OpenMed/multicare-articles huggingface dataset:
Florid plasmacytosis in a case of acute myeloid leukemia: A diagnostic dilemma
Authors: Aruna Rangan, Bhavna Arora, Pooja Rangan, Tina Dadu
Journal: Indian J Med Paediatr Oncol (2010)
Keywords: acute myeloid leukemia, myeloma, plasmacytosis
MeSH terms: Case Reports

The association of acute myeloid leukemia (AML) with plasmacytosis is a known, although rare event. There are very few case reports documenting an increase in the number of plasma cells at the time of AML diagnosis. Here, we present the case of a 65-year-old male diagnosed as acute myelomonocytic leukemia with exuberant plasmacytosis, which posed a difficulty in diagnosis. Paracrine interleukin-6 production by leukemic blast cells is thought to contribute to this associated reactive plasma cell proliferation.
Multisystem Inflammatory Syndrome With Complete Kawasaki Disease Features Associated With SARS-CoV-2 Infection in a Young Adult. A Case Report
Authors: Elie Cogan, Pierre Foulon, Olivier Cappeliez, Nicole Dolle, Gaëlle Vanfraechem, Daniel De Backer
Journal: Front Med (Lausanne) (2020)
Keywords: covid-19, kawasaki disease, mis-c, sars-cov-2, case report, serology, tocilizumab
MeSH terms: Case Reports

A severe multisystem inflammatory syndrome associated with Kawasaki disease manifestations (MIS-C) has been recently reported in children with signs of recent infection with SARS-CoV-2. We here reported the case of a young adult woman who presented the complete manifestations of Kawasaki disease associated with a severe myocarditis, acute respiratory distress syndrome and hemodynamic instability a few weeks after a transient anosmia. The detection of specific antibodies to SARS-CoV-2 in the absence of detection of the virus suggested that the syndrome was the result of a delayed immune response to a recent COVID-19 infection. A combined treatment with colchicine, tocilizumab, high dose immunoglobulins, and methylprednisolone allowed to control the inflammatory process and to limit the development of coronary aneurysm. The patient recovered without sequelae. This case emphasized the importance of SARS-CoV-2 serology for the diagnosis of delayed immune complications of COVID-19. Clinicians caring for adult patients must be aware that not only children but also young adults can be affected by a multisystem inflammatory syndrome with KD features associated with COVID-19.
Bacterial co-infections and superinfections in COVID-19: a case report of right heart infective endocarditis and literature review
Authors: Rime Benmalek, Hanane Mechal, Hamza Choukrallah, Anas Maaroufi, El Ghali Benouna, Rachida Habbal, Ouissal Aissaoui, Anass Erragh, Afak Nssiri, Rachid AlHarrar
Journal: Pan Afr Med J (2020)
Keywords: covid-19, co-infections, infective endocarditis, multidisciplinary management
MeSH terms: COVID-19 / complications, Endocarditis, Bacterial / diagnosis, Respiratory Distress Syndrome / therapy, Superinfection / diagnosis, Case Reports, Review, Aged, COVID-19 / therapy, Catheterization, Central Venous / adverse effects, Coinfection, Echocardiography, Endocarditis, Bacterial / therapy, Female, Humans, Intensive Care Units, Intubation, Intratracheal, Respiration, Artificial, Respiratory Distress Syndrome / virology, Superinfection / therapy

Coronavirus disease of 2019 (COVID-19) is a worldwide pandemic with significant morbidity and mortality. Patients with severe forms of the disease are usually managed in the Intensive Care Unit (ICU), where they can develop secondary infections particularly bacterial, favored by prolonged intubation and central venous catheterization (CVC), hence increasing the disease's mortality. Infectious endocarditis (IE) represents a rare and severe cardiovascular complication in patients with CVC. We report the case of a patient admitted to the ICU for an acute respiratory distress syndrome (ARDS) due to COVID19. Her management included intubation and mechanical ventilation, CVC and treatment with Hydroxychloroquine and azithromycin, and echocardiography findings were unremarkable. On the 10th day of onset, the patient developed septic shock and both echocardiography and blood cultures were in favor of A positive diagnosis of tricuspid valve infective endocarditis, accordingly to the modified Duke criteria. Specific treatment was started with a good clinical evolution. Our case outlines the difficulty of management of bacterial co-infections and superinfections in COVID-19 ICU patients, and particularly rare infections such as right-heart IE, which usually require a multidisciplinary approach and coordination between intensivits, cardiologists and infectiologists.
Recurrent Left Atrial Myxoma: The Significance of Active Surveillance
Authors: Oluwaremilekun Tolu-Akinnawo, Rabira R Dufera, Nagendra Ramanna
Journal: Cureus (2023)
Keywords: active, atrial myxoma, left atrial mass, surveillance, transthoracic echocardiogram
MeSH terms: Case Reports

