OpenMed/multicare-articles huggingface dataset:
West Nile Virus Encephalitis in a Patient with Neuroendocrine Carcinoma
Authors: Romina Deldar, Derek Thomas, Anna Maria Storniolo
Journal: Case Rep Oncol Med (2016)

Importance. Oftentimes, when patients with metastatic cancer present with acute encephalopathy, it is suspected to be secondary to their underlying malignancy. However, there are multiple causes of delirium such as central nervous system (CNS) infections, electrolyte abnormalities, and drug adverse reactions. Because West Nile Virus (WNV) neuroinvasive disease has a high mortality rate in immunosuppressed patients, a high index of suspicion is required in patients who present with fever, altered mental status, and other neurological symptoms. Observations. Our case report details a single patient with brain metastases who presented with unexplained fever, encephalopathy, and new-onset tremors. Initially, it was assumed that his symptoms were due to his underlying malignancy or seizures. However, because his unexplained fevers persisted, lumbar puncture was pursued. Cerebrospinal fluid analysis included WNV polymerase chain reaction and serologies were ordered which eventually led to diagnosis of WNV encephalitis. Conclusions and Relevance. Patients with metastatic cancer who present with encephalopathy are often evaluated with assumption that malignancy is the underlying etiology. This can lead to delays in diagnosis and possible mistreatment. Our case highlights the importance of maintaining a broad differential diagnosis and an important diagnostic consideration of WNV encephalitis in patients with cancer.
Primary adenocarcinoma of the upper oesophagus
Authors: Yash P Verma, Ashok K Chauhan, Rajiv Sen
Journal: Ecancermedicalscience (2013)
Keywords: malignancy, middle oesophagus, oesophageal adenocarcinoma, radiotherapy, rare
MeSH terms: Case Reports

Upper oesophageal adenocarcinoma is a rare malignancy that occurs in the ectopic gastric mucosa, in the upper part of the oesophagus. Only 29 cases so far have been reported. We report the 30th case in a 50-year-old Asian female presenting with difficulty in swallowing.
Simultaneous Accessory Pathway and AV Node Mechanical Block
Authors: Daniel Garofalo, Alfonso Gomez Gallanti, David Filgueiras Rama, Rafael Peinado Peinado
Journal: Indian Pacing Electrophysiol J (2013)
Keywords: accessory pathway, atrioventricular node, block, cryoablation, orthodromic reciprocating tachycardia

We report a clinical case of a 22-year-old female referred to our institution due to palpitations and preexcitation. Her ECG suggested a right superior paraseptal accessory pathway (AP), which was localised during the electrophysiological study at the superior paraseptal region in close proximity to the His recordings. Reproducible orthodromic reciprocating tachycardia was induced by atrial pacing with extrastimuli. Cryo-mapping performed in the area of earliest atrial activation was not able to terminate the tachycardia. A second attempt, slightly more posterior, caused mechanical block of the AP, which rendered the tachycardia non-inducible. More pressure with the ablation catheter determined a Wenckebach type supra-hisian AV block, which was transient but reproducible. Given this finding no ablation was done. Simultaneous block to the AP and the atrioventricular node has rarely been reported using radiofrequency energy. However, to our knowledge this phenomenon has not been previously reported in large series using cryo-thermal energy.
Case Report: Retroaortic Innominate Vein With Supracardiac Total Anomalous Pulmonary Venous Connection
Authors: Toshinobu Ifuku, Ayako Kuraoka, Tomoko Ohhira, Koichi Sagawa, Toshihide Nakano, Hideaki Kado
Journal: Front Pediatr (2021)
Keywords: cardiac surgery, computed tomography, congenital heart disease, echocardiogram, retroaortic innominate vein, total anomalous pulmonary venous connection
MeSH terms: Case Reports

