OpenMed/multicare-articles huggingface dataset:
Acute Flaccid Tetraparesis after COVID-19 Infection: Think of the Thyroid
Authors: Sarah Ying Tse Tan, Jiaqing Xiong, Troy H Puar, Joan Khoo, Andy Jun-Wei Wong, Shui Boon Soh
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

A previously well 32-year-old Chinese male presented with acute bilateral upper and lower limb paralysis upon waking, ten days after the onset of COVID-19 infection. Examination revealed areflexia over all four limbs, associated with reduced muscle strength, but no sensory or cranial nerve deficit. Initial concern was Guillain-Barre syndrome given the acute flaccid paralysis following COVID-19 infection. However, investigations revealed severe hypokalaemia (1.7 mmol/L) and primary hyperthyroidism. He was treated for thyrotoxic periodic paralysis (TPP) with β-blockers, antithyroid medications, and intravenous potassium chloride (KCl). Despite frequent monitoring of potassium, rebound hyperkalaemia occurred with prompt resolution of paralysis.
A Case of Cushing's Syndrome due to Ectopic Adrenocorticotropic Hormone Secretion from Esthesioneuroblastoma with Long Term Follow-Up after Resection
Authors: Leslee N Matheny, Sudipa Sarkar, Hanyuan Shi, Jiun-Ruey Hu, Hannah Harmsen, Ty W Abel, Shubhada M Jagasia, Shichun Bao
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

We present a case of a 52-year-old male who developed Cushing's Syndrome due to ectopic adrenocorticotrophic hormone (ACTH) secretion from a large esthesioneuroblastoma (ENB) of the nasal sinuses. The patient initially presented with polyuria, polydipsia, weakness, and confusion. Computed tomography scan of the head and magnetic resonance imaging showed a 7 cm skull base mass centered in the right cribriform plate without sella involvement. Work-up revealed ACTH-dependent hypercortisolemia, which did not suppress appropriately after high-dose dexamethasone. Subsequent imaging of the chest, abdomen, and pelvis did not reveal other possible ectopic sources of ACTH secretion besides the ENB. His hospital course was complicated by severe hypokalemia and hyperglycemia before successful surgical resection of the tumor, the biopsy of which showed ENB. Postoperatively, his ACTH level dropped below the limit of detection. In the ensuing 4 months, he underwent adjuvant chemoradiation with carboplatin and docetaxel with good response and resolution of hypokalemia and hyperglycemia, with no sign of recurrence as of 30 months postoperatively. His endogenous cortisol production is rising but has not completely recovered.
Metastatic Small Cell Carcinoma of the Urinary Bladder That Recurred in the Vagina 6 Years after Radical Cystectomy: A Case Report
Authors: Makoto Isono, Keiichi Ito, Shinsuke Hamada, Masahiro Takahashi, Hidenori Sasa, Hideyuki Shimazaki, Tomohiko Asano
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Small cell carcinoma (SCC) of the urinary bladder is highly aggressive and portends a poor outcome. Herein, we report a patient with recurrent SCC of the urinary bladder who experienced an unusually long-term disease-free duration after radical cystectomy. The patient was a 60-year-old woman who had undergone transurethral resection followed by radical cystectomy for muscle-invasive bladder cancer (high-grade urothelial carcinoma with adenocarcinomatous differentiation) 6 years prior; the surgical specimen had a negative surgical margin. She was referred to our hospital because of continuous bleeding from her vagina. Magnetic resonance imaging showed a mass located at the anterior wall of her residual vagina, a biopsy of which confirmed a pathological diagnosis of adenocarcinoma. The vaginal tumor and a section of the sigmoid colon were resected en bloc and were pathologically diagnosed as adenocarcinoma and SCC. We reevaluated the initial transurethral resection specimen and found SCC with foci of adenocarcinoma concomitant with high-grade urothelial carcinoma. Local recurrence and metastasis at the pelvic bone occurred 4 months later; although radiation therapy was performed, she died of the progressive disease.
Hyperdiploidy associated with T315I mutation in BCR-ABL kinase domain in an accelerated phase-chronic myeloid leukemia case
Authors: Walid Al-Achkar, Faten Moassass, Adnan Ikhtiar, Thomas Liehr, Moneeb Abdullah Kassem Othman, Abdulsamad Wafa
Journal: Mol Cytogenet (2014)
Keywords: chronic myeloid leukemia, hyperdiploidy, philadelphia chromosome, prognostic factors, t315i mutation
MeSH terms: Case Reports