Cardiac myxoma recurrence is uncommon following surgical resection. Recurrence is about 2-3% in familial cases; however, recurrence is uncommon in sporadic cases. Most of the recurrences will occur during the first three to four years. Ten percent of myxomas are of the inherited autosomal dominant disorder called Carney's complex, while the rest appear sporadic. We are reporting a nonfamilial case of atrial myxoma, recurring rapidly seven years after resection of the initial left atrial myxoma with a pathologically proven clear margin and no malignant transformation. Cardiac neoplasms are rare and occur less commonly than metastatic disease of the heart. Congestive heart failure symptoms and thromboembolism account for nearly half of the presenting signs and symptoms. The initial presentation of our case was an embolic phenomenon, presenting with a stroke. The patient subsequently underwent resection of the mass, with pathology confirming the complete excision of the myxoma with a clear margin and no evidence of malignant transformation. Our patient was closely followed up in the clinic on annual transthoracic echocardiography surveillance, with a recurrence noted on surveillance echocardiography in 2021 (seven years after initial diagnosis) despite the patient being asymptomatic. This case illustrates transthoracic echocardiography as the mainstay of detection of recurrent left atrial myxoma; however, it also asks the question of how often patients need to be screened for recurrence of left atrial myxoma and for how long they need to have surveillance echocardiography. Clinical presentation and transesophageal echocardiographic views are extremely helpful in sharpening the accuracy of the diagnosis.
Laparoscopic Management of Chylous Leakage Using a Direct Lymph Node Injection with Methylene Blue as a Leakage Point Location Strategy in a Patient with Retroperitoneal Extragonadal Seminoma
Authors: José Daniel Subiela, Josep Balañà, Amad Abu-SubohAbadia, Julio Francisco Calderón, Asier Mercadé, José Salvador Bayarri, Antonio Rosales Bordes
Journal: J Endourol Case Rep (2018)
Keywords: chyle leakage, extragonadal seminoma, intranodal lymphangiography, laparoscopic management
MeSH terms: Case Reports

Background: The first-line treatment in cases of chylous leakage is conservative, and operation should be considered only in patients who fail to respond to this treatment. The main clinical concern is the difficulty of intraoperative localization of the site of leakage that can affect surgical outcome. Case Presentation: A 33-year-old man presented with a 4-month history of abdominal pain and weight loss. CT scan revealed enlarged retroperitoneal lymph nodes. Retroperitoneal lymph node biopsy was performed owing to the suspicion of lymphoproliferative disease, with a pathological result of nonspecific adenitis. Because of persistence of pain, an abdominal CT scan showed a large left retroperitoneal fluid collection that was found to be compatible with chyle after drainage. Conservative treatment was established, but because of its failure, surgical management was attempted by the laparoscopic approach. Intraoperative direct lymph node injection of methylene blue was used as a leakage point location strategy that allows selective ligation of the site of leakage. Thereafter a gradual reduction in chyle output to zero was observed. Conclusion: The laparoscopic approach could be a feasible and successful method for the management of chyle leakage in patients refractory to conservative treatment. Intraoperative direct lymph node injection of methylene blue could be a useful technique to facilitate detection of the site of leakage during operation.
Urgent Airway Management and Postoperative Complications in a Patient with Trichorhinophalangeal Syndrome
Authors: Sarvie Esmaeilzadeh, Ryan S D'Souza, Thomas M Stewart, Matthew A Sexton
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