A retroaortic innominate vein (RAIV) is a rare anomaly that passes posterior to the ascending aorta to join the superior vena cava and is associated with congenital heart disease (CHD). The RAIV and normal left innominate vein (LIV) rarely duplicate. The etiology of the RAIV and its relationship with CHD remains unknown. We report a case involving a 1-month-old baby girl with RAIV and supracardiac total anomalous pulmonary venous connection (TAPVC). Transthoracic echocardiogram demonstrated a pulmonary venous confluence (CPV) posterior to the left atrium, an abnormal vertical vein (VV) that originated from the CPV, and a normally positioned LIV. Three-dimensional cardiac computed tomography revealed the VV and RAIV to which it merged. This is the first reported case of a combination of RAIV and isolated TAPVC. We speculate that the VV is connected to the CPV during fetal life, thus leaving the RAIV behind. The RAIV may be detected in various forms with the development of new diagnostic imaging methods. Although a RAIV itself does not require treatment, establishing a correct diagnosis before invasive tests and procedures are performed can help prevent unexpected complications.
Case Report: A Review of the Literature on Spinal Intradural Hemangiopericytoma With Spinal Cord Infiltration and a Case Report
Authors: Liu Chunyang, Zhu Huiqin, Sun Mo, Wang Yubo, Zhang Xianfeng
Journal: Front Surg (2020)
Keywords: hemangiopericytoma, intramedullary, intraspinal canal, spinal tumor, treatment
MeSH terms: Case Reports

Purpose: Primary spinal intradural hemangiopericytoma (HPC) with spinal cord infiltration is rare. The purposes of this study were to investigate the clinical features of intradural HPC with spinal cord infiltration and to explore the related factors affecting tumor recurrence. Methods: We report a case of intramedullary HPC with intramedullary infiltration of the thoracic spine. The relevant literature was searched for with PubMed, and clinical data were extracted from the included studies. Clinical patient data were described and statistically analyzed. Then, Kaplan-Meier (KM) curves were used to describe the relapse-free survival (RFS) of patients in different groups, and the log-rank test was used for evaluation. Results: A total of 11 cases of spinal intradural HPC with spinal cord infiltration were included (including the case described in this report). Further data analysis showed that sex (P = 0.249), age (P = 0.876), tumor location (P = 0.524), and postoperative radiotherapy (P = 0.12) had no significant influence on RFS. The range of tumor resection (P = 0.004) and the WHO grade (P = 0.014) significantly affect the patient RFS. Conclusion: RFS was higher in patients with total tumor resection than in patients with subtotal tumor resection. The patients with lower WHO grade have better RFS. Total tumor resection is the primary objective of surgical treatment of spinal intradural HPC with spinal infiltration. Long-term postoperative follow-up is considered necessary.
Atypical Presentation of Kimura's Disease in a Male Patient: A Case Report and Review of Literature
Authors: Zahra A Natsha, Islam A Hamarsheh, Rawan S Utt, Bassam Abu Alrob, Adnan A Wahdan
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Kimura's disease (KD) is a rare chronic inflammatory condition of unknown aetiology. It is a benign disease that might mimic a neoplastic process. It primarily affects the head and neck region, presenting as deep subcutaneous masses, and is often accompanied by triad regional lymphadenopathy, salivary gland involvement, and high serum immunoglobulin E (IgE) levels. Here, we report the second documented case of KD in Palestine diagnosed in a 28-year-old male patient who presented with lymphadenopathy and increased serum immunoglobulin E and G (IgE and IgG) associated with intermittent abdominal pain, generalised fatigue, hepatomegaly, cardiomyopathy, reactive airway disease, peripheral vasculopathy, peripheral neuropathy, and focal segmental glomerulosclerosis. The patient was managed with steroids and an immunosuppressant (Azathioprine) with a moderate response for two years. In 2021, treatment with Mycophenolate Mofetil was initiated, which was more effective than Azathioprine.
Report of a Misleading Case of the Superior Mesenteric Artery Syndrome
Authors: Amir Mohammad Salehi, Hossain Salehi, Maryam Hasanzarrini, Elham Khanlarzadeh
Journal: Case Rep Gastrointest Med (2022)
MeSH terms: Case Reports

Superior mesenteric artery syndrome (SMAS), which is also known as the cast syndrome, Wilkie's syndrome, or chronic duodenal ileus, is a specific type of duodenal obstruction characterized by the obstruction of the inferior part of the duodenum due to its compression between the superior mesenteric artery (SMA) and the aorta. This problem is usually resulting from loss of the mesenteric fat pad. The present report describes a case of SMAS who was an 18-year-old woman presenting with weight loss and postprandial pain. The patient was initially diagnosed with Helicobacter pylori infection and underwent antibiotic therapy. However, the related symptoms did not resolve. Finally, she was ordered a CT scan, which led to the diagnosis of SMAS.
Maternal Mortality: 10 Year Experience of a Tertiary Center in Turkey
Authors: Erdem Fadiloglu, Canan Unal, Atakan Tanacan, Serpil Ocal, Banu Kilicaslan, Seda Banu Akinci, Arzu Topeli, M Sinan Beksac
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

