OpenMed/multicare-articles huggingface dataset:
Pericardial Tuberculosis in a Non-endemic Region Presenting as a Persistent Upper Respiratory Tract Infection With Negative Serology, Bronchial Washings, and Pleural Aspirate
Authors: Philip Nolan, Sanya Samad, Thomas Kiernan
Journal: Cureus (2024)
Keywords: cardiology, case report, echocardiography, extrapulmonary tuberculosis (eptb), pericardial diseases, pericardiectomy, tuberculosis
MeSH terms: Case Reports

This paper reports on the unlikely case of a 68-year-old man presenting with a non-resolving, mild lower respiratory tract infection, subsequently diagnosed with pericardial tuberculosis (TB) in the absence of TB risk factors and with negative TB serology. Pericardial and pleural effusions were found incidentally on CT pulmonary angiogram, with a small pericardial effusion without tamponade seen on the echocardiogram. During his three-month inpatient stay, the patient was rarely very unwell, though no treatment led to clinical and biochemical resolution of symptoms. Later deterioration prompted another echocardiogram, which found a moderate-sized pericardial effusion, septal bounce, and new regional wall motion abnormalities. To avert the impending cardiac tamponade, the patient underwent pericardiectomy, which provided a tissue diagnosis of TB. Pericardial TB is extremely uncommon, especially outside of TB endemic regions, though it is well described. This case is especially noteworthy, as serology, bronchial washings, and pleural aspirate had been negative for TB though a Quantiferon test was positive. The diagnosis was only confirmed after pericardiectomy. The patient was subsequently treated with anti-TB therapy, with a good clinical response. This case highlights diagnostic challenges and strategies for investigating and managing similar complex scenarios, particularly in non-endemic settings.
Case report: A case of oviductal and uterine leiomyosarcoma in an 11-year-old dog
Authors: Jillian Kazmierczak, Nicole J Sugai, Katie E Withowski, Abe Jonatan, Tanya LeRoith, Julie T Cecere
Journal: Front Vet Sci (2023)
Keywords: dog, neoplasia, oviduct, oviductal leiomyosarcoma, oviductal mass, uterine leiomyosarcoma, uterine mass, uterus
MeSH terms: Case Reports

An 11-year-old, intact female Pomeranian dog was presented for evaluation due to an 18-h history of anorexia and lethargy. Abdominal ultrasound revealed a 3×3 cm mass of mixed echogenicity at the level of the left ovary. At laparotomy, a 5 mm mass was identified at the cranial region of the right uterine horn and a 3 cm round mass was visualized near the cranial aspect of the left uterine horn. Ovariohysterectomy was performed. A diagnosis of grade 1 oviductal and uterine leiomyosarcoma was made via histopathology for both masses. Oviductal leiomyosarcomas are rare and generally locally invasive similar to other soft tissue sarcomas but do not often metastasize. Uterine leiomyosarcomas are also uncommon but are one of the more common tumors affecting the female reproductive tract. This is the only known case report of oviductal leiomyosarcoma in the dog and the only report of uterine leiomyosarcoma in addition to oviductal leiomyosarcoma as well. This case illustrates the oviduct as an additional site that can be affected by leiomyosarcoma and demonstrates surgery as a treatment option for patients diagnosed with this condition.
Case report: CMV retinitis following local and systemic immunosuppression
Authors: Bryant A Menke, William Wagner, Helen Song, William Thomas, Natalia E Castillo Almeida, Christopher D Conrady, Steven Yeh
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: case report, cytomegalovirus, immunosuppression, intravitreal dexamethasone, retinitis
MeSH terms: Case Reports

We report the case of a 71-year-old man who presented 2 years following renal transplantation with diffuse, unilateral cytomegalovirus retinitis five weeks after receiving an intravitreal dexamethasone implant device for the management of central retinal vein occlusion. Examination of the left eye showed diffuse retinal hemorrhages, attenuated and tortuous retinal vessels, and superior retinal whitening. The patient was successfully treated with serial intravitreal foscarnet injections and oral valganciclovir with disease regression observed by 12 weeks after presentation. The patient's visual acuity and examination remained stable at 9-months follow-up.
Case report: Psychotherapy for enhancing psychological adjustment to dysphoric milk ejection reflex
Authors: Reem Deif
Journal: Front Psychiatry (2024)
Keywords: body shaming, breastfeeding, dysphoric milk ejection reflex, postpartum mental health, psychotherapy
MeSH terms: Case Reports