Background:
Chronic myeloid leukemia (CML) is genetically characterized by the occurrence of a reciprocal translocation t(9;22)(q34;q11), resulting in a BCR/ABL gene fusion on the derivative chromosome 22, i.e. the Philadelphia (Ph) chromosome. During CML progression 60-80% of the cases acquire additional genetic changes. Even though hyperdiploidy is not a rare finding in advanced phase-CML, hyperdiploidy together with a T315I kinase domain (KD) mutation in the BCR-ABL gene has not yet been reported.
Results:
A complete cytogenetic and molecular cytogenetic analysis; molecular biology methods such as quantitative reverse transcription polymerase chain reaction (RQ-PCR) and allele-specific oligonucleotide (ASO)-PCR; and immunophenotypically confirmed CML in acceleration phase (AP). Our case revealed the presence of hyperdiploidy including multiple copies of the Ph chromosome, presence of b3a2 fusion transcript,T315I mutation in BCR-ABL KD in pre imatinib mesylate (IM) treatment. The ratio of BCR-ABL/ABL expression in post nilotinib treatment was 0.07% on international scale.
Conclusions:
The patient demonstrated a good response to nilotinib after imatinib failure; while the hyperdiploid clone disappeared the T315I mutation remained during follow-up. The underlying mechanisms and prognostic implications of these cytogenetic abnormalities are discussed.
Brachybacterium paraconglomeratum Endophthalmitis Postcataract Operation
Authors: Kazuhiro Murata, Kenji Ozawa, Hideaki Kawakami, Kiyofumi Mochizuki, Kiyofumi Ohkusu
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Purpose:
To present our findings in a case of delayed-onset postoperative endophthalmitis caused by Brachybacterium paraconglomeratum, a rare organism. Observations. A 57-year-old man presented with epiphora and photophobia 17 weeks after a routine cataract extraction with phacoemulsification and intraocular lens implantation. Because endophthalmitis was suspected to be caused by a low-grade pathogen or fungus, an anterior chamber tap was performed. However, both multiplex PCR and culturing were negative. The patient was treated with topical cefmenoxime, oral minocycline, and subconjunctival injection of vancomycin and ceftazidime, but the intraocular inflammation increased. Then, the anterior chamber was tapped again, and the second PCR amplification and direct sequencing which targeted Actinomycetes detected Brachybacterium paraconglomeratum, a rare organism.
Conclusion:
This is the first reported case of an ocular disorder caused by B. paraconglomeratum. We recommend that B. paraconglomeratum be considered in cases of delayed-onset postcataract endophthalmitis.B. paraconglomeratum. We recommend that B. paraconglomeratum be considered in cases of delayed-onset postcataract endophthalmitis.
Sacral Myeloid Sarcoma Manifesting as Radiculopathy in a Pediatric Patient: An Unusual Form of Myeloid Leukemia Relapse
Authors: Joana Ruivo Rodrigues, Manuel João Brito, Rui Pedro Faria Pais, Sílvia Carvalho
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Myeloid sarcoma (MS), granulocytic sarcoma or chloroma, is defined as a localized extramedullary mass of blasts of granulocytic lineage with or without maturation, occurring outside the bone marrow. MS can be diagnosed concurrently with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). The authors report a case of sacral MS occurring as a relapse of myeloid leukemia in a 5-year-old girl who was taken to the emergency department with radiculopathy symptoms.
Caesarean delivery of first prediagnosed COVID-19 pregnancy in Nigeria
Authors: Christian Chigozie Makwe, Kehinde Sharafadeen Okunade, Muyiwa Kayode Rotimi, Oluwayemisi Esther Ekor, Olalekan Gabriel Oyeleke, Qazeem Oladele Bello, Ayodeji Ayotunde Oluwole, Iorhen Ephraim Akase, Beatrice Nkoli Ezenwa, Iretiola Bamikeolu Fajolu, Rotimi Williams Dada, Yewande Oshodi, John Olutola Olatosi, Olabisi Oluranti Opanuga, Sunday Omilabu, Veronica Chinyere Ezeaka, Bosede Bukola Afolabi
Journal: Pan Afr Med J (2020)
Keywords: covid-19, nigeria, sars-cov-2, caesarean section, delivery, pregnancy
MeSH terms: Cesarean Section, Coronavirus Infections / diagnosis, Pneumonia, Viral / diagnosis, Pregnancy Complications, Infectious / virology, Pregnancy Outcome, Case Reports, Adult, COVID-19, Female, Humans, Nigeria, Pandemics, Pregnancy, Pregnancy Complications, Infectious / diagnosis, Prenatal Diagnosis

