OpenMed/multicare-articles huggingface dataset:
Recurrence of Herpetic Keratitis after COVID-19 Vaccination: A Report of Two Cases
Authors: Ali Mahdavi Fard, Jeffrey Desilets, Sangita Patel
Journal: Case Rep Ophthalmol Med (2022)
MeSH terms: Case Reports

Background:
Recurrence of herpetic keratitis following vaccination has been documented following vaccination with the Zostavax, trivalent flu, hepatitis A, and rabies vaccines. The USFDA and WHO have acknowledged that the novel COVID-19 vaccines similarly have a risk of reactive immunologic-based inflammation, namely, myositis, pericarditis, and Guillain-Barré syndrome. Case Presentation. We present two patients with latent herpetic keratitis who experienced reactivation of keratitis within weeks of COVID-19 vaccination despite prolonged periods of prior latency. A 52-year-old healthy male with no herpes simplex virus (HSV) keratitis recurrences in two years developed visual decline and patchy stromal haze within 24-48 hours of receiving the second Pfizer-BioNTech (COVID-19 BNT162b2) vaccine. A 67-year-old female with chronic neurotrophic keratitis developed her most severe exacerbation of herpes zoster keratitis in over 10 years occurring 2-3 weeks after her first Moderna (mRNA-1273) vaccine, which was later complicated by bacterial superinfection.
Conclusions:
The COVID-19 vaccines work by generating both adaptive humoral and cellular immune responses in humans, including elevation of anti-spike neutralizing antibody titers, antigen-specific CD4+ and CD8+ T-cell responses, and increased levels of proinflammatory cytokines such as interferon gamma (IFNγ). The general activation of the T-cell-mediated immune response and proinflammatory cytokines such as IFNγ may underlie the role of the COVID vaccines in reactivation of herpetic stromal keratitis and the clinical findings in our reported cases.
Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
Authors: Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira Filho
Journal: Rev Bras Ter Intensiva (2017)
MeSH terms: Chlorine / poisoning, Noninvasive Ventilation / methods, Positive-Pressure Respiration / methods, Respiratory Distress Syndrome / therapy, Case Reports, Humans, Male, Middle Aged, Oxygen, Partial Pressure, Respiratory Distress Syndrome / chemically induced, Severity of Illness Index, Tidal Volume, Treatment Outcome, Chlorine, Oxygen

Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case. We classified severe acute respiratory distress syndrome based on an oxygen partial pressure/oxygen inspired fraction ratio <100, although the Berlin classification is limited in considering patients with severe hypoxemia managed exclusively with noninvasive ventilation. The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions.
Histological Evaluation and Management of Rare Case of Supernumerary "Ghost" Teeth
Authors: Dino Re, Elena Canciani, Corinne Poli, Laura Buccarella, Marilisa Toma, Andrea Carlo Butti, Claudia Dellavia
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Supernumerary teeth are teeth that exceed the normal dental formula. Their prevalence in the permanent dentition is 1-14% and they occur more frequently in maxilla with a sex ratio of 2 : 1 in favor of males. They are often associated with syndromes but there are examples of nonsyndromic multiple supernumerary teeth reported in the literature. CBCT is usually the best exam for radiographic diagnosis and treatment planning, because it provides 3D information about location and morphology of supernumerary teeth. This paper reports a rare case of four supernumerary teeth in a nonsyndromic 9-year-old boy. The peculiarity of this case is that two more exceeding teeth were found during surgical procedure. After extraction, all the teeth underwent a histological undecalcified processing for light microscopical examination. The two "ghost" supernumerary teeth seemed to be primordial dental germs, possibly resulting from an altered odontogenic process. After supernumerary teeth extraction, X-rays and exfoliation monitoring are recommended, since permanent retained teeth often erupt naturally or, at least, improve their condition. Radiographic follow-up is also useful in order to assess the formation of further teeth due to the hyperactivity of the dental lamina.
A lumpy bumpy stomach: The more the murkier
Authors: Binit Sureka, Siddhi Chawla, Sudeep Khera, Ashish Agarwal, Chhagan L Birda, Sandeep Bairwa
Journal: SA J Radiol (2022)
Keywords: dlbcl, malt lymphoma, computed tomography, gastric wall thickening, primary gastric lymphoma, stomach thickening
MeSH terms: Case Reports