We retrospectively evaluated five maternal mortality cases that occurred in our institution within the last 10 years. Rate of maternal mortality was 24.5 per 100000 live births. Maternal mortality causes were cardiopulmonary failure secondary to veno-occlusive disease, septic shock secondary to osteosarcoma, pulmonary thromboembolism secondary to metastatic breast cancer, septic shock secondary to cholecystitis, and postpartum hemorrhage secondary to Niemann-Pick disease. Four out of five cases were evaluated as indirect maternal mortality cases. Three out of five cases ended up with a healthy newborn, while other cases ended up with abortus and postpartum exitus.
Giant choledochal cyst type 4A: a surgical challenge
Authors: Sakthivel Harikrishnan, Servarayan Murugesan Chandramohan, Apsara Chandramohan
Journal: Pan Afr Med J (2020)
Keywords: choledochal cyst, choledochal cyst type 4a, giant choledochal cyst
MeSH terms: Anastomosis, Roux-en-Y / methods, Cholecystectomy / methods, Choledochal Cyst / surgery, Case Reports, Adult, Choledochal Cyst / diagnosis, Female, Hepatic Duct, Common / surgery, Humans, Jejunostomy / methods

Choledochal cysts are rare congenital anomalies of the biliary tract. There are 5 subtypes of choledochal cyst and in adults type 4 is the most common. Choledochal cyst rarely exceeds the size of 6cm in the reported literature. Only a handful of cases of giant choledochal cysts are reported in the literature. Here we report a case of a 33-year-old lady who presented with a huge abdominal mass and on evaluation was found to have a giant choledochal cyst type 4A. The patient underwent excision of the extrahepatic hugely dilated choledochal cyst with cholecystectomy and reconstruction was done by Roux-en-Y hepaticojejunostomy to the confluence of the right and left hepatic duct at the hilum.
Case Report: Fatal Complications of BK Virus-Hemorrhagic Cystitis and Severe Cytokine Release Syndrome Following BK Virus-Specific T-Cells
Authors: Elizabeth M Holland, Corina Gonzalez, Elliot Levy, Vladimir A Valera, Heather Chalfin, Jacquelyn Klicka-Skeels, Bonnie Yates, David E Kleiner, Colleen Hadigan, Hema Dave, Haneen Shalabi, Dennis D Hickstein, Helen C Su, Michael Grimley, Alexandra F Freeman, Nirali N Shah
Journal: Front Immunol (2021)
Keywords: bk virus associated hemorrhagic cystitis, dock8 immunodeficiency syndrome, hsct = hematopoietic stem cell transplant, cytokine release syndrome, virus specific t-cells
MeSH terms: Adoptive Transfer / adverse effects, BK Virus / pathogenicity, Cystitis / therapy, Cytokine Release Syndrome / immunology, Hematopoietic Stem Cell Transplantation / adverse effects, Hemorrhage / therapy, Polyomavirus Infections / therapy, T-Lymphocytes / transplantation, Tumor Virus Infections / therapy, Case Reports, Research Support, N.I.H., Intramural, Adolescent, BK Virus / immunology, Cystitis / diagnosis, Cystitis / immunology, Cystitis / virology, Cytokine Release Syndrome / diagnosis, Fatal Outcome, Hemorrhage / diagnosis, Hemorrhage / immunology, Hemorrhage / virology, Humans, Male, Multiple Organ Failure / etiology, Polyomavirus Infections / diagnosis, Polyomavirus Infections / immunology, Polyomavirus Infections / virology, Severity of Illness Index, T-Lymphocytes / immunology, T-Lymphocytes / virology, Treatment Outcome, Tumor Virus Infections / diagnosis, Tumor Virus Infections / immunology, Tumor Virus Infections / virology

