Cases (2019)
Keywords: ophthalmoplegia, superior orbital fissure syndrome, trauma
MeSH terms: Case Reports

Objective: Traumatic superior orbital fissure syndrome is a rare complication that occurs in association with craniofacial trauma. In the present case, there were no associated orbital fractures or other lesions to explain. Methods: We present a-16-year-old patient with total ophthalmoplegia, ptosis, and anesthesia of the upper eyelid and forehead 6 hours after a reported trauma to the left eye. We measured the width of the superior orbital fissure on the horizontal plane including the optic canal using computed tomography scans. Results: Radiological examinations did not reveal any orbital fractures. However, the superior orbital fissure on the affected side was only 1.86 mm, increasing susceptibility to indirect trauma. Conclusions: A narrow superior orbital fissure may play a role for superior orbital fissure syndrome altering the transmitted force from the trauma and edema.
Severe Acute Hepatitis B in HBV-Vaccinated Partner of a Patient with Multiple Myeloma Treated with Cyclophosphamide, Bortezomib, and Dexamethasone and Autologous Stem Cell Transplant
Authors: Majed M Almaghrabi, Kyle J Fortinsky, David Wong
Journal: Case Reports Hepatol (2017)
MeSH terms: Case Reports

Hepatitis B reactivation can occur with various forms of immunosuppression. Cyclophosphamide, Bortezomib, and Dexamethasone (CYBOR-D) chemotherapy is commonly used for the treatment of multiple myeloma and has not been noted in guidelines to be causative in HBV reactivation. Indeed, current guidelines do not recommend providing antiviral prophylaxis to patients with prior HBV infection. We present a case of HBV reactivation as a result of CYBOR-D and autologous stem cell transplant which is complicated by the patient's partner who developed acute hepatitis B. Our case highlights the need to review the role of antiviral prophylaxis for patients undergoing treatment of multiple myeloma and also the role of ensuring immunity for close contacts of these patients who may also be at risk.
Case report: Early-onset parkinsonism among the neurological features in children with PHACTR1 variants
Authors: Roberto Previtali, Alessia Leidi, Martina Basso, Giana Izzo, Cecilia Stignani, Luigina Spaccini, Maria Iascone, Pierangelo Veggiotti, Stefania Maria Bova
Journal: Front Neurol (2023)
Keywords: phactr1, developmental delay, epilepsy, movement disorder, parkinsonism
MeSH terms: Case Reports

PACHTR1 is expressed in cardiovascular and neurological tissues. In the brain, it has a role in pre- and post-natal maturation. Previously reported PHACTR1-mutated patients showed early-onset epilepsy and intellectual disability. We describe two unreported cases with de novo pathogenic variants in PHACTR1 and their clinical pictures, compared with those of cases already reported in the literature. In line with previous reports, the two patients presented early-onset developmental and epileptic encephalopathy. In addition, one patient developed a speech disorder and a progressive movement disorder characterized by hypertonus, hypo-bradykinesia, hypomimia, ataxic gait, and retropulsion. She was treated with levodopa without any clinical improvement. Pathogenic variants in PHACTR1 may result in a cardiological or neurological phenotype. Severe developmental delay, intellectual disability, and early-onset developmental and epileptic encephalopathy are the main features of PHACTR1-mutated patients with neurological involvement. Movement and speech disorders have never previously been described and could be new features of the neurological phenotype.
Bilateral facial palsy in rapidly progressive course of Wegener's granulomatosis: a case report
Authors: Anna Roszkowska, Monika Morawska-Kochman, Hanna Temporale, Małgorzata Sikorska-Żuk, Tomasz Kręcicki
Journal: Case Rep Otolaryngol (2013)

Introduction. Wegener's granulomatosis belongs to a group of systemic vasculitis diseases, which is characterized by necrotizing vasculitis and presence of granulomas. In a lot of cases, the first symptoms of the disease are observed in the head and neck region, but the bilateral facial nerve palsy occurs very rarely. Objective. The objective of our report was to describe the unusual course of Wegener's granulomatosis with the bilateral facial nerve paralysis, which subsided after application of steroids and immunosuppressive therapy in combination with surgical treatment. Results and Conclusions. Hearing loss may precede other symptoms in Wegener's granulomatosis. Ear pain and otorrhea may suggest the diagnosis of bacterial purulent otitis media and delay the proper diagnosis. In the presented case, considering the clinical course, it was necessary to apply both pharmacological and surgical treatments.
Recurrent gastric volvulus associated with a gastrointestinal stromal tumor: A case report
Authors: Ryohei Murata, Yo Kamiizumi, Chihiro Ishizuka, Sayuri Kashiwakura, Takeshi Tsuji, Hironori Kasai, Yasuhiro Tani, Tsutomu Haneda, Tadashi Yoshida, Kenzo Okamoto, Koji Ito
Journal: Int J Surg Case Rep (2019)
Keywords: acute abdominal syndrome, epigastric pain, gastrectomy, gastric volvulus, gastrointestinal stromal tumor, submucosal tumor

Introduction:
Gastric volvulus (GV) is defined as a rotation of the stomach along its short or long axis leading to variable degrees of gastric outlet obstruction. Rotation of the stomach >180° may cause closed loop obstruction and possible strangulation, which often causes acute abdominal pain. Strangulation and gangrene of the twisted stomach sometimes occurs, which demands immediate surgical intervention. We report a case of acute gastric volvulus due to a gastrointestinal stromal tumor (GIST), with multiple recurrences, that eventually required emergency gastrectomy.
Presentation of the case:
A 71-year-old woman with a history of recurrent epigastric pain, nausea, and anorexia was diagnosed to have a 70-mm sized submucosal tumor (SMT) in the lesser curvature of the stomach. An elective gastrectomy was planned; however, before the procedure, she visited the emergency room with acute recurrent epigastric pain associated with postural variations. Computed tomography (CT) revealed a GV and the tumor had shifted to the greater curvature. An emergency gastrectomy was performed. The postoperative course was uneventful and pathological examination revealed features consistent with that of GIST.
Discussion:
GV with GIST has rarely been reported and risk factors such as size or localization are unknown. In this case, GV was probably caused by GIST of the stomach, which was large and heavy enough to rotate the gastric body around the mesenteroaxis.
Conclusion:
Surgical intervention without delay should be planned in similar scenarios accounting for the risk of GV in GIST.
Bilateral Subdural Hematoma following Ventriculoperitoneal Shunt Insertion in a Ten-month Old Tanzanian Female with Congenital Hydrocephalus: An Uncommon Presentation
Authors: Jay Lodhia, Sakina Mehboob Rashid, Abdallah Msemo, Rune Philemon, Adnan Sadiq, Kondo Chilonga, David Msuya
Journal: East Afr Health Res J (2021)
MeSH terms: Case Reports

There is an unmet need for the treatment of hydrocephalus in Tanzania. Thousands of newborns each year in the region are affected by this condition and access to care remains a challenge. While treatment options like cerebrospinal fluid diversion through ventriculo-peritoneal shunting are within the skill set of general surgeons, the potential complications represent an additional challenge. We present a 10-month-old Tanzanian female who developed bilateral-subdural hematomas after insertion of a ventriculoperitoneal shunt.