OpenMed/multicare-articles huggingface dataset:
Bacillus Cereus bacteremia complicated by brain abscess in a severely immunocompromised patient: Addressing importance of early recognition and challenges in diagnosis
Authors: David Schoenfeld, Dasom Lee, John A Arrington, John Greene, Olga Klinkova
Journal: IDCases (2022)
Keywords: 16s rrna pcr sequencing, aml, acute myeloid leukemia, b cereus, bacillus cereus, bacillus cereus, brain abscess, cns infection, cns, central nervous system, csf, cerebrospinal fluid, ct, computer tomography, combination antibiotic therapy, iv, intravenous, immunocompromised, mri, magnetic resonance imaging, pcr, polymerase chain reaction, rrna, ribosomal ribonucleic acid
MeSH terms: Case Reports

Bacillus cereus (B. cereus) is a known cause of a food poisoning in the general population. However, it can cause life-threatening sepsis and shock in severely immunocompromised patients with hematologic malignancies, which frequently lead to central nervous system (CNS) infections associated with high mortality and morbidity. In this case report, we describe a patient with a newly diagnosed acute myeloid leukemia that underwent induction chemotherapy and developed B. cereus infection that was associated with septic shock and brain abscesses. Definitive diagnosis of multiple brain abscesses was not manifested with routine microbiological investigation but required the use of 16S ribosomal (rRNA) gene polymerase chain reaction (PCR) sequencing of the resected brain lesion. The patient was eventually treated with 8-week course of intravenous vancomycin and high-dose ciprofloxacin which led to a full recovery. This report highlights the significant risk posed by B. cereus infection in neutropenic patients, the use of 16S rRNA PCR sequencing test for definitive diagnosis and use of combination therapy for successful treatment of B. Cereus CNS infection.
Novel duplication of the cell adhesion molecule L1-like gene in an individual with cognitive impairment, tall stature, and obesity: A case report
Authors: Kenny V Onate-Quiroz, Benjamin Udoka Nwosu, Parissa Salemi
Journal: Front Neurol (2023)
Keywords: chl 1 gene, autism, duplication, obesity, tall stature
MeSH terms: Case Reports

The gene that codes for the close homolog of L1 (CHL1 gene) is located in the 3p26.3 cytogenetic band in the distal portion of the 3p chromosome. This gene is highly expressed in the central nervous system and plays an important role in brain formation and plasticity. Complete or partial CHL 1 gene-deficient mice have demonstrated neurocognitive deficits. In humans, mutations of the CHL 1 gene are infrequent with most mutations described in the literature as deletions. This case report describes an individual with a duplication in the CHL 1 and a presentation consistent with a syndromic form of neurocognitive impairment. To the best of our knowledge, this mutation has not been previously described in the literature.
Secondary psoas abscess after an open cholecystectomy and a common bile duct exploration
Authors: Marlon Uriel Alvarado, Cristhian Alejandro Colindres, Luis José Pinto, Cintia G Padilla, Carlos E Reyes
Journal: Int J Surg Case Rep (2019)
Keywords: case report, cholecystectomy, complication, psoas abscess

Background:
A psoas abscess presents a diagnostic challenge, due to its rarity, non-specific clinical manifestations and wide range of etiologies.
Case report:
We describe a case of a secondary psoas abscess containing Staphylococus aureus following open cholecystectomy and common bile duct exploration in a woman who had no history or evidence of comorbidity.
Conclusions:
Two possible causes of this abscess are performance of the Kocher maneuver during the surgical procedure and external contamination. This case adds cholecystectomy and cholecystitis to the list of known causes of psoas abscesses.
Case Report: The application of associating liver partition and portal vein ligation for staged hepatectomy in patients with hepatitis b virus-related hepatocellular carcinoma after undergoing treatment with an immune checkpoint inhibitor: a report of two cases
Authors: Cong Ning, Guanmo Liu, Junwei Zhang, Xiaobo Yang, Yiyao Xu, Haitao Zhao
Journal: Front Immunol (2023)
Keywords: associating liver partition and portal vein ligation for staged hepatectomy, future liver remnant, immune checkpoint inhibitors, immunotherapy, unresectable hepatocellular carcinoma
MeSH terms: Carcinoma, Hepatocellular / etiology, Carcinoma, Hepatocellular / surgery, Liver Neoplasms / etiology, Liver Neoplasms / surgery, Case Reports, Hepatectomy / adverse effects, Hepatitis B virus, Humans, Immune Checkpoint Inhibitors / therapeutic use, Portal Vein / pathology, Portal Vein / surgery, Immune Checkpoint Inhibitors

Hepatocellular carcinoma (HCC) is often diagnosed at an unresectable stage without opportunities for curative therapy. Future liver remnant (FLR) insufficiency limits the range of patients who can undergo radical resection. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can ultimately achieve short-term hypertrophy of the FLR in patients with viral hepatitis-related fibrosis/cirrhosis and R0 resection. However, the influence of immune checkpoint inhibitors (ICIs) on liver regeneration remains unknown. We report two patients diagnosed with Barcelona Clinic Liver Cancer (BCLC)-B stage hepatitis B virus (HBV)-related HCC who underwent pioneering ALPPS after immunotherapy without posthepatectomy liver failure (PHLF). ALPPS has been shown to be safe and feasible in patients with HCC who underwent immunotherapy previously for the first time and might provide an alternative salvage option for future conversion therapy of HCC.
Isolated Nasal Tip Metastasis from Esophageal Squamous Cell Carcinoma: Case Report and Literature Review
Authors: Georg J Ledderose, Anna S Englhard
Journal: Case Rep Otolaryngol (2015)

Objectives. Cutaneous metastases can be the first sign of a malignant disease and have an unfavorable prognostic significance. The external nose is rarely affected. The uncommon clinical presentation of these cutaneous metastases may lead to the wrong diagnosis and treatment. Methods. We present the case of a 59-year-old patient with a small indolent tumor on the tip of the nose that turned out to be the first sign of an extended esophageal cancer. Conclusion. The differential diagnosis of tumors of the facial skin and the nasal tip includes metastases from an unknown primary tumor. In rare cases, squamous cell carcinoma of the esophagus needs to be considered.
Repetitive Sinus-Related Symptoms May Accelerate the Progression of Chronic Maxillary Atelectasis
Authors: Shu Kikuta, Kyohei Horikiri, Kaori