The COVID-19 pandemic is currently causing widespread infection and deaths around the world. Since the identification of the first case in Nigeria in February 2020, the number of confirmed cases has risen to over 9,800. Although pregnant women are not necessarily more susceptible to infection by the virus, changes to their immune system in pregnancy may be associated with more severe symptoms. Adverse maternal and perinatal outcomes have been reported among pregnant women with COVID-19 infection. However, literature is scarce on the peripartum management and pregnancy outcome of a pregnant woman with COVID-19 in sub-Saharan Africa. We report the first successful and uncomplicated caesarean delivery of a pregnant woman with COVID-19 infection in Nigeria.
Verteporfin photodynamic therapy of retinal capillary hemangioblastoma in von Hippel-Lindau disease
Authors: Harsha Bhattacharjee, Hemalata Deka, Satyen Deka, Manab Jyoti Barman, Mrinal Mazumdar, Jnanankar Medhi
Journal: Indian J Ophthalmol (2010)
MeSH terms: Hemangioblastoma / drug therapy, Photochemotherapy / methods, Photosensitizing Agents / therapeutic use, Porphyrins / therapeutic use, Retinal Neoplasms / drug therapy, von Hippel-Lindau Disease / complications, Case Reports, Adolescent, Diagnosis, Differential, Follow-Up Studies, Hemangioblastoma / complications, Hemangioblastoma / diagnosis, Humans, Male, Retinal Neoplasms / complications, Retinal Neoplasms / diagnosis, Time Factors, Verteporfin, von Hippel-Lindau Disease / diagnosis, Photosensitizing Agents, Porphyrins, Verteporfin

An 18-year-old boy presented to us with bilateral retinal hemangioblastoma and von Hippel-Lindau disease with history of cerebral capillary hemangioblastoma and embryonic cell carcinoma of left testes. The vision in the right eye was already lost with development of secondary closed angle glaucoma, optic atrophy with subsequent development of bullous keratopathy. The multiple retinal angiomatous lesions in the seeing left eye were treated with various modalities like triple freeze thaw cryopexy, focal lasers and transpupillary thermo therapy in multiple sittings over a period of almost 20 years since detection. One particular angiomatous lesion in the left eye was showing resistance to all the above mentioned modalities and was finally successfully treated with verteporfin and photodynamic therapy to achieve complete regression without any post-treatment complication and with a sustained 20/20 vision till a follow-up of 15 months.
Not always 'squame': The rare entity of follicular dendritic cell sarcoma of the tonsil presenting with cervical nodal metastases
Authors: Jaanri Brugman, Gerard de Bruyn, Komeela Naidoo, Marc Merven, Johan Opperman, Leon Janse van Rensburg
Journal: SA J Radiol (2020)
Keywords: follicular dendritic cell sarcoma, head and neck neoplasm, magnetic resonance, nodal metastasis, oropharynx, squamous cell carcinoma, tonsil
MeSH terms: Case Reports

Although squamous cell carcinoma accounts for the overwhelming majority of head and neck malignant neoplasms, extranodal follicular dendritic cell sarcoma (FDCS) of the pharyngeal region can have a similar clinical presentation. The histopathological features of this rare entity have been described and emphasised in the literature. We present the case of a 65-year-old male patient with FDCS of the tonsil to illustrate the radiologic findings of FDCS and also highlight this infrequent but salient differential diagnosis for adult head and neck neoplasia.
Poroid hidradenoma of the scalp in a US Veteran's Administration (VA) patient
Authors: M Mukit, M Mitchell, I Ortanca, N Krassilnik, X Jing
Journal: Case Reports Plast Surg Hand Surg (2021)
Keywords: scalp, veteran’s administration, poroid hidradenoma
MeSH terms: Case Reports

Poroid hidradenomas are a rare subtype of hidradenoma. A Veteran's Administration patient presented with a mobile, cystic scalp lesion. Intraoperatively the mass spontaneously ruptured. We hope clinicians will consider this entity on their differential when treating patients presenting with similar scalp lesions and intraoperative findings.
Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair
Authors: Valentina Silvestrin, Stefano Bonvini, Michele Antonello, Franco Grego, Roberto Vettor, Marco Rossato
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