BK virus (BKV)-hemorrhagic cystitis (HC) is a well-known and rarely fatal complication of hematopoietic stem cell transplantation (HSCT). Treatment for BKV-HC is limited, but virus-specific T-cells (VST) represent a promising therapeutic option feasible for use posttransplant. We report on the case of a 16-year-old male with dedicator of cytokinesis 8 (DOCK8) deficiency who underwent haploidentical HSCT complicated by severe BKV-HC, catastrophic renal hemorrhage, and VST-associated cytokine release syndrome (CRS). Gross hematuria refractory to multiple interventions began with initiation of posttransplant cyclophosphamide (PT/Cy). Complete left renal arterial embolization (day +43) was ultimately indicated to control intractable renal hemorrhage. Subsequent infusion of anti-BK VSTs was complicated by CRS and progressive multiorgan failure, with postmortem analysis confirming diagnosis of hepatic sinusoidal obstruction syndrome (SOS). This case illustrates opportunities for improvement in the management of severe BKV-HC posttransplant while highlighting rare and potentially life-threatening complications of BKV-HC and VST therapy.
Bilateral pulmonary embolism in a patient with pulmonary tuberculosis: a rare association in Yaoundé, Cameroon
Authors: Nkoke Clovis Ekukwe, Luchuo Engelbert Bain, Ahmadou Musa Jingi, Kotta Sylvia, Pierre Mintom, Alain Menanga
Journal: Pan Afr Med J (2014)
Keywords: pulmonary embolism, cardiomegaly, dyspnea, pulmonary tuberculosis
MeSH terms: Mycobacterium tuberculosis / isolation & purification, Pulmonary Embolism / microbiology, Tuberculosis, Pulmonary / complications, Case Reports, Anticoagulants / therapeutic use, Antitubercular Agents / therapeutic use, Cameroon, Dyspnea / etiology, Echocardiography, Humans, Male, Middle Aged, Pulmonary Embolism / diagnosis, Pulmonary Embolism / pathology, Tomography, X-Ray Computed, Treatment Outcome, Tuberculosis, Pulmonary / diagnosis, Anticoagulants, Antitubercular Agents

Pulmonary embolism is a complication of pulmonary tuberculosis that has received little emphasis in the literature. We describe a 52 year old male, with no risk factors for thromboembolic disease referred to our service for an in depth clinical review for cardiomegaly and dyspnea on exertion. Echocardiography and CT scans revealed dilated heart cavities and bilateral proximal pulmonary emboli respectively and a cavitation in the apical lobe of the right lung. Bronchial aspirate and culture revealed the presence of mycobacterium tuberculosis. There was no evidence of malignancy. Elsewhere, a clinical review and a lower limb ultrasound showed no evidence of deep venous thrombosis. Clinical course on anti - tuberculosis and anti - coagulant therapies was remarkably favorable. Clinicians need to be conscious of the risk of developing thromboembolic disease in patients treated for tuberculosis, in especially high prevalence settings like ours.
Case Report: Seaweed Bezoar Masquerading as a Malignant Obstruction
Authors: E C Abboud, B Babic
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Bezoars represent a rare cause of small bowel obstruction (SBO). Nonoperative management of bezoars includes use of endoscopy with mechanical or chemical dissolution methods. When obstruction persists, surgical intervention becomes necessary. Here, we present the case of an Asian woman with a SBO secondary to a phytobezoar masquerading as a malignancy. She presented with two days of acute-on-chronic abdominal pain that started after eating seaweed. Initial computed tomography (CT) scan showed a SBO with a jejunal transition point and ill-defined liver lesions, worrisome for a malignant obstruction with liver metastases. Further imaging, however, showed the resolution of these artifacts. Subsequent laparotomy revealed a small bowel loop with copious obstructing seaweed. A distal stricture was palpated, and the involved segment was resected. Intraoperative liver ultrasound was negative, and final pathology revealed benign small intestine with a mild stricture. Given the rarity of bezoar-related obstructions, the diagnosis is often delayed particularly when confounding factors exist such as our patient's concomitant hepatic findings. Contrast-enhanced CT has a high sensitivity but a lower specificity in identifying bezoars. A high index of suspicion is therefore necessary especially when managing higher risk patients.
Cystoisospora belli Gallbladder Infection in a Liver Transplant Donor
Authors: Clifford Akateh, Christina A Arnold, Dathe Benissan-Messan, Anthony Michaels, Sylvester M Black
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Introduction:

