OpenMed/multicare-articles huggingface dataset:
Case Report: Severe ARDS in a Pediatric Hematopoietic Stem-Cell Transplantation Recipient Caused by Disseminated Toxoplasmosis
Authors: Sara de la Mata Navazo, María Slöcker Barrio, Marina García-Morín, Cristina Beléndez, Laura Escobar Fernández, Elena María Rincón-López, David Aguilera Alonso, Jesús Guinea, Mercedes Marín, Laura Butragueño-Laiseca, Jesús López-Herce Cid
Journal: Front Pediatr (2022)
Keywords: ards, hematopoietic stem cell transplantation (hcst), intensive care unit, leukemia, pediatric, toxoplasma and toxoplasmosis, ventilation
MeSH terms: Case Reports

Toxoplasma gondii infection is a severe complication of hematopoietic stem-cell transplantation (HSCT) recipients that can remain unnoticed without a high clinical suspicion. We present the case of a 6-year-old patient with acute lymphoblastic leukemia and HSCT recipient who was admitted to the Pediatric Intensive Care Unit (PICU) on post-transplantation day +39 with fever, hypotension, severe respiratory distress and appearance of a lumbar subcutaneous node. She developed severe Acute Respiratory Distress Syndrome (ARDS) and underwent endotracheal intubation and early mechanical ventilation. Subsequently, she required prone ventilation, inhaled nitric oxide therapy and high-frequency oscillatory ventilation (HFOV). An etiologic study was performed, being blood, urine, bronchoalveolar lavage and biopsy of the subcutaneous node positive for Toxoplasma gondii by Polymerase Chain Reaction (PCR). Diagnosis of disseminated toxoplasmosis was established and treatment with pyrimethamine, sulfadiazine and folinic acid started. The patient showed clinical improvement, allowing weaning of mechanical ventilation and transfer to the hospitalization ward after 40 days in the PICU. It is important to consider toxoplasmosis infection in immunocompromised patients with sepsis and, in cases of severe respiratory distress, early mechanical ventilation should be started using the open lung approach. In Toxoplasma IgG positive patients, close monitoring and appropriate anti-infectious prophylaxis is needed after HSCT.
Propionibacterium acnes Causing Mediastinal Infection following Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration
Authors: Katherine Janssen, Joseph Keenan, Roy Cho, Erhan Dincer
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is now a standard of care to sample mediastinal lymph nodes and masses with high diagnostic accuracy and low complication rates. However, the procedure has potential complications that might be life-threatening. Here, we present the first case of Propionobacterium acnes (P. acnes) causing mediastinitis following EBUS-TBNA of a subcarinal lymph node.
Ehrlichiosis in a Recent Liver Transplant Recipient Leading to Multiorgan Failure
Authors: Fawwaz Almajali, Catherine Oleary, Taylor Hallcox, Justin Lok, Daniela Hermelin, Alexis Guenette, Mustafa Nazzal
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Ehrlichia infection has a broad spectrum of diseases ranging from asymptomatic to fatal. While Ehrlichia often presents as a mild form of the disease in immunocompetent patients, immunosuppressed patients are at increased risk for a more virulent and potentially fatal infection. Our liver transplant patient presented with fever, persistent headaches, and negative Ehrlichia antibodies. Empiric antibiotic therapy was started and along with knowledge of prior tick infection, doxycycline was added. Subsequent positive PCR and observation of Ehrlichia chaffeensis in peripheral blood smear confirmed the diagnosis. The patient did recover from infection but not before it manifested in hepatic, renal, and pulmonary involvement. Therefore, a high level of suspicion is necessary for early detection and treatment initiation to prevent a devastating progression of the disease in immunosuppressed patients.
A Rare Occurrence of Isolated Brain Metastases from Gastric Cancer
Authors: Manish M Karamchandani, Tej Ganti, Sunny Jaiswal, Julian K Wu, Muhammad Wasif Saif
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Background:
Gastric cancer is the fourth most common cancer worldwide and the second most common cause of cancer-related death. The majority of newly diagnosed gastric cancer cases present either as locally advanced tumor growth or with distant metastases.
Case report:
Here, we describe a case of isolated brain metastases in a male patient with gastric cancer. Initially, our patient presented with dysphagia and was diagnosed with gastric cancer after a thorough evaluation. One year after chemotherapy and surgical resection of his gastric cancer, he presented with headaches, nausea, dizziness, and photophobia. Further evaluation of these symptoms led to the discovery of three metastatic brain lesions without evidence of extracranial metastases.
Conclusions:
Our review of the literature has found that such cases are rare. Additionally, our review of the literature demonstrates the poor outcomes associated with metastatic brain lesions from gastric cancer and highlights the importance of surgical resection in increasing overall survival time.
Clozapine-Induced Pneumonitis: A Case Report
Authors: Tyler Torrico, Ronald O Crandall, Carlos Meza, Sara Abdijadid
Journal: Front Psychiatry (2020)
Keywords: adverse reactions, atypical antipsychotic, case report, drug-induced, drug-induced lung disease, non- neutropenic fever
MeSH terms: Case Reports