Trichorhinophalangeal syndrome (TRPS) is a genetic disorder that may pose anesthetic challenges. We present a case of airway management for urgent surgery in a 56-year-old female with TRPS and difficult airway (macroglossia, narrow glottic opening, and hypoplastic epiglottis). Intubation was successful with video laryngoscopy using a size 2.5 pediatric blade and size 5.0 endotracheal tube. During emergence, she experienced bronchospasm and persistent urosepsis, necessitating intensive care unit (ICU) admission. Her pulmonary reserve was hindered by a Morgagni hernia causing lung compression. Our case demonstrates challenges in TRPS including challenging airway, decreased pulmonary reserve, and joint laxity introducing potential for spinal cord injury.
A Predictable Aesthetic Rehabilitation of Deciduous Anterior Teeth in Early Childhood Caries
Authors: Priyanka Agarwal, Rashmi Nayak, Ghayathri Elangovan
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Aesthetic dentistry plays a significant role not only in adults but also in pediatric patients. However, a pediatric dentist is faced with the dual problem of satisfying the aesthetic expectations of the patient and parents as well as managing the pediatric patient. In the present era, there are numerous restorative techniques that can be applied to different clinical scenarios. However, we have to choose the technique that best suits our patient, not only biologically but also aesthetically, psychologically, functionally, and financially. The following paper presents the clinical sequence of rehabilitation of severely carious maxillary anterior teeth from left to right lateral incisors in a child with early childhood caries. Severely carious anterior teeth were endodontically treated. The central incisors were restored with gamma loop posts which is mainly used for pediatric patients in endodontically treated teeth. Lateral incisors were treated with Ribbond polyethylene fibre posts. Following this, all the teeth were restored aesthetically with free-hand composite buildup after proper shade selection. The occlusion was restored, and the restorations were finished and polished.
Spontaneous regression of pulmonary metastases from breast angiosarcoma
Authors: S W Kim, J Wylie
Journal: Sarcoma (2008)
MeSH terms: Case Reports

Spontaneous regression of cancer is a rare phenomenon. We present a rare case of pulmonary metastases in a 72-year-old woman with metastatic breast angiosarcoma. She was diagnosed with a breast angiosarcoma in 2005 and underwent a total mastectomy and postoperative radiotherapy. Unfortunately, a year later she was found to have multiple lung and scalp metastases but in a view of her poor general fitness, she was not a candidate for chemotherapy and was kept on regular followup. Despite the absence of any treatment, the followup chest X-ray showed a significant reduction in the number and size of lung nodules and her scalp lesions regressed completely. Seven months after the diagnosis of metastatic disease, the nodules in her scalp remain controlled.
Case report: Successful outcome of treatment using rituximab in an adult patient with refractory minimal change disease and β-thalassemia complicating autoimmune hemolytic anemia
Authors: Jing Zhuang, Zhigang Zhao, Changrong Zhang, Xue Song, Chen Lu, Xuefei Tian, Hong Jiang
Journal: Front Med (Lausanne) (2022)
Keywords: autoimmune hemolytic anemia, minimal change disease, refractory nephrotic syndrome, rituximab, β-thalassemia
MeSH terms: Case Reports

Minimal change disease (MCD) is one of the common causes of idiopathic nephrotic syndrome (INS), accounting for 10-20% of INS in adults. Glucocorticoids are the most commonly used and effective drugs in the treatment of MCD, but there is still a proportion of adult patients with MCD who are characterized by glucocorticoid resistance, glucocorticoid dependence, and frequent relapse, which are defined as refractory nephrotic syndrome. Glucocorticoid combination with immunosuppressants is frequently used in patients with refractory nephrotic syndrome, and patients concerned about adverse effects caused by long-term high-dose glucocorticoid therapy. Recent studies have suggested that Rituximab (RTX), a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20, combined with a small or medium dose of glucocorticoid has a beneficial effect with less adverse effects on adult patients with refractory MCD. β-thalassemia is an inherited hemoglobulin disorder caused by the mutation of genes that encode β-globin and results in ineffective erythropoiesis. We here report a case of an adult patient with refractory MCD complicated with β-thalassemia minor accompanied by autoimmune hemolytic anemia (AIHA). MCD relapsed several times despite treatment using glucocorticoid combined with or without different immunosuppressive agent regimens. The β-thalassemia minor was caused by heterozygosity for a 4-base deletion mutation [codons 41/42 (-TTCT) BETA0] of the β-globin gene. After the administration of RTX, MCD achieved clinical complete remission, and the anemia due to mild β-thalassemia recovered to normal as well. The disease situation remained stable during 36 months of follow-up. These findings suggest that RTX may contribute to the improvement of refractory MCD and anemia in β-thalassemia minor accompanied by AIHA.
Congenital fistula of the fourth branchial arch: Report of case with long-lasting misdiagnosis
Authors: Thomas M Stadler, Grégoire B Morand, Stephan Schmid, Martina A Broglie
Journal: Clin Case Rep (2019)
Keywords: branchial cleft anomalies, craniofacial abnormalities, diagnostic errors, fistula
MeSH terms: Case Reports

