OpenMed/multicare-articles huggingface dataset:
Fluoroquinolone and macrolide treatment failure in pneumococcal pneumonia and selection of multidrug-resistant isolates
Authors: Emilio Pérez-Trallero, José M Marimon, Luis Iglesias, Julián Larruskain
Journal: Emerg Infect Dis (2003)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Anti-Infective Agents / therapeutic use, Drug Resistance, Multiple, Bacterial, Pneumococcal Infections / drug therapy, Streptococcus pneumoniae / drug effects, Case Reports, Aged, Fluoroquinolones, Humans, Macrolides, Male, Microbial Sensitivity Tests, Point Mutation, Streptococcus pneumoniae / genetics, Treatment Failure, Anti-Bacterial Agents, Anti-Infective Agents, Fluoroquinolones, Macrolides

Streptococcus pneumoniae serotype 3, isolated from a penicillin-allergic patient and initially susceptible to fluoroquinolones, macrolides, lincosamides, quinupristin-dalfopristin, and telithromycin, became resistant to all these drugs during treatment. Mutations in the parC and gyrA and in the 23S rRNA and the ribosomal protein L22 genes were detected in the resistant isolates.
T Cell Lymphoma and Leukemia in Severe Combined Immunodeficiency Pigs following Bone Marrow Transplantation: A Case Report
Authors: Ellis J Powell, Jared Graham, N M Ellinwood, Jesse Hostetter, Michael Yaeger, Chak-Sum Ho, Lynden Gault, Veronica Norlin, Elizabeth N Snella, Jackie Jens, Emily H Waide, Adeline N Boettcher, Maureen Kerrigan, Raymond R R Rowland, Jason W Ross, Jack C M Dekkers, Christopher K Tuggle
Journal: Front Immunol (2017)
Keywords: artemis, bone marrow transplantation, leukemia, lymphoma, pig, severe combined immunodeficiency

After the discovery of naturally occurring severe combined immunodeficiency (SCID) within a selection line of pigs at Iowa State University, we found two causative mutations in the Artemis gene: haplotype 12 (ART12) and haplotype 16 (ART16). Bone marrow transplants (BMTs) were performed to create genetically SCID and phenotypically immunocompetent breeding animals to establish a SCID colony for further characterization and research utilization. Of nine original BMT transfer recipients, only four achieved successful engraftment. At approximately 11 months of age, both animals homozygous for the ART16 mutation were diagnosed with T cell lymphoma. One of these ART16/ART16 recipients was a male who received a transplant from a female sibling; the tumors in this recipient consist primarily of Y chromosome-positive cells. The other ART16/ART16 animal also presented with leukemia in addition to T cell lymphoma, while one of the ART12/ART16 compound heterozygote recipients presented with a nephroblastoma at a similar age. Human Artemis SCID patients have reported cases of lymphoma associated with a "leaky" Artemis phenotype. The naturally occurring Artemis SCID pig offers a large animal model more similar to human SCID patients and may offer a naturally occurring cancer model and provides a valuable platform for therapy development.
Case report: Medical student types journals during ketamine infusions for suicidal ideation, treatment-resistant depression, post-traumatic stress disorder, and generalized anxiety disorder
Authors: Joshua Willms, Ben McCauley, Lindsay Kerr, Peyton Presto, Ankith Arun, Nazeen Shah, Kierra Irby, Megan Strawn, Jonathan Kopel
Journal: Front Psychiatry (2022)
Keywords: depression, ketamine, ketamine assisted psychotherapy, medical school, suicidality
MeSH terms: Case Reports

Suicide is the most common cause of death in male resident physicians and the second most common cause of death in resident physicians overall. Physicians also experience high rates of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and burnout. These conditions frequently develop during medical school, and threaten not only physicians but the patients they care for. A 30-year-old medical student presented to our clinic with a history of treatment-resistant depression (TRD), generalized anxiety disorder (GAD), PTSD, and 5 years of daily suicidal ideation. Previous treatments included therapy, lifestyle modifications, and various combinations of six antidepressants. These interventions had little effect on the patient's mental health. The patient was treated at our clinic with an 8-month regimen of IV ketamine infusions and ketamine-assisted psychotherapy (KAP). The patient achieved remission from suicidality and PTSD within 1 month; and TRD and GAD within 7 months. The patient's Patient Health Questionnaire (PHQ-9) score decreased from 25 (severe depression) to 1 (not depressed). These findings suggest that ketamine and KAP may represent effective interventions for mental health applications in healthcare professionals. The patient made the unique decision to attempt to type narrative journals during four of his ketamine infusions (doses ranged from 1.8 to 2.1 mg/kg/h IV). The patient successfully typed detailed journals throughout each 1-h ketamine infusion. To our knowledge, these journals represent the first independently typed, first-person, real-time narratives of ketamine-induced non ordinary states of consciousness. The transcripts of these journals may provide useful insights for clinicians, particularly in the context of KAP.
A Brisk and Life-Saving Diagnosis of Pericardial Effusion as the Cause for Recurrent Dyspnea
Authors: Jacob E Sundberg, Ankit Mehta
Journal: POCUS J (2022)
Keywords: diagnosis, dyspnea, pericardial effusion, ultrasound
MeSH terms: Case Reports