This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review differentiating the pathological subtypes, important for patient prognostication and planning of therapy.
Mandibular Full-Arch Rehabilitation over 3 Straight Immediately Loaded Implants: 8 Years of Follow-Up
Authors: Márcio de Carvalho Formiga, Magda Nagasawa, Jamil Awad Shibli
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Mandibular full-arch restoration is a good and successful treatment option for totally edentulous patients. In the past years, several studies have described the placement of 4 to 6 implants to restore this type of case; however, an option using 3 dental implants placed in strategic and specific positions could also be an alternative. Therefore, this case report describes a full-arch rehabilitation on 3 straight, immediately loaded implants after 8 years of follow-up. The restoration presented no biological or technical complications during this follow-up period, showing that an adequate treatment plan was able to allow good results using this treatment option.
Mortality and Disability Due to Japanese Encephalitis in Elderly Adults: Evidence From an Adult Tertiary Care Center in West China
Authors: Weixi Xiong, Lu Lu, Yingfeng Xiao, Jinmei Li, Dong Zhou
Journal: Front Neurol (2019)
Keywords: japanese encephalitis, elderly, follow-up, mortality, outcome

Japanese encephalitis (JE) is the most important cause of viral encephalitis in Asia, with most cases seen in children <15 years. Recently, cases of JE in people aged >50 years have been increasingly reported, but the clinical presentation in these cases is largely unknown. We report here the first case series of elderly JE patients from an adult tertiary hospital in West China. Medical records of laboratory-confirmed JE patients diagnosed from January 2011 to September 2018 were reviewed retrospectively. Patients were grouped into the elderly (patients > 50 years old) and control groups (patients aged 14-50 years). Data regarding demographics, clinical features, and outcome at discharge were collected. Telephonic follow-up was performed with the survivors in November 2018. Of the 50 patients with laboratory-confirmed JE, 11 were aged >50 years. In the elderly group, all patients had high fever and altered sensorium, and six had symptomatic seizures. Though the key symptoms as well as the cerebrospinal fluid and neuroimaging findings were similar in both groups, the worst Glasgow coma scale score was lower in the elderly group (6.14 ± 2.27 vs. 10.54 ± 3.37, p = 0.001). Compared to the control group, the incidence of acute secondary complications, including respiratory failure requiring mechanical ventilation or tracheotomy (81.82%), hypoalbuminemia (100%), thrombocytopenia (100%), deep venous thrombosis (63.64%), septicemia (36.36%), and upper gastrointestinal bleeding (27.27%) was higher in the elderly. The median modified Rankin scale (mRS) score at discharge was lower in the elderly group than in the control group (5 vs. 3, p = 0.017), with four and two cases of death, respectively. During the average 18-month follow-up, the median mRS score was 5 in the elderly and 2 in the control group (p = 0.001). Patients >50 years old accounted for 22% of JE cases diagnosed in a tertiary adult center, with high mortality rate and long-term disability compared to younger patients. Though no particular findings were found regarding clinical features and investigations in patients >50 years, most needed intensive care. In the future, it is imperative to recognize the importance of JE in adults and to reconsider the vaccination strategy in adult residents of endemic areas, especially for those over 50 years.
Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety
Authors: Wanessa T Clemente, Luciana C Faria, Gláucia F Cota, Leandro Ricardo de Navarro Amado, Jaqueline G F Oliveira, Silvana Spíndola de Miranda, Omar Lopes Cançado Jr, Roberta M C Romanelli, Agnaldo S Lima, Luiza Bastos Frade, Fernando Lucas Jr, Marcelo Dias Sanches
Journal: Case Rep Transplant (2021)
MeSH terms: Case Reports

Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is associated with high mortality. In this context, the main strategy to minimize the risk of DD transmission is to identify high-risk donors. Despite screening recommendations, failures may result in a breakdown of safety that ends in the transmission of potentially fatal diseases. This report describes a case of DD-TB and emphasizes communication gaps that may occur between organ procurement organizations and transplant centers. Failure in reporting results, lack of exchanging information regarding recipients from the same donor, and inefficient communication between organ procurement organizations and transplant centers are lacks that may be prevented by a more efficient approach towards screening protocols and communication.
Anlotinib combined with Sintilimab is win-win cooperation for primary squamous cell carcinoma of the thyroid: A case report and literature review
Authors: Zichang Liu, Maosheng Yu, Feng Zhao, Chenfang Zhu
Journal: Front Oncol (2023)
Keywords: anlotinib, sintilimab, autoimmune liver disease, immune checkpoint inhibitors, immune-related adverse reactions, primary squamous cell carcinoma of the thyroid, tyrosine kinase inhibitors
MeSH terms: Case Reports

Background:
Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignant tumor. The incidence rate of PSCCT is less than 1%. However, the diagnosis and treatment of PSCCT are limited. Surgical resection is considered to be one of the few effective intervention methods. In this article, we reported a case of taking tyrosine kinase inhibitors (TKIs) combined with immune checkpoint inhibitors (ICIs) for PSCCT.
Case summary:
An 80-year-old male was admitted to our hospital with dyspnea, cough, wheezing, and hoarseness for a giant thyroid mass. He underwent bronchoscopy and tracheal stent implantation to alleviate the respiratory obstruction. Then he accepted right partial thyroid and right lymph node biopsy. Postoperative pathology revealed squamous cell carcinoma. Subsequently, he underwent an endoscopy to exclude upper gastrointestinal squamous cell carcinoma. Finally, he was diagnosed with PSCCT. The patient was tentatively treated with a combination of Anlotinib and Sintilimab. After two courses, the tumor volume significantly reduced in MRI images and shrank further after five courses of combined treatment. Unfortunately, the patient died of fulminant liver failure and autoimmune liver disease after 5-month-treatment.
Conclusion:
TKIs combined with ICIs may be an effective and novel way for PSCCT treatment, but immune-related complications, especially liver damage, should be cared.
Clear Cell Sarcoma of the Foot in an 18-Year-Old Female
Authors: Marwan A Albeshri, A Ashour
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We report a case of an 18-year-old female without a relevant medical history who presented with an 8-month history of a left foot mass. It started as a small nodule that progressively increased in size over time. The mass then became ulcerative with foul-smelling discharge. There was no palpable left inguinal or other lymph nodes upon physical examination. Histological examination of the biopsy confirmed a diagnosis of clear cell sarcoma. Clear cell sarcoma is a rare soft tissue neoplasm. However, early diagnosis is crucial to prevent metastasis and worsened prognosis. Clear cell sarcoma has an extremely poor prognosis once metastasis occurs, and to the best of our knowledge, only fewer than 100 cases have been reported in the literature.
Massive bilocular spinal cord intramedullary lipoma of the thoracic spine
Authors: Aikaterini Solomou, Vasileios Panagiotopoulos, Pantelis Kraniotis, Katerina Apostolopoulou, Fotis Tzortzidis
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Spinal cord intramedullary lipomas are rare, comprising 2% of intramedullary tumours. They are more often associated with spinal dysraphism, while lipomas not associated with spinal dysraphism are even less frequent, accounting for 1% of cases. The pathogenesis of spinal cord intramedullary lipomas remains unclear. MRI is the gold standard for the evaluation of these lesions. We hereby present a case of a 37-year-old male, who underwent MRI due to spastic paraparesis. MRI revealed a bilocular, spinal cord intramedullary lesion at the level of T 2-T 5, with dilatation of the spinal canal and signal characteristics compatible with lipoma. There was no clear imaging evidence of spinal dysraphism. The patient underwent surgery and diagnosis was confirmed histopathologically.
Roles of neurally adjusted ventilatory assist in improving gas exchange in a severe acute respiratory distress syndrome patient after weaning from extracorporeal membrane oxygenation: a case report
Authors: Yuya Goto, Shinshu Katayama, Atsuko Shono, Yosuke Mori, Yuya Miyazaki, Yoko Sato, Makoto Ozaki, Toru Kotani
Journal: J Intensive Care (2016)
Keywords: compliance, electrical impedance tomography, electromyography, neurally adjusted ventilatory assist, patient-ventilator synchrony, ventilation distribution
MeSH terms: Case Reports