Cystoisospora belli (previously Isospora belli) is a parasitic protozoan of the human gastrointestinal system. It rarely causes symptoms in immunocompetent hosts but can cause severe diarrhea in immunocompromised patients, with a rate of recurrence and risk of dissemination. Gallbladder infections are however rare. The treatment of choice for symptomatic patients is a 7-10-day course of trimethoprim-sulfamethoxazole.
Case:
In this case, we report on an incidental finding of Cystoisospora belli organisms in the donor gallbladder following a transplant cholecystectomy. There was no report of symptoms in the donor. The recipient was treated with a course of trimethoprim-sulfamethoxazole, without evidence of cystoisosporiasis. Given the risk of recurrence in immunocompromised hosts, the patient will continue to be monitored for reactivation in the future.
Conclusion:
Despite advances in transplant protocols and screening, disease transmission from the donor to recipient still occurs in about 0.2% of all organ transplants. With the increased use of organs from drug overdose victims and other high-risk donors, practitioners (including pathologists, hepatologists, and surgeons) must maintain a high index of suspicion for such potentially harmful organisms.
Incidental radiographic discovery of a screw in a primary molar: an unusual case report in a 6 year old child
Authors: Farhin Katge, Sajjad Mithiborwala, Thejokrishna Pammi
Journal: Case Rep Dent (2013)

Dentists often find foreign bodies in the primary dentition of children who habitually place objects in their mouths. The objects are frequently embedded in exposures that result from carious or traumatic lesions or from endodontic procedures that have been left open for drainage. Such bodies are often detected on routine radiographs and, less frequently, during clinical examination. We report a case of a 6-year-old boy who had inadvertently embedded a screw in his mandibular right first primary molar and had forgotten about it until it became symptomatic. The screw was impacted in the exposed pulp chamber due to a large carious lesion in the affected molar. This case report considers the possible medical and dental consequences of placing foreign bodies in the mouth.
Bile duct carcinoma associated with congenital biliary dilatation in a 16-year-old female: a case report and literature review
Authors: Hideki Izumi, Naoki Yazawa, Daisuke Furukawa, Yoshihito Masuoka, Misuzu Yamada, Taro Mashiko, Yohei Kawashima, Masami Ogawa, Yoshiaki Kawaguchi, Tetsuya Mine, Kenichi Hirabayashi, Toshio Nakagohri
Journal: Surg Case Rep (2016)
Keywords: bile duct carcinoma, congenital biliary dilatation, pancreaticobiliary maljunction, pancreaticoduodenectomy

We encountered a very rare case of bile duct carcinoma associated with congenital biliary dilatation (CBD) in a 16-year-old female who was admitted to our hospital because of right upper abdominal pain and vomiting. Abdominal computed tomography demonstrated a cystic dilatation of the common bile duct measuring 7 cm in diameter and two enhanced tumors 4 cm in diameter located in the inferior bile duct and middle bile duct. Magnetic resonance cholangiopancreatography clearly demonstrated a cystic dilatation of the extrahepatic bile duct (Todani's CBD classification: type 4-A). Endoscopic retrograde cholangiopancreatography also revealed two tumors. Biopsy results of one of the tumors confirmed adenocarcinoma. Excision of the perihilar bile duct and subtotal stomach-preserving pancreaticoduodenectomy with dissection of the major lymph nodes were performed. A postoperative histopathologic examination revealed a well-differentiated tubular adenocarcinoma, which remained within the mucosal layer, and no lymph node metastasis was found. The postoperative course was uneventful, and the patient was discharged 10 days after surgery and has remained disease-free for 21 months.
Clostridium perfringens Septicemia and a Bleeding Ulcer of a Jejunal Interposition: A Case Report and Short Review of the Literature
Authors: W Wild, F Bormann, H Sweiti, N Tamimi, D Pichulek, M Divo, P Dörr, M Schwarzbach
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Introduction:
We report a case of Clostridium perfringens septicemia in a patient presenting with a bleeding ulcer of a jejunal interposition.
Case presentation:
An 81-year-old female patient was acutely admitted to our hospital due to hematemesis and melena. She had a history of metastatic gastrointestinal stromal tumor, for which she was receiving second line treatment with sunitinib. She had also undergone a Merendino procedure 4 years prior to presentation. The patient underwent emergency gastroscopy, which revealed a bleeding ulcer in the jejunal interposition. Despite initial endoscopic control of the bleeding and transfusion of blood products, the hemoglobin level continued to drop, and the patient was treated for an assumed hemolytic transfusion reaction. The patient died 3 days following admission, and the results of blood cultures later confirmed a Clostridium perfringens septicemia. The postmortem examination revealed a diffuse spread of Clostridium perfringens to multiple organs.
Conclusion:
This case is a reminder of the importance of considering septicemia, particularly in association with Clostridium perfringens, as a potential cause of hemolysis. It also demonstrates the extent of organ involvement in a case of diffuse clostridial myonecrosis.