Point of care ultrasound (POCUS) is a reliable diagnostic tool for the evaluation of a patient with dyspnea. This case provides an example of an acutely dyspneic patient in which standard evaluation failed to elucidate the true etiology of the patient's dyspnea. The patient was initially diagnosed with pneumonia but returned to the emergency department with acute worsening of his symptoms despite empiric antibiotics leading to the presumption of antibiotic failure. POCUS revealed a large pericardial effusion requiring pericardiocentesis ultimately leading to the accurate diagnosis. This case highlights the importance of POCUS in evaluating patients with shortness of breath.
Mycobacterium fortuitum skin infection as a complication of anabolic steroids: a rare case report
Authors: R Pai, U Parampalli, G Hettiarachchi, I Ahmed
Journal: Ann R Coll Surg Engl (2013)
MeSH terms: Abscess / chemically induced, Anabolic Agents / adverse effects, Mycobacterium Infections, Nontuberculous / chemically induced, Mycobacterium fortuitum, Skin Diseases, Bacterial / chemically induced, Steroids / adverse effects, Case Reports, Abscess / microbiology, Adult, Humans, Male, Recurrence, Anabolic Agents, Steroids

Mycobacterium fortuitum is a rare cause of recurrent skin abscesses in an immunocompetent person. We report the case of a 37-year-old man presenting with multiple recurrent non-healing skin abscesses. Culture of the abscess wall yielded growth of M fortuitum. In our case, we highlight the association of anabolic steroids with non-tuberculous mycobacterial skin abscesses that fail to resolve despite repeated drainage.
A PD-1 Inhibitor Induces Complete Response of Advanced Bladder Urothelial Carcinoma: A Case Report
Authors: Jianzheng Wang, Qingli Li, Huifang Lv, Caiyun Nie, Beibei Chen, Weifeng Xu, Tiejun Yang, Yinping Zhang, Shuiping Tu, Xiaobing Chen
Journal: Front Oncol (2021)
Keywords: pd-1, advanced, case report, complete response, urothelial carcinoma
MeSH terms: Case Reports

The prognosis of patients with advanced urothelial carcinoma is dismal. Platinum-based chemotherapy is still the main first-line treatment for advanced urothelial carcinoma, while immunotherapy can be used as a first-line treatment option for people who cannot tolerate platinum. Immunotherapy is preferred in the second-line treatment of bladder urothelial carcinoma. PD-1 inhibitors (Pembrolizumab, nivolumab and atezolizumab) and PD-L1 inhibitors (Ddurvalumab and avelumab) have not been approved for the treatment of advanced urothelial cancer in China. We describe a patient with advanced urothelial carcinoma experienced disease progression after gemcitabine chemotherapy. Following a treatment of domestic PD-1 inhibitor (sintilimab), the patient achieved a durable complete response with mild toxicity. This case indicates that PD-1 inhibitor sintilimab might be a second-line treatment choice for advanced urothelial carcinoma.
Management of a Parturient with Mast Cell Activation Syndrome: An Anesthesiologist's Experience
Authors: Sangeeta Kumaraswami, Gabriel Farkas
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

Mast cell activation syndrome (MCAS) is a disorder in which patients experience symptoms and signs attributable to inappropriate mast cell activation and mediator release. Multiorgan involvement in patients can result in significant morbidity and possible mortality. Limited literature exists regarding anesthetic management of patients with MCAS. We report a case of vaginal delivery with neuraxial labor analgesia in a parturient with this condition and highlight the importance of multidisciplinary planning for uneventful outcomes. Stress can trigger life-threatening symptoms, and counseling is important to allay patients' fears. Optimum medical control, adequate premedication, avoidance of triggers, and preparedness to treat serious mediator effects are key. We review MCAS and discuss anesthetic considerations for patients with this mast cell disorder.
Myocardial Damage in a Highly Suspected Case With Paraneoplastic Pemphigus: A Case Report and Literature Review
Authors: Xiao Du, Miao Zhang, Shilan Zhang, Feng Tian, Tie Wen, Ling Liu
Journal: Front Med (Lausanne) (2022)
Keywords: autoantibodies, autoimmune disease, myocardial damage, paraneoplastic pemphigus, tumor
MeSH terms: Case Reports