Background:
Patient-ventilator asynchrony is a major cause of difficult weaning from mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is reported useful to improve the synchrony in patients with sustained low lung compliance. However, the role of NAVA has not been fully investigated.
Case presentation:
The patient was a 63-year-old Japanese man with acute respiratory distress syndrome secondary to respiratory infection. He was treated with extracorporeal membrane oxygenation for 7 days and survived. Dynamic compliance at withdrawal of extracorporeal membrane oxygenation decreased to 20 ml/cmH2O or less, but gas exchange was maintained by full support with assist/control mode. However, weaning from mechanical ventilation using a flow trigger failed repeatedly because of patient-ventilator asynchrony with hypercapnic acidosis during partial ventilator support despite using different types of ventilators and different trigger levels. Weaning using NAVA restored the regular respiration and stable and normal acid-base balance. Electromyographic analysis of the diaphragm clearly showed improved triggering of both the start and the end of spontaneous inspiration. Regional ventilation monitoring using electrical impedance tomography showed an increase in tidal volume and a ventilation shift to the dorsal regions during NAVA, indicating that NAVA could deliver gas flow to the dorsal regions to adjust for the magnitude of diaphragmatic excursion. NAVA was applied for 31 days, followed by partial ventilatory support with a conventional flow trigger. The patient was discharged from the intensive care unit on day 110 and has recovered enough to be able to live without a ventilatory support for 5 h per day.
Conclusion:
Our experience showed that NAVA improved not only patient-ventilator synchrony but also regional ventilation distribution in an acute respiratory distress patient with sustained low lung compliance.
Localized Breast Amyloidosis Associated with Sjörgren Syndrome
Authors: Edgar G Fischer
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Sjörgren syndrome is a systemic autoimmune disease that is rarely associated with amyloid deposits, and in most reported cases, these deposits are localized to a single organ. Amyloidosis of the breast is a rare and unexpected finding, and only 5 case series with 63 patients have been published in the past 40 years. To date, only 6 cases have been reported in which Sjörgren syndrome is associated with amyloid deposits in the breast. A 61-year-old female diagnosed with Sjörgren syndrome underwent a breast needle core biopsy for calcifications. Microscopic examination revealed amyloid deposits in the periductular basement membranes, in the walls of arteries and veins, and in the surrounding connective tissue. No malignancy was found. Clinical workup revealed the amyloid deposits to be localized to the breast and did not reveal an underlying hematolymphoid neoplasm. The association between Sjörgren syndrome and breast amyloidosis is rare, but few reports have appeared in recent years, and it may be an emerging disease association. The finding of localized amyloid in the breast and other organs should lead to a clinical workup not only for hematopoietic neoplasms but also for autoimmune diseases such as Sjörgren syndrome.
Incidental Intraoperative Diagnosis of Term Conjoined Twins: A Case Series
Authors: Ravi Kumar Shah, Arushi Jaiswal, Rehana Mushtaq, Sana Ansari, Pravin Shah, Ruby Shrestha, Sneha Shakya, Saroj Yadav, Madhu Sah, Saruna Pathak, Jagat Prasad Deep
Journal: JNMA J Nepal Med Assoc (2023)
Keywords: conjoined, monozygotic twinning, siamese twins, twins
MeSH terms: Labor, Obstetric, Twins, Conjoined / surgery, Case Reports, Female, Humans, Parity, Pregnancy, Ultrasonography, Prenatal