After Endovascular repair of thoracic aortic aneurysm, a systemic inflammatory response, named postimplantation syndrome, can develop. This syndrome is characterized by fever, leukocytosis, and elevated CRP plasma levels and its pathogenetic mechanisms are still unknown. Although this syndrome generally resolves within few days, some patients develop a persisting severe inflammatory reaction leading to mild or severe complications. Here we describe the case of a male patient who developed postimplantation inflammatory syndrome and severe thrombocytopenia after endovascular repair of thoracic aortic aneurysm. Treatment with prednisone (50 mg/bid) for two weeks did not improve the clinical and laboratory findings. We utilized danazol, a weak androgen that has been shown to be effective in the treatment of immune and idiopathic thrombocytopenic purpura, and after 12 days of treatment with danazol (200 mg/bid), the patient improved progressively and platelet number increased up to 53,000/μL. Patients undergoing endovascular repair of thoracic aortic aneurysm should be carefully monitored for the development of postimplantation syndrome. This clinical condition is relatively common after the endovascular repair of aortic aneurysm but is rarely observed after endovascular repair of thoracic aortic aneurysms. The different known therapeutical approaches are still empiric, with reported beneficial effects with the use of NSAID, corticosteroids, and danazol.
An unusual presentation of a malignant jejunal tumor and a different management strategy
Authors: Atul Samaiya, Sv Suryanarayana Deo, Sanjay Thulkar, Sidhartha Hazarika, Sunil Kumar, Dillip K Parida, Nootan K Shukla
Journal: World J Surg Oncol (2005)

BACKGROUND: Malignant small bowel tumors are very rare and leiomyosarcoma accounts for less than 15% of the cases. Management of these tumors is challenging in view of nonspecific symptoms, unusual presentation and high incidence of metastasis. In this case report, an unusual presentation of jejunal sarcoma and management of liver metastasis with radiofrequency ablation (RFA) is discussed. CASE PRESENTATION: A 45-year-old male presented with anemia and features of small bowel obstruction. Operative findings revealed a mass lesion in jejunum with intussusception of proximal loop. Resection of bowel mass was performed. Histopathological findings were suggestive of leiomyosarcoma. After 3-years of follow-up, the patient developed recurrence in infracolic omentum and a liver metastasis. The omental mass was resected and liver lesion was managed with radiofrequency ablation. CONCLUSION: Jejunal leiomyosarcoma is a rare variety of malignant small bowel tumor and a clinical presentation with intussusception is unusual. We suggest that an aggressive management approach using a combination of surgery and a newer technique like RFA can be attempted in patients with limited metastatic spread to liver to prolong the long-term survival in a subset of patients.
Lepromatous leprosy and perianal tuberculosis: a case report and literature review
Authors: Maria Rita Parise-Fortes, Joel Carlos Lastória, Silvio Alencar Marques, Maria Stella Ayres Putinatti, Hamilton Ometto Stolf, Mariângela Ester Alencar Marques, Vidal Haddad
Journal: J Venom Anim Toxins Incl Trop Dis (2014)
Keywords: erythema nodosum leprosum, leprosy, mycobacteria, tuberculosis
MeSH terms: Case Reports

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, a microorganism that usually affects skin and nerves. Although it is usually well-controlled by multidrug therapy (MDT), the disease may be aggravated by acute inflammatory reaction episodes that cause permanent tissue damage particularly to peripheral nerves. Tuberculosis is predominantly a disease of the lungs; however, it may spread to other organs and cause an extrapulmonary infection. Both mycobacterial infections are endemic in developing countries including Brazil, and cases of coinfection have been reported in the last decade. Nevertheless, simultaneous occurrence of perianal cutaneous tuberculosis and erythema nodosum leprosum is very rare, even in countries where both mycobacterial infections are endemic.
Case report: Mechanical-electric feedback and atrial fibrillation-Revelation from the treatment of a rare atrial fibrillation caused by annular constrictive pericarditis
Authors: Dong Yi, Lei Li, Min Han, Rujie Qiu, Liang Tao, Li Liu, Chengwei Liu
Journal: Front Cardiovasc Med (2023)
Keywords: annular constrictive pericarditis, atrial fibrillation, atrioventricular groove, mechanical-electric feedback, predisposing factors
MeSH terms: Case Reports