Fourth branchial arch anomalies are extremely rare. The anatomic course of the fourth branchial arch fistula usually determines the delay in diagnosis. High clinical suspicion should be given to reoccurring neck infections in infants and young adults. Diagnosis is obtained by direct laryngoscopy.
Perampanel Improves Cortical Myoclonus and Disability in Progressive Myoclonic Epilepsies: A Case Series and a Systematic Review of the Literature
Authors: Giovanni Assenza, Cristofaro Nocerino, Mario Tombini, Giancarlo Di Gennaro, Alfredo D'Aniello, Alberto Verrotti, Alfonso Marrelli, Lorenzo Ricci, Jacopo Lanzone, Vincenzo Di Lazzaro, Leonilda Bilo, Antonietta Coppola
Journal: Front Neurol (2021)
Keywords: disability, myoclonus, perampanel, progressive myoclonic epilepsy, systematic (literature) review
MeSH terms: Systematic Review

Introduction: Progressive myoclonic epilepsies (PMEs) are a heterogenous group of genetic diseases presenting with epilepsy, cognitive impairment, and severe action myoclonus, which can severely affect daily life activities and independent walking ability. Perampanel is a recent commercially available antiseizure medication with high efficacy against generalized seizures. Some reports supported the role of perampanel in ameliorating action myoclonus in PMEs. Here, we aimed to describe a case series and provide a systematic literature review on perampanel effects on PMEs. Methods: We report the perampanel effectiveness on myoclonus, daily life activities, and seizures on an original Italian multicenter case series of 11 individuals with PMEs. Then, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we performed a systematic review on perampanel effect on myoclonus and disability in PMEs. We searched PubMed, Scopus, and Google Scholar articles on perampanel and PMEs up to June 2020. No prospective trials were found. We reviewed 11 case series manuscripts reporting 104 cases of different PMEs. Results: Here, we are reporting the effectiveness of perampanel in five individuals affected by Unverricht-Lundborg disease, three by Lafora disease, two by sialidosis, and one by an undetermined PME. Nine out of 11 individuals improved their disability related to the action myoclonus (two with Lafora disease did not). Among the 104 persons with PMEs collected by the systematic review, we found that more than half of the patients receiving perampanel exhibited an amelioration of action myoclonus and, consequently, of their independence in daily life activities. The Unverricht-Lundborg disease seemed to show the best clinical response to perampanel, in comparison with the other more severe PMEs. A significant seizure reduction was achieved by almost all persons with active epilepsy. Only 11% of PME patients dropped out due to inefficacy. Conclusions: Perampanel demonstrated a beneficial effect with regard to action myoclonus, disability, and seizures and was well-tolerated in people with PMEs, independently from their genetic diagnosis. Given the limited scientific evidence, broader prospective trials should be encouraged.
Reversible dementia due to neurocysticercosis: Improvement of the racemose type with antihistamines
Authors: Gislaine Cristina Lopes Machado-Porto, Leandro Tavares Lucato, Fábio Henrique de Gobbi Porto, Evandro Cesar de Souza, Ricardo Nitrini
Journal: Dement Neuropsychol (2015)
Keywords: taenia solium, antihistamine, dementia, dexchlorpheniramine, neurocysticercosis, racemose form, reversible dementia
MeSH terms: Case Reports