Given its endless benefits, breastfeeding is widely acknowledged as the optimal choice for both maternal and infant health. Nevertheless, breastfeeding mothers often encounter various challenges that may hinder their ability to fully embrace this experience. This report delves into a compelling case of Dysphoric Milk Ejection Reflex (D-MER), a largely underexamined mental health issue among lactating mothers. D-MER is characterized by intense aversion right before milk let down, which can significantly impede a mother's willingness to breastfeed. The primary aim of this case report is to provide a comprehensive psychological understanding of D-MER, emphasizing aspects of attachment, the transition into motherhood, and the sociocultural sexualization of the female body. We also offer an overview of the psychotherapeutic journey, highlighting key insights and progress achieved over a span of six months. Therapy adopted an integrative approach combining narrative techniques and skills training such as mindfulness to facilitate a comprehensive therapeutic experience. This case underscores the psychological dimensions of the breastfeeding experience, complementing the well-established biochemical and physiological aspects of D-MER. It also emphasizes the need for further research into the psychological facets of both successful and less successful breastfeeding experiences.
Genioplasty and Hyoid Advancement by Distraction Osteogenesis for the Correction of Obstructive Sleep Apnea in a Pediatric Patient
Authors: Makoto Omori, Hiroatsu Iwatani, Hiroki Fukuoka
Journal: Cureus (2024)
Keywords: distraction osteogenesis, genioglossus advancement, genioplasty, hyoidpexy, obstructive sleep apnea
MeSH terms: Case Reports

Advancement genioplasty is one variation of genioglossus advancement (GA) and GA is a surgical intervention that can be applied for obstructive sleep apnea (OSA) caused by hypopharyngeal collapse. The genioglossus muscle originates from the posterior surface of the midline mandible and inserts into the entire tongue mass and the body of the hyoid bone. Placing horizontal tension on the genioglossus muscle enlarges the posterior airway space. We use a modified GA that applies distraction osteogenesis to increase forward movement of the genioglossus muscle and also connects the bone transport segment to the hyoid bone with a thread to maximize the anterior movement of the hyoid bone. We used this technique on a young patient and obtained good results.
Case report: Generalized bullous fixed drug eruption mimicking epidermal necrolysis
Authors: Maren Paulmann, Felix Reinkemeier, Marcus Lehnhardt, Maja Mockenhaupt
Journal: Front Med (Lausanne) (2023)
Keywords: gbfde, case report, epidermal necrolysis, generalized bullous fixed drug eruption, metamizole, re-exposure, recurrence
MeSH terms: Case Reports

Generalized bullous fixed drug eruption (GBFDE) is the most severe form of fixed drug eruption and can be misdiagnosed as epidermal necrolysis (EN). We report the case of a 42-year-old male patient presenting with more than 50% skin detachment without defined areas of exanthema or erythema and a history of one prior event of EN caused by acetaminophen (paracetamol), allopurinol, or amoxicillin 1.5 years ago. The initial diagnosis was GBFDE or EN. The histology of a skin biopsy was unable to distinguish between the two diseases. The course of the disease, the later clinical presentation, and the medical and medication history, however, were in favor of a diagnosis of GBFDE with two potentially culprit drugs: metamizole and ibuprofen. Moxifloxacin, enoxaparin sodium, hydromorphone, and insulin human were administered concomitantly, which makes them suspicious as well. Unfortunately, the patient received an additional dose of metamizole, one of the possible causative drugs, and he developed another bullous reaction within 1 month. This led to the diagnosis of GBFDE due to metamizole. This report highlights the challenges of distinguishing two rare diseases and elucidates the importance of distinct clinical presentation and detailed medication history.
A case of inguinal lymphaticovenular anastomosis for refractory lymphatic ascites after uterine cancer surgery
Authors: Atsuhiko Iwao, Noriko Ikari, Akihito Higashi, Yuki Moriuchi, Rina Akashi, Koumei Asabe, Kazuya Kashiyama, Yuriko Kitajima, Katsumi Tanaka
Journal: Case Reports Plast Surg Hand Surg (2024)
Keywords: inguinal lymphaticovenular anastomosis, para-aortic lymphadenectomy, pelvic lympha­denectomy, refractory lymphatic ascites, uterine cancer
MeSH terms: Case Reports