Paraneoplastic pemphigus (PNP) is a rare mucocutaneous autoimmune disease. It has multiple clinical accompanied symptoms by affecting various types of epithelia, including the gastrointestinal and respiratory tract. However, an extensive review of the literature found no cases of PNP associated with myocardial damage. Here, we present a 56-year-old male patient with clinically and histopathologically typical paraneoplastic pemphigus (PNP), who had sustained myocardial injury due to non-cardiac disease involvement. Therefore, we suppose that, when persistent cardiac necrosis markers are elevated in patients with paraneoplastic pemphigus (PNP), the possibility of concomitant myocardial damage should get more attention from clinicians to obtain quick diagnosis and treatment.
A simple combined approach using anterior transpetrosal and retrosigmoid approach: A case report
Authors: Ryota Tamura, Ryo Ueda, Kosuke Karatsu, Taichi Sayanagi, Kento Takahara, Utaro Hino, Takashi Iwama, Hirotsugu Nogawa, Masato Nakaya, Takashi Horiguchi, Masahiro Toda
Journal: Front Surg (2023)
Keywords: anterior transpetrosal approach, combined transpetrosal approach, lateral suboccipital approach, posterior cranial fossa, retrosigmoid approach, skull base
MeSH terms: Case Reports

Background:
A combined transpetrosal approach (CTP) is often used for large lesions in the posterior cranial fossa (PCF). Although CTP provides a wide surgical corridor, it has complex and time-consuming bony work of mastoidectomy and cosmetic issues. Here, we describe a simple combined surgical technique to approach the supratentorial region, anterolateral surface of the brainstem, petroclival region, and foramen magnum by drilling only the petrous apex with a combination of retrosigmoid approach (RA).
Clinical presentation:
A 27-year-old female was referred with extra-axial left cerebellopontine angle space-occupying epidermoid cyst extending to the prepontine cistern, anterior to the basilar artery, superior to the chiasma, and caudally to the foramen magnum. A one-stage surgical procedure using the anterior transpetrosal approach (ATP) and RA was performed after one-piece temporal-suboccipital craniotomy. These two approaches complemented each other well. Near-total removal was achieved.
Conclusion:
A one-stage surgical procedure using ATP and RA provides the wider viewing and better visualization of the PCF with minimal technical difficulty.
Papillion-Lefèvre Syndrome: Periodontists' Perspective
Authors: Sunil Kumar Biraggari, K Krishna Mohana Reddy, J Sudhakar, Shiva Shankar Bugude, Rajesh Nichenametla, Mazher Ahmed Hakeem, Swati Reddy Tiyyagura
Journal: Case Rep Dent (2015)