Infection of the human central nervous system (CNS) by the larvae of Taenia solium, termed neurocysticercosis (NCC), is endemic in most developing countries, where it is a major cause of acquired seizures and other neurological morbidity, including neuropsychiatric symptoms. However, despite its frequent manifestation, some findings, such as cognitive impairment and dementia, remain poorly understood. Less commonly, NCC may affect the ventricular system and subarachnoid spaces and this form is known as extraparenchymal neurocysticercosis. A particular presentation of the subarachnoid form is called racemose cysticercosis, which has a progressive pattern, frequently leads to hydrocephalus and can be life-threatening. Here we review a case of the racemose variety of cysticercosis, complicated by hydrocephalus and reversible dementia, with remission of symptoms after derivation and that remained stable with use of dexchlorpheniramine. We discuss the challenges in diagnosis, imaging findings, treatment and follow-up of this disease.
Paecilomyces variotii as an Emergent Pathogenic Agent of Pneumonia
Authors: Bruna Steiner, Valerio R Aquino, Alessandra A Paz, Lucia Mariano da Rocha Silla, Alexandre Zavascki, Luciano Z Goldani
Journal: Case Rep Infect Dis (2013)

Paecilomyces variotii is a commonly occurring species in air and food, and it is also associated with many types of human infections. Pneumonia due to Paecilomyces variotii has been rarely reported in the medical literature. The authors report a 48-year-old patient with refractory lymphoma who underwent allogenic hematopoietic cell transplantation and developed pneumonia due to Paecilomyces variotii. They also review the published case reports of pneumonia caused by this fungus.
Case report of a medication error by look-alike packaging: a classic surrogate marker of an unsafe system
Authors: Joerg Schnoor, Christina Rogalski, Roberto Frontini, Nils Engelmann, Christoph-Eckhardt Heyde
Journal: Patient Saf Surg (2015)
Keywords: costs, high work load, lasa, look alike-sound alike, medication error, patient safety

Background:
The acronym LASA (look-alike sound-alike) denotes the problem of confusing similar- looking and/or sounding drugs accidentally. The most common causes of medication error jeopardizing patient safety are LASA as well as high workload.
Case presentation:
A critical incident report of medication errors of opioids for postoperative analgesia by look-alike packaging highlights the LASA aspects in everyday scenarios. A change to a generic brand of medication saved costs of up to 16% per annum. Consequently, confusion of medication incidents occurred due to the similar appearance of the newly introduced generic opioid. Due to consecutive underdosing no life-threatening situation arose out of this LASA based medication error.
Conclusions:
Current recommendations for the prevention of LASA are quite extensive; still, in a system with a lump sum payment per case not all of these security measures may be feasible. This issue remains to be approached on an individual basis, taking into consideration local set ups as well as financial issues.
Reversible confluent deep white matter abnormalities: a new variant of posterior reversible encephalopathy syndrome
Authors: Yuebing Li, John Castaldo, Joshua Bemporad, Hussam A Yacoub
Journal: Case Rep Neurol Med (2013)

We describe a confluent deep white matter abnormalities variant of PRES, further strengthening the notion that PRES is a disorder of radiological heterogeneity. We present 2 cases of PRES with findings of diffuse but reversible vasogenic edema located in the deep periventricular white matter regions of bilateral hemispheres without a clearly posterior distribution. We feel that this represents a rare variant of PRES on imaging, thus adding to the existing radiological spectrum for this entity. Both of our patients presented with malignant hypertension (mean arterial blood pressure of 200 mmHg) and developed neurological symptoms that included encephalopathy, seizure, headache, and vision changes. Additionally, both patients presented with significant subcortical white matter edema that improved dramatically on follow-up imaging. The clinical and radiological improvement in both patients occurred following successful blood pressure management. It is possible that the deep white matter changes of PRES are seen exclusively in the setting of severe accelerated hypertension. Our case reports reveal that, in patients with hypertensive encephalopathy, a deep white matter pattern of diffuse signal changes may not necessarily indicate chronic ischemic changes and follow-up imaging studies are essential to rule out a diagnosis of PRES.