We herein report a case of refractory lymphatic ascites after uterine cancer surgery treated with bilateral inguinal lymphaticovenular anastomosis (LVA). LVA was performed four months after the uterine cancer surgery in a patient with refractory ascites that had developed one month after the gynecologic surgery. One year and eight months after LVA, there was no recurrence of ascites accumulation.
Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
Authors: Liang Hu, Lina Li, Angcheng Li, Jianyong Tong
Journal: Open Med (Wars) (2024)
Keywords: tfe3, xp112 translocations, natural progressive course, radical nephrectomy, renal cell carcinoma
MeSH terms: Case Reports

Background:
Renal cell carcinoma (RCC) with TFE3 gene fusion caused by Xp11.2 translocations is a rare RCC subtype. This tumor is typically seen in children, comprising 20‒40% of overall RCC cases compared to 1‒1.6% observed in adults. Xp11.2 RCC is associated with a poor prognosis due to both the progression of local lesions and early distant and lymphatic metastasis.
Case presentation:
A case of RCC with Xp11.2 RCC translocations and TFE3 gene fusion was found in a pediatric patient, illustrating the catastrophic effects of ignoring the condition. The tumor developed from a local lesion to lymph metastasis (3.2-12 cm) within 4 years. Despite ongoing controversy, surgical resection remains the most common and productive approach. In this patient, renal retroperitoneal lymph node dissection and radical nephrectomy of the left kidney were performed via laparoscopic surgery. The RCC-associated Xp11.2 translocation/TFE3 gene fusions were identified by postoperative pathology. Microscopic analysis showed the presence of intravascular cancer thrombus, renal sinus invasion, and cancer necrosis. The pathological stages were confirmed as PT3aN1M0 with a negative margin. Follow-up at 5 months showed that the patient recovered without the use of any adjuvant treatments.
Conclusion:
Our study highlights the natural course, diagnosis, and treatment of RCC-associated Xp11.2 translocation/TFE3 gene fusions, especially the necessity of early surgery. This case may be a helpful reference for urologists in the treatment of similar cases. It also serves as a precautionary signal for patients who neglect the renal neoplasm.
Prolonged Doppler US-guided pneumatic compression of a radial artery pseudoaneurysm after percutaneous coronary intervention: a simple and effective solution for a rare and challenging problem
Authors: Marcos Danillo Oliveira, Pedro Perillo, Lélio Lemos, Adriano Caixeta
Journal: J Vasc Bras (2023)
Keywords: complications, management, pneumatic compression, pseudoaneurysm, transradial access
MeSH terms: Case Reports

Transradial access is associated with fewer access site-related complications, earlier patient mobilization, and greater postprocedural comfort. Pseudoaneurysms are an extremely rare complication after transradial procedures and the radial artery itself is the most atypical arterial site of occurrence. We report a case in which a non-surgical, non-invasive, simple, and effective solution (prolonged pneumatic compression) was used to manage a radial artery pseudoaneurysm, a very rare and challenging complication of transradial procedures.
Application of 18F-FDG PET/CT imaging in a primary angiomatoid fibrous histiocytoma of pulmonary bronchus: case report and literature review
Authors: Mingyan Shao, Sisi Fan, Wanling Qi, Zhehuang Luo, Rong Xu, Fengxiang Liao
Journal: Front Med (Lausanne) (2024)
Keywords: 18f-fdg pet/ct, ct, angiomatoid fibrous histiocytoma, primary, pulmonary bronchus
MeSH terms: Case Reports