Papillion-Lefèvre Syndrome is a very rare disorder of autosomal recessive inheritance distinguished by palmar plantar hyperkeratosis and early onset of periodontitis affecting the dentition. Genetic studies have identified a mutation in the major gene locus of chromosome 11q14 with loss of function. Cathepsin C gene is to be responsible for Papillion-Lefèvre Syndrome. The present case report describes a 13-year-old female, who visited the Department of Periodontology with the chief compliant of bleeding gums and loose teeth. She presented with the signs and symptoms of Papillion-Lefèvre Syndrome. The patient had premature shedding of her deciduous dentition. On clinical examination, extraorally, the patient presented with persistent thickening, flaking, and scaling of the skin of palms and soles. Her intraoral examination revealed gingival inflammation, abscess formation, and periodontal pockets. Her intraoral radiographs showed bone loss involving the central incisors and molars. The patient underwent periodontal therapy and is under maintenance.
An Intriguing Case of Multisystem Inflammatory Syndrome in an Adult Patient with Remote Infection with COVID-19 and Acute Chlamydia
Authors: Madhuri Chandnani, William A Charini, Anil Jha, Chetan Dodhia, Eduardo Haddad
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Introduction:
COVID-19 is associated with a broad range of immune inflammatory phenomena, with different manifestations in adults and children. We describe a case of COVID-19-related multisystem inflammatory syndrome in an adult (MIS-A), similar to that described in children (MIS-C), which may have been set off by an unrelated secondary infection.
Case:
A 27-year-old male patient presented with acute epididymitis secondary to acute Chlamydia infection that progressed to multisystem inflammatory failure with respiratory failure requiring endotracheal intubation and mechanical ventilation, cardiogenic shock with heart failure, and gastrointestinal and renal dysfunction. He tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase-polymerase chain reaction on a nasopharyngeal swab thrice within 4 days of presentation, but positive for SARS-CoV-2 immunoglobulin G antibody signifying remote infection. The patient was treated with tocilizumab and steroids, along with doxycycline for concurrent Chlamydia infection, resulting in dramatic improvement in all organ function. We suspect that C. trachomatis infection in this instance may have triggered an aberrant immune response that was shaped by prior exposure to SARS-CoV-2.
Conclusion:
We present a case of an adult patient with acute Chlamydia trachomatis infection occurring in the wake of asymptomatic (or at least unrecognized) COVID-19 resulting in MIS-A. Clinicians should be alert to the possibility of other such unusual reactions occurring in the aftermath of COVID-19. This case also highlights the importance for clinicians who care for adult patients of being familiar with the multisystem inflammatory syndrome of children, as an identical syndrome may occur in adult patients.
Primary intraosseous meningioma with subcutaneous and dural invasion: A case report and literature review
Authors: Mingang Zou, Ruijin Yang, Zhiji Tang, Defang Luo, Qiuhua Jiang
Journal: Front Surg (2022)
Keywords: case report, intraosseous meningiomas, osteogenesis, skull, surgical techniques
MeSH terms: Case Reports

Primary intraosseous meningiomas (PIOMs) are a rare subset of meningiomas, comprising fewer than 1% of all such tumors. Furthermore, PIOMs presenting as osteogenic lesions that invade both the dura and subcutaneous tissue are extremely rare. Unlike intracranial meningiomas, diagnosing and treating PIOMs are challenges due to their insidious clinical behavior and a lack of clear radiological diagnostic criteria. We report the case of a 60-year-old female with headache and a slightly outward protrusion of the parietal region of the skull. CT showed an osteogenic lesion in the right parietal bone. MR imaging indicated mild to moderate homogeneous enhancement with an intense dural reaction. The suggested clinical diagnosis was lymphoma, so we performed a skull biopsy, which revealed an intraosseous benign meningioma. A precise resection strategy was planned with a neuronavigation system accompanied by a one-step customized titanium mesh cranioplasty. The lesion was completely removed, and pathological analysis confirmed a meningothelial meningioma (WHO Grade I) of intraosseous layer origin invading the dura mater and subcutaneous tissue. This case highlights the need for an initial biopsy when the lesion is difficult to diagnose on imaging. Complete resection should be attempted to minimize the risk of recurrence.
Case report: A case of incontinentia pigmenti
Authors: Lingfeng Xie, Yong Zhu, Liya He, Bing Yu, Jiajue Wang, Ruiqiang Fan, Xiumei Mo, Yu Zhang, Ting Xie
Journal: Front Med (Lausanne) (2023)
Keywords: ikbkg/nemo mutations, ectodermal dysplasia, female infant, histopathological examination, incontinentia pigmenti
MeSH terms: Case Reports