Introduction: Clozapine is the most effective antipsychotic used for treatment resistant schizophrenia and recurrent suicidal behavior in schizophrenia or schizoaffective disorder. However, it has been underutilized due to its adverse reaction profile. Although clozapine is typically associated with neutropenia leading to increased risk of infection (i.e., pneumonia), there have been a few case reports of non-neutropenic, non-infectious drug-induced lung disease (i.e., pneumonitis). Although pneumonia and pneumonitis may have similar clinical presentation, their etiology, management, and treatment are different. Case presentation: A 53-year-old African American female with schizoaffective disorder was hospitalized for being no longer able to appropriately utilize food, clothing, and shelter. The patient developed a sepsis-like presentation during clozapine titration which resolved after treatment for presumed pneumonia and clozapine discontinuation. When clozapine was resumed due to persistent psychosis, the patient again developed a sepsis-like presentation. Clozapine was again discontinued with no other interventions and the patient's symptoms resolved. Conclusions: Drug-induced pneumonitis is a very rare adverse reaction of clozapine. Recognizing conditions that mimic sepsis may prevent patients from undergoing unnecessary laboratory testing and prevent exposure to unwarranted antibiotics.
Motor vehicle collision patient with simultaneous duodenal transection and thoracic aorta injury: a case report and review of the literature
Authors: Charlie Chen, Kevin Schuster, Bishwajit Bhattacharya
Journal: Case Rep Surg (2015)

Blunt polytrauma can present complex management decisions. Here we report the case of a 31-year-old male involved in a high speed motor vehicle collision resulting in both duodenal and thoracic aorta injury that was managed collaboratively between the trauma, vascular, and cardiothoracic surgical teams. The patient went on to a full recovery. We also review the management of such injuries which has evolved over the past two decades resulting in less morbidity and mortality.
Late open conversion in ruptured abdominal aortic aneurysm after endovascular repair
Authors: Erol Kurç, Onur Sokullu, Serdar Akansel, Murat Sargın
Journal: J Vasc Bras (2018)
Keywords: evar, late open conversion, re-intervention, ruptured abdominal aortic aneurysm
MeSH terms: Case Reports

Despite technological advances, the long-term outcomes of endovascular aortic aneurysm repair (EVAR) are still debatable. Although most endograft failures after EVAR can be corrected with endovascular techniques, open conversion may still be required. A 70-year-old male patient presented at the emergency unit with abdominal pain. Twice, in the third and fourth years after the first repair, a stent graft had been placed over a non-adhesive portion of the stent graft due to type Ia endoleaks. In the most recent admission, a CT scan showed type III endoleak and ruptured aneurysm sac. On this occasion the patient underwent late open conversion. The failure was repaired with total preservation of the main endovascular graft body and interposition of a bifurcated dacron graft. This case demonstrates that lifelong radiographic surveillance should be considered in this subset of patients. Late open conversion following EVAR of ruptured abdominal aortic aneurysms can be performed safely.
Case report: Bipolar disorder in 48,XXYY syndrome
Authors: Nur Atikah Razali, Tuti Iryani Mohd Daud, Luke Sy-Cherng Woon, Suriati Mohamed Saini, Noor Azimah Muhammad, Shalisah Sharip
Journal: Front Psychiatry (2023)
Keywords: 48, xxyy syndrome, aggression, bipolar mood disorder, case report, metabolic syndrome
MeSH terms: Case Reports