Background:
Angiomatoid fibrous histiocytoma (AFH) is a clinically rare, low-grade malignant soft tissue tumor that occasionally metastasizes. It accounts for 0.3% of all soft tissue tumors and most frequently occurs in the extremities, followed by the trunk, and the head and neck. Primary angiomatoid fibrous histiocytoma (PAFH) of the pulmonary bronchus is rare. In this paper, the clinical and imaging data of a case of PAFH of the pulmonary bronchus are reported, and the literature is reviewed.
Case description:
A 57-year-old female patient presented with a six-month history of cough without apparent cause, characterized by paroxysmal dry cough, chest tightness, and shortness of breath, which worsened with activity. She did not experience fever, chills, chest pain, hemoptysis, or night sweats. Laboratory tests revealed an elevated C-reactive protein and ferritin levels, while tumor markers such as AFP, CEA, CA199, CA125, CA50, and T-SPOT were negative. A chest CT scan showed bronchial obstruction, atelectasis, and a soft tissue density in the right middle lobe of the lung. The enhanced scan demonstrated uneven enhancement of endobronchial nodules. An 18F-FDG PET/CT scan revealed a nodular soft tissue density shadow in the right lung bronchus with uneven density, clear boundaries, and increased 18F-FDG uptake, with a maximum standard uptake value (SUVmax) of 11.2. Bronchoscopy revealed a nodular or polypoid mass that was yellow and tough. Based on imaging findings, the preoperative diagnosis favored lung cancer. However, the postoperative pathological diagnosis confirmed primary angiomatoid fibrous histiocytoma (PAFH) of the pulmonary bronchus.
Conclusion:
The incidence of primary angiomatoid fibrous histiocytoma (PAFH) is very low, and its clinical manifestations and imaging findings lack specificity, with the final diagnosis relying on pathology. PET/CT imaging has a certain value in the diagnosis of PAFH and holds significant application value in preoperative staging, postoperative efficacy evaluation, and follow-up monitoring. In conclusion, this case report further expands the spectrum of lung and bronchial tumors.
Post-traumatic Brodie's Abscess of the Tarsal Cuboid: A Case Report and Review of the Literature
Authors: Ioannis K Tzellios, Dimitrios I Gelalis, Ioannis Gkiatas, Emilios Ε Pakos, Ioannis D Gelalis
Journal: Cureus (2024)
Keywords: brodie's abscess, chronic sub-acute osteomyelitis, curettage, escherichia coli, infection, penetrating trauma, tarsal cuboid
MeSH terms: Case Reports

Brodie's abscess of the tarsal cuboid is a relatively rare presentation of this disease. In this study, we present the case of a 20-year-old male with post-traumatic Brodie's abscess of the tarsal cuboid that was left untreated for three years after the traumatic episode (penetrating injury with a sharp piece of wood). The patient presented pain over the injured area, limping, while plain foot radiographs showed a small lytic cavitary area in the cuboid. The magnetic resonance imaging revealed the presence of the abscess in a 2-cm diameter cavity in the cuboid bone and chronic inflammation of the surrounding plantar musculature. The treatment regime included curettage of the cavity, debridement of the inflammatory tissues, and administration of antibiotics, according to the cultures harvested intraoperatively, for six weeks. During this period, symptoms completely resolved.
Medical Management to Treat Chronic Non-healing Ulcers: A Case Series
Authors: Joseph Jose, Bhanushree Soni, Saji Jose, Jose K Kokkatt
Journal: Cureus (2024)
Keywords: atypical ulcers, autoimmune ulcers, chronic non-healing ulcers, chronic venous ulcers, immunotherapy, wound care management

Introduction:
Chronic non-healing leg ulcers are skin defects below the knee that resist healing for more than six weeks. They cause physical, emotional, and economic burdens to patients and society.
Objectives:
To introduce an innovative medical strategy that targets the chronic inflammation component in non-healing ulcers (NHUs) with rheumatic features and to evaluate its potential effectiveness in achieving complete healing.
Methods:
We employed an empirical medical therapy regimen, which combined medications like deflazacort, colchicine, dapsone, hydroxychloroquine, and azathioprine. We retrospectively selected 25 patients with chronic pedal ulcers who underwent our therapy.
Results:
The mean duration of ulcers was 7.84 years, and the time to heal was 5.97 months. Among 25 patients, 19 had atypical ulcers, four had venous ulcers, and two had diabetic neuropathy ulcers. Four patients with venous ulcers additionally underwent endovenous laser ablation.
Conclusion:
Our medical strategy showed promising results in healing chronic NHUs with rheumatic features without significant steroid-induced adverse effects.
Late-onset renal variant Fabry disease with R112H mutation and mild increase in plasma globotriaosylsphingosine: a case report
Authors: Keiko Tanaka, Hitoshi Sugiyama, Hiroshi Morinaga, Akifumi Onishi, Katsuyuki Tanabe, Haruhito A Uchida, Hiroki Maruyama, Jun Wada
Journal: Front Med (Lausanne) (2024)
Keywords: fabry disease, r112h mutation, chronic kidney disease, migalastat, proteinuria
MeSH terms: Case Reports