Incontinentia pigmenti (IP) is a rare neuroectodermal dysplasia caused by mutations in the IKBKG gene. We present a case of a 4-month-old female infant with erythematous vesicular skin lesions on the trunk and extremities. Histopathologic examination of the blisters revealed an eosinophilic infiltrate. Further investigation revealed that her mother had three unexplained miscarriages and two normal uncomplicated pregnancies, resulting in the birth of two male infants. We performed a comprehensive genetic evaluation to rule out the interference of pseudogene IKBKGP, and the infant was finally diagnosed with IP. During the subsequent 2-year follow-up, we observed a significant improvement in her dermatologic symptoms, with no evidence of recurrence, and there were no other associated symptoms in the hair, nails, oral mucosa, eyes, or central nervous system.
Targeted Transforaminal Epidural Blood Patch for Postdural Puncture Headache in Patients with Postlaminectomy Syndrome
Authors: Yu Na Choi, Sang Ji Kang, Jin Deok Joo, Yu Mi Kim, Jang Hyeok In, Yoo Jung Park
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Postdural puncture headache is a leak of cerebrospinal fluid that lowers intracranial pressure and usually presents as a positional headache. If conservative treatments are not successful, the epidural blood patch is the gold standard of the treatment for dural puncture. The interlaminar approach is the most commonly used technique for an epidural blood patch. This case report describes a patient who was treated with a transforaminal epidural blood patch for postdural puncture headache following an acupuncture procedure on his lower back after two epidural blood patches using an interlaminar approach had failed. The patient underwent an acupuncture therapy for management of chronic low back pain due to postlaminectomy syndrome. After the procedure, the patient had a severe headache and the conservative treatment was not effective. The two interlaminar epidural blood patches at the L2-3 level and at the L3-4 level were failed. We performed transforaminal epidural blood patch at the L3-4 and L4-5 levels on the left side, the site of leakage in the MRI myelogram. His symptoms finally subsided without complication. This case demonstrates that targeted transforaminal epidural blood patch is a therapeutic option for the treatment of postdural puncture headache when epidural blood patch using an interlaminar approach is ineffective.
Liver involvement by multiple myeloma presenting as hypervascular focal lesions in a patient with chronic hepatitis B infection
Authors: Magda Marcon, Lorenzo Cereser, Rossano Girometti, Palmina Cataldi, Stefano Volpetti, Massimo Bazzocchi
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Extramedullary myeloma refers to the infiltration of neoplastic monoclonal plasma cells in either organs or soft tissues. The disease is clinically and radiologically underestimated compared with the autopsy findings and is usually associated with a more aggressive clinical course and poorer outcome. A minority of patients with extramedullary myeloma show hepatic involvement, usually in the form of diffuse parenchymal infiltration. When focal infiltration is present, variable imaging findings have been described both on CT scan and MRI. We report the case of a 63-year-old male with hepatitis B virus-related liver disease and biopsy-proven multiple myeloma involving the liver, manifesting as hypervascular focal liver lesions on MRI. A brief review of the literature is also proposed.
Preservative Monitoring of a Greek Woman with Hydrops Fetalis due to Parvovirus B19 Infection
Authors: Zacharias Fasoulakis, Panagiotis Antsaklis, Emmanuel N Kontomanolis
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Primate erythroparvovirus 1 (parvovirus B19) is a member of the Erythrovirus genus of the Parvoviridae family and it is one of the few members of the family known to be pathogenic in human. B19 infection is common and widespread with the virus being associated with numerous rheumatologic and haematologic manifestations. More specifically, maternal infection with parvovirus B19 during pregnancy can cause severe anemia which may lead to nonimmune hydrops or fetal demise, as a result of fetal erythroid progenitor cells infection with shortened half-life of erythrocytes. We present a rare case reported in the Greek population, of subclinical transient reticulocytopenia due to B19 parvovirus infection, in an asymptomatic pregnant woman, without medical history of hemoglobinopathy, and with the presence of hydrops fetalis during the third trimester of her pregnancy.
The Black Esophagus in the Renal Transplant Patient
Authors: Michael Andrew Yu, Ramzi Mulki, Julia Massaad
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Acute esophageal necrosis (AEN) is an uncommon disease characterized by gastrointestinal bleeding and endoscopic findings of circumferential black-colored necrosis of the distal esophagus. Patients at risk include elderly males over the age of 65, who typically have multiple chronic medical issues including vascular disease and diabetes. Mortality is reported to be 32%. Here, we present a case of AEN in a renal transplant patient and describe potential inciting factors such as immunosuppression and opportunistic diseases.
Acute Ischemic Pediatric Stroke Management: An Extended Window for Mechanical Thrombectomy?
Authors: Ashish Kulhari, Elizabeth Dorn, Jonathan Pace, Vilakshan Alambyan, Stephanie Chen, Osmond C Wu, Macym Rizvi, Anthony Hammond, Ciro Ramos-Estebanez
Journal: Front Neurol (2017)
Keywords: cerebral infarction, child, management, mechanical thrombectomy, restrictive cardiomyopathy, stroke, tissue plasminogen activator
MeSH terms: Case Reports

Ischemic stroke is a rare condition to afflict the pediatric population. Congenital cardiomyopathy represents one of several possible etiologies in children. We report a 9-year-old boy who developed right middle cerebral artery stroke secondary to primary restrictive cardiomyopathy. In the absence of pediatric guidelines, the child met adult criteria for mechanical thrombectomy given the small core infarct and large penumbra. The literature suggests children may benefit from mechanical thrombectomy in carefully selected cases. Our patient exemplifies specific circumstances in which acute stroke therapy with thrombolysis and thrombectomy may be safe.