48,XXYY syndrome is a rare condition. The presentations of impulsive and aggressive behavior have been reported in several case reports among patients with 48,XXYY syndrome. The management of the psychological impact and neuropsychiatric sequela of this condition is a significant issue faced by families, carers, and healthcare professionals. We report a patient, 21-year-old Malay male, with underlying 48,XXYY syndrome with attention deficit hyperactivity disorder (ADHD) and intellectual disability, diagnosed later in adulthood with a bipolar mood disorder and benefited after being started on lithium. We describe the key clinical features and diagnostic workouts that allowed the arrival of the correct psychiatric diagnosis. Challenges in psychopharmacotherapy, including the risks of metabolic syndrome and deep vein thrombosis associated with 48,XXYY syndrome, are also considered. We suggest that for patients with 48,XXYY syndrome, routine psychological screening for mood symptoms such as mania and depression should be done by healthcare professionals with early involvement of psychiatrist in the multidisciplinary team due to the challenges in the management of these patients.
Identification of Abnormal Biliary Anatomy Utilizing Real-Time Near-Infrared Cholangiography: A Report of Two Cases
Authors: Joseph Bozzay, Diego Vicente, Elliot M Jessie, Carlos J Rodriguez
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Biliary duct anomalies are commonly encountered during laparoscopic cholecystectomy. Advancements in the field of surgery allow for enhanced intraoperative detection of these abnormalities. Fluorophore injection and near-infrared (NIR) imaging can provide real-time intraoperative anatomic feedback without intraoperative delays and ionizing radiation. This report details two cases where the PINPOINT Endoscopic Fluorescence Imaging System (NOVADAQ, Ontario, Canada) was used to identify anomalies of the biliary tree and guide operative decision-making.
Case report: Prenatal diagnosis of fetal non-compaction cardiomyopathy with bradycardia accompanied by de novo CALM2 mutation
Authors: Wen Zhang, Xiaohui Dai, Hanmin Liu, Lei Li, Shu Zhou, Qi Zhu, Jiao Chen
Journal: Front Pediatr (2022)
Keywords: calm2 mutation, bradycardia, non-compaction cardiomyopathy, prenatal, ultrasound
MeSH terms: Case Reports

We herein report what appears to be the first case of fetal non-compaction cardiomyopathy in both ventricles accompanied by a mutation in the calmodulin gene (CALM2). A 25-year-old woman was referred to our hospital at 25+1 weeks of gestation for evaluation of fetal defects. Prenatal echocardiography showed biventricular non-compaction cardiomyopathy with sinus bradycardia. After termination of the pregnancy, fetal biventricular non-compaction cardiomyopathy was confirmed by autopsy and histopathologic examination. Additionally, whole-exome sequencing of genomic DNA demonstrated a de novo heterozygous mutation (c.389A > G; p.D130G) in CALM2, whereas the parents were normal. In this case report, we highlight the importance of prenatal ultrasound and genetic testing in fetal non-compaction cardiomyopathy with arrhythmia.
Left hand extensor tenosynovitis due to Histoplasma capsulatum complicated by immune reconstitution inflammatory syndrome
Authors: Talha Riaz, Mark Collins, Mark Enzler, Marco Rizzo, Audrey N Schuetz, Julia S Lehman, Douglas Osmon, Irene G Sia
Journal: J Bone Jt Infect (2021)
MeSH terms: Case Reports

We describe a case of left hand extensor tenosynovitis due to histoplasmosis in a patient with dermatomyositis on chronic immunosuppression. Treatment involved surgical debridement and antifungal therapy. The patient experienced paradoxical worsening of tenosynovial inflammation during de-augmentation of immunosuppression felt to be immune reconstitution inflammatory syndrome.
Acute Paraplegia due to Thoracic Hematomyelia
Authors: Aykut Akpınar, Bahattin Celik, Ihsan Canbek, Ergun Karavelioğlu
Journal: Case Rep Neurol Med (2016)