Fabry disease (FD) is an X-linked disorder resulting in a deficiency of α-galactosidase A (GLA) activity. The R112H mutation of GLA is relatively common in Japanese FD patients, characterized by a late-onset phenotype, almost normal to mild lyso-Gb3 elevation, and mild clinical symptoms, despite low GLA activity. This is due to the structural features of the R112H GLA protein. We herein report the case of a 42-year-old male patient with late-onset FD with a R112H mutation. The patient exhibited only renal involvement with no other organ damage and was successfully treated with galactosidase beta and subsequent migalastat for approximately 10 years. Especially, migalastat was clinically effective in normalizing plasma lyso-Gb3 levels and inhibiting the progression of renal damage associated with FD. Therefore, the use of migalastat in the FD patients with R112H mutation is highly recommended based on this case report.
"Very" Very Late Stent Thrombosis: The Occurrence of Thrombosis 12.3 Years After Paclitaxel-Eluting Stent Implantation
Authors: Hung D Tran, Ha V T Pham, Thang D Vu
Journal: Cureus (2024)
Keywords: coronary artery disease, drug-eluting stents, neoatherosclerosis, neointima, paclitaxel eluting stent, stent thrombosis
MeSH terms: Case Reports

Very late stent thrombosis (VLST) refers to stent thrombosis occurring beyond one year after coronary intervention. "Very" very or extremely late stent thrombosis (VVLST), occurring after five years of drug-eluting stent (DES) implantation, is extremely rare. We report a case of a 60-year-old male patient with ST-elevation myocardial infarction (STEMI) due to in-stent thrombosis 12.3 years after first-generation DES implantation; we also engage in a brief discussion of its pathogenesis and prevention.
Malignant atrophic papulosis treated with eculizumab and hirudin: a fatal case report and literature review
Authors: Linna Yu, Yun Wang, Xiaodan Tang, Xueru Zhao, Zhengji Song
Journal: Front Cardiovasc Med (2024)
Keywords: complement, eculizumab, interferon, malignant atrophic papulosis, treprostinil, vascular disease
MeSH terms: Case Reports

Background:
Malignant atrophic papulosis (MAP) is a rare obliterative vasculopathy whose etiology and pathophysiological mechanisms remain unknown, and the treatment is still empirical. It can involve multiple systems, especially the gastrointestinal tract and central nervous system, and has a poor prognosis.
Case presentation:
A 20-year-old Chinese male appeared to have Widespread atrophic papules and plaques, intermittent abdominal pain, recurrent bowel perforation, and psoas abscess. The clinical diagnosis of MAP was supported by skin biopsy. He was then treated with anticoagulants, antiplatelets, glucocorticoids, and immunosuppressants and started on eculizumab and hirudin after the first surgical interventions. Despite the aggressive immunosuppression, anticoagulant, antiplatelet, humanized monoclonal antibodies, and surgery therapy, he died five months after presentation.
Conclusions:
MAP is an extremely rare obliterative vasculopathy manifesting as benign cutaneous involvement or potentially malignant systemic involvement. MAP patients who exhibit any abdominal symptoms should undergo laparoscopy and evaluation in time and start on eculizumab and treprostinil as soon as possible, as the combination of them is presently the most effective treatment option for gastrointestinal MAP and hopefully reduce mortality.
Case report: Giant cell tumor of bone in the mandible of a goat-diagnostics, surgical treatment, and outcome
Authors: Nora M Biermann, Susanna Piechl, Nora Dinhopl, Andrea Fuchs-Baumgartinger, Christiane Weissenbacher-Lang, Christof A Bertram
Journal: Front Vet Sci (2024)
Keywords: giant cell tumor (gct), head surgery, large animal, mandibulectomy, neoplasia, oral cancer, surgery
MeSH terms: Case Reports

Neoplastic processes of the mandible and their treatment are rarely reported in large animal species. Specifically, giant cell tumor of bone is an uncommon tumor in animals and has been associated in humans with locally invasive behavior and a high recurrence rate. En-bloc resection is the treatment of choice, but depending on the localization of the tumor, this may result in functional deficits. This report details the diagnostic work-up, treatment, and long-term outcome of a giant cell tumor of bone involving the rostral mandible and mandibular symphysis of a goat. Extensive rostral mandibulectomy involving the entire mandibular symphysis without surgical fixation of the hemimandibles was performed. Histological and electron microscopic findings of the tumor were consistent with a giant cell tumor of bone. Although a mutation of the H3F3A gene is considered the driver of tumor development in human giant cell tumors, using molecular analysis, this gene mutation could not be confirmed in this case. Follow-up examinations revealed spontaneous secondary fusion of both hemimandibles and no signs of tumor recurrence. Nearly 1 year after surgery, the owners reported no signs of tumor regrowth.