Conjoined twins (Siamese twins) represent the rarest form of twin pregnancy. Reported here are two rare cases of conjoined term twins presented to the department of Obstetrics and Gynaecology within 3 months. The first case, 32 years of gravida 6 parity 5 referred from periphery after full trial of labour following multi-organ dysfunction and term intrauterine dead twins. Intraoperatively it was dead conjoined thoraco-omphalopagus females. The patient died after 3 days following multiorgan dysfunction syndrome and disseminated intravascular coagulation. The second case, 22 years gravida 2 parity 1 also referred from periphery in second stage of labour with diagnosis of 39 weeks intrauterine dead twins with obstructed labour, delivered by caesarean with intraoperative conjoined dead females of thoracophagus type. Twins are high-risk pregnancy. This rare diagnosis with complications could have been prevented by regular antenatal checkups, ultrasonography performed by radiologists and early referral antenatally in labour along with multidisciplinary approach.
Keywords:
conjoined; monozygotic twinning; siamese twins; twins.
Allogeneic Hematopoietic Stem Cell Transplantation for PEX1-Related Zellweger Spectrum Disorder: A Case Report and Literature Review
Authors: Kai Chen, Na Zhang, Jing-Bo Shao, Hong Li, Jie Li, Jia-Ming Xi, Wu-Hen Xu, Hui Jiang
Journal: Front Pediatr (2021)
Keywords: curative effect, hematopoietic stem cell transplantation, infantile refsum disease, pex1, zellweger spectrum disorder
MeSH terms: Case Reports

Zellweger spectrum disorder (ZSD) is a heterogeneous group of autosomal recessive disorders characterized by a defect in peroxisome formation and attributable to mutations in the PEX gene family. Patients with ZSD have profound neurologic impairments, including seizures, severe retardation, and dysmorphic features, and poor prognosis. Currently, there is no specific, effective treatment. Here, we investigated the effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on PEX1-related ZSD. The suspected clinical proband was first diagnosed at the Department of Neurology of our hospital. The proband died soon after diagnosis, and his family was studied. We found that a brother had the same genetic alterations, and he was diagnosed with Infantile Refsum disease (IRD) as the mildest form of ZSD. We implemented treatment with allo-HSCT, at the request of the child's parents. After transplantation, we observed significant improvements in the clinical manifestations, very-long-chain fatty acids, and brain MRI. The patient has recovered well and not showed any abnormal clinical manifestations after 2 years of follow-up. We have achieved satisfactory short-term results in the treatment of ZSD-IRD with allo-HSCT. Long-term follow-up and observation will be performed to determine the long-term prognosis.
Conservative Management of Ureteral Injury Caused by a Lumbar Osteophyte
Authors: Max Fuller, Michael Brekhus
Journal: J Endourol Case Rep (2016)
Keywords: disk space extravasation, lumbar osteophyte, ureter injury
MeSH terms: Case Reports

Background: Osteophytes are bony outgrowths commonly found on lumbar vertebrae. They rarely produce complications with the most common complication being nerve entrapment, but rarer complications including aorta or inferior vena cava rupture, superior mesenteric artery syndrome, compression of the iliopsoas muscle, and cerebrospinal fluid leaks have been described. Rare cases affecting the ureter resulting in ureteral colic or extravasation of urine have been described. Case Presentation: We describe a case in which a lumbar osteophyte bridging the L4 and L5 disks was encircling the ureter and minor trauma caused a ureteral injury, resulting in urine extravasation into the L4 and L5 disks space and the retroperitoneum. Owing to the comorbidities of this patient, this case was treated conservatively with stenting and the patient has suffered no further complications. Conclusion: This is a rare complication of a lumbar osteophyte but should be considered as a potential cause of ureter injury. Treatment should be individualized by patient preference and comorbidities, as some patients would elect to pursue more aggressive therapy whereas others would incline for conservative measures.