Spontaneous intraspinal intramedullary hemorrhage is a rare entity with the acute onset of neurologic symptoms. The etiology of idiopathic spontaneous hematomyelia (ISH) is unknown, and there are few published case reports. Hematomyelia is mostly associated with trauma, but the other nontraumatic etiologies are vascular malformations, tumors, bleeding disorders, syphilis, syrinx, and myelitis. MRI is a good choice for early diagnosis. Hematomyelia usually causes acute spinal cord syndrome due to the compression and destruction of the spinal cord. A high-dose steroid treatment and surgical decompression and evacuation of hematoma are the urgent solution methods. We present idiopathic spontaneous hematomyelia of a previously healthy 80-year-old male with a sudden onset of back pain and paraplegia.
Esophageal Squamous Cell Carcinoma Presenting with Streptococcus intermedius Cerebral Abscess
Authors: Rabih Nayfe, Mustafa S Ascha, Esther H Rehmus
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Background:
Cerebral abscess is caused by inoculation of an organism into the brain parenchyma from a site distant from the central nervous system. Streptococcus intermedius (S. intermedius) is a commensal organism that is normally present in the aerodigestive tract and was reported to be the cause of brain abscesses after esophageal dilatation or upper endoscopy.
Case presentation:
We report the case of a 53-year-old female who presented with hematemesis and melena followed by left-sided weakness. Initially, her hemiplegia was found to be secondary to a right thalamic brain abscess caused by S. intermedius. Investigations led to the diagnosis of a mid-esophageal squamous cell carcinoma. We hypothesize that the cause of the abscess with this bacterium that naturally resides in the digestive tract and oral cavity is secondary to hematogenous spread from breach in the mucosal integrity from ulceration due to the cancer.
Conclusion:
To our knowledge, our case is the first in the literature to describe a brain abscess caused by S. intermedius in association with a previously undiagnosed esophageal squamous cell carcinoma without any prior esophageal intervention.
Varicella zoster-associated retinal and central nervous system vasculitis in a patient with multiple sclerosis treated with natalizumab
Authors: Xenia Kobeleva, Florian Wegner, Inez Brunotte, Mete Dadak, Reinhard Dengler, Martin Stangel
Journal: J Neuroinflammation (2014)
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Herpes Zoster / complications, Multiple Sclerosis / complications, Multiple Sclerosis / drug therapy, Vasculitis, Central Nervous System / complications, Case Reports, Research Support, Non-U.S. Gov't, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Natalizumab, Antibodies, Monoclonal, Humanized, Natalizumab

We report the first case of combined retinal and CNS varicella zoster-associated vasculitis in a 49-year-old patient with multiple sclerosis who had been treated with natalizumab. He presented with a progressive bilateral visual loss. The diagnosis of a vasculitis was based on the fundoscopic examination and MRI findings. We confirmed the varicella zoster virus (VZV) infection of the CNS by PCR and increased intrathecal antibody indices in the cerebrospinal fluid. The patient was stabilized with antiviral treatment, methylprednisolone, plasmapheresis and cycophosphamide. Natalizumab was discontinued. This case illustrates the neuroimmunological and neuroinfectiological consequences of treatments with biologicals that influence the immune system.
Successful Pregnancy following Myomectomy Accompanied with Abdominal Radical Trachelectomy for an Infertile Woman with Early Cervical Cancer: A Case Report and Literature Review
Authors: Yuji Kamei, Ai Miyoshi, Nao Wakui, Takeya Hara, Serika Kanao, Hirokazu Naoi, Hirofumi Otsuka, Takeshi Yokoi
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Women in the reproductive age group diagnosed with cervical cancer can receive radical trachelectomy in case they wish to preserve fertility. However, the indication for this procedure in infertile women with cervical cancer is controversial depending on the underlying cause of infertility. Here, we present a case of a successful pregnancy following myomectomy accompanied with abdominal radical trachelectomy for an infertile woman with early cervical cancer. The patient was a 38-year-old nulliparous woman with a significant past medical history of infertility of unknown origin. She had been undergoing treatment with assisted reproductive technologies including artificial insemination and in vitro fertilization for over four years. During her treatment for infertility, she was diagnosed with stage IB1 cervical squamous cell carcinoma. She received abdominal radical trachelectomy and abdominal myomectomy in the same surgical procedure. Six months after the surgery, she went for the first embryo transfer and became pregnant. At 26 weeks of pregnancy, a male baby weighing 980 g was delivered with an Apgar score of 3/5/7 by cesarean section due to chorioamnionitis. The baby has received general care in a neonatal intensive care unit for four months and weighed 4520 g when discharged.
The Influence of Spiritual Leadership on Harmonious Passion: A Case Study of the Hotel Industry in China
Authors: Yingda Wang, Yixing Jin, Lin Cheng, Ying Li
Journal: Front Psychol (2021)
Keywords: calling, harmonious passion, intrinsic motivation, psychological capital theory, self-determination, spiritual leadership