Atrial fibrillation (AF) is one of the most common arrhythmias encountered in clinical practice. The pathophysiological mechanisms responsible for its development are complex, vary amongst individuals, and associated with predisposing factors. Here, we report a case of AF caused by annular constrictive pericarditis (ACP), which is extremely rare due to its unusual anatomical form. In our patient, AF was refractory to multiple antiarrhythmic medications; however, spontaneous conversion to sinus rhythm occurred when the ring encircling the right and left ventricular (RV and LV) cavities along the atrioventricular (AV) groove was severed. This suggests that atrial stretch due to atrial enlargement and increased left atrial (LA) pressure may contribute to the initiation and maintenance of AF. This report highlights the importance of the careful investigation of rare predisposing factors for AF using non-invasive diagnostic approaches and mechanical-electric feedback (MEF) as a pathophysiological mechanism for AF initiation and maintenance.
Satisfaction with Maternal Healthcare Services in the Ketu South Municipality, Ghana: A Qualitative Case Study
Authors: Hubert Amu, Samuel H Nyarko
Journal: Biomed Res Int (2019)
MeSH terms: Maternal Health Services, Personal Satisfaction, Qualitative Research, Adult, Attitude of Health Personnel, Female, Ghana, Humans, Perception

Background:
Women's satisfaction with maternal healthcare services is vital in quality healthcare delivery. However, the dearth of in-depth information on the issue is a challenge in Ghana. In this study, we explore women's satisfaction with maternal care services at a health facility in the Ketu South Municipality, Ghana.
Methods:
This is a qualitative study that used a purposive sampling technique to select 15 women who attended a child welfare clinic at the facility for in-depth interviews. The interviews were tape-recorded, and the results presented in quotes in accordance with the themes that emerged.
Results:
The study found that respondents were generally satisfied with the quality of maternal healthcare services provided to them. However, they were dissatisfied with drug administration procedures at the facility. Respondents generally reported poor attitudes on the part of healthcare providers at the health facility. Some logistics were also reported to be in unfavorable condition. Nonetheless, respondents generally had positive perceptions about maternal care services provided to them by the healthcare facility.
Conclusions:
Drug administration procedures and attitude of healthcare providers toward clients as well as logistics need to be improved to enhance satisfaction with services at the health facility, particularly among pregnant women and mothers.
Distal Humerus Fracture Malunion in Adults: A Case Report and a Review of the Literature
Authors: Ioannis M Stavrakakis, Zisis Ntontis, Olga Kastritsi, Constantinos Chaniotakis, Kalliopi Alpantaki, Grigorios Kastanis
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Introduction:
Neglected distal humerus fractures are rare injuries, which the orthopaedic surgeon will not deal many times in his career. We present a case of a young patient with such an injury, who was treated with a corrective osteotomy and fixation, resulting in a very good outcome. This case report highlights the importance of surgical intervention for distal humerus fracture malunion. A narrative review of the literature regarding this topic is presented as well. Case Report. A 42-year-old female patient presented to our department nine weeks after a displaced distal humerus fracture, which was treated conservatively in another institution. Ulnar nerve neuropathy, pain, and severe stiffness of the elbow were her main symptoms. Open correction of the deformity, anatomical reduction of the articular surface, and realignment of the metaphyseal level of the fracture were performed. Six months postoperation, a painless flexion-extension arc of 110° and a normal rotation of the forearm was achieved.
Conclusion:
Distal humerus fracture malunion is a challenge. The operation needed for this purpose is much more demanding, and postsurgical complications are more likely to occur as opposed to the treatment of acute fractures. If a proper surgery is performed though, a good clinical outcome can be expected.
Vaginal Endosalpingiosis Case Report: A Rare Entity Presenting as Intermenstrual Bleeding
Authors: Sara Câmara, Gustavo Mendinhos, Rosa Madureira, Amália Martins, Carlos Veríssimo
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Endosalpingiosis is a benign and rare entity whose pathophysiology remains unknown. It has been described in pelvic organs, the abdomen, or axillar lymph nodes. Its underrecognition has occasionally led to its misinterpretation for an adenocarcinoma. This case reports the treatment and follow-up of vaginal endosalpingiosis, presenting as a vaginal polyp in a premenopausal women with intermenstrual bleeding. To our knowledge this is the first reported case of vaginal endosalpingiosis and the second mucosal localization after bladder endosalpingiosis.