The hotel manager has the responsibility to stimulate the passion of the staff. The vision, hope/faith, and altruistic love advocated by spiritual leaders can meet the independent psychological needs of employees, thus enhancing their harmonious passion. This study is based on self-determination theory, intrinsic motivation theory and psychological capital theory, and explores the relationship between spiritual leadership and employees' harmonious passion. This study uses 260 employees of star hotels in Beijing, Shanghai, Hangzhou, Hefei, Huangshan, and other cities in China. Results show that spiritual leadership positively impacts employees' harmonious passion, and calling plays an mediation role between spiritual leadership and employees' harmonious passion. The results are helpful to clarify the formation mechanism of employees' harmonious passion from the perspective of self-determination theory, intrinsic motivation theory and psychological capital theory and show that spiritual leadership can drive employees' harmonious passion, especially when hotel vision and employee calling are consistent. Furthermore, the altruistic love of spiritual leaders for their followers also plays a key role in employee calling and promoting harmonious passion. Therefore, this study also emphasizes the importance of calling in improving the harmonious passion of employees. The theoretical and management implications that help to enhance the harmonious passion of employees are discussed in detail.
Achieving Hemostasis Posttranscatheter Aortic Valve Replacement in a Patient with Aortobifemoral Bypass Graft Using Perclose Device: A Novel Technique
Authors: Ebubechukwu Ezeh, Mohammad Amro, Esiemoghie Akhigbe, Mackenzie Hamilton, Mehrette Maru
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

The presence of aortobifemoral bypass graft can complicate vascular access during percutaneous intervention. Choosing an access route for transcatheter aortic valve replacement (TAVR) in this patient population can be challenging. Access options are further limited by the presence of coexisting vascular comorbidities such as extensive peripheral artery diseases in these patients. Adequate preoperative planning to determine the suitability of different access sites is, therefore, very crucial. Our case report shows that the use of Perclose can be a viable option for achieving hemostasis after a direct puncture of an aortobifemoral bypass graft during transfemoral TAVR.
One-stage closure of large bronchopleural fistula with pedicled latissimus dorsi muscle flap after preemptive antibiotics: A case report
Authors: Satoru Okada, Masanori Shimomura, Hiroaki Tsunezuka, Shunta Ishihara, Narumi Ishikawa, Kenji Kameyama, Shuta Kitaoka, Masayoshi Inoue
Journal: Int J Surg Case Rep (2020)
Keywords: bronchopleural fistula, ischemic bronchitis, latissimus dorsi muscle flap, lung cancer surgery, preemptive antibiotics
MeSH terms: Case Reports

Introduction:
Bronchopleural fistula (BPF) after lung cancer surgery is a life-threatening complication and often needs two-stage closure after fenestration. Although one-stage closure of BPF is challenging, it would provide shorter treatment time and lower patient physical burden than two-stage closure. However, there have been few reports of one-stage closure of a large BPF.
Presentation of case:
A 53-year-old man underwent robotic right lower lobectomy with systematic lymph node dissection. Postoperative bronchoscopy revealed an ischemic change in the bronchial stump, which progressed to a large BPF. However, under the preemptive antibiotic treatment without chest drainage, local infection was controlled within a limited pleural space. We successfully performed one-stage closure of a 3-cm sized BPF with pedicled latissimus dorsi (PLD) muscle flap.
Discussion:
Early diagnosis of ischemic bronchitis and appropriate preceding antibiotic treatment could minimize the local infection around the fistula. To our knowledge, our case represented the largest BPF that was successfully treated by one-stage procedure using preemptive antibiotics and the PLD muscle flap.
Conclusion:
One-stage closure using the PLD muscle flap may be a treatment option even for a 3-cm sized BPF, wherein infection is controlled and the relevant pleural cavity is limited.
A Challenging Combination: Anomalous Left Anterior Descending Coronary Artery, Myocardial Bridging, and Endothelial Dysfunction
Authors: Edward A El-Am, Michel T Corban, Amy W Pollak, Amir Lerman, Naser M Ammash
Journal: Front Cardiovasc Med (2020)
Keywords: anomalous coronary artery, case report, endothelial dysfunction, myocardial bridging, vasospasm
MeSH terms: Case Reports

50 years old female patient with a medical history of hypertension presented to the clinic with chest pain, palpitations, and dyspnea on exertion of 2 years duration. Extensive workup in search of the culprit etiology of her chest pain revealed a challenging combination of an anomalous left anterior descending artery with myocardial bridging and endothelial dysfunction. She was treated medically with long acting nitrates, L-arginine and calcium channel blockers, and remains asymptomatic after 12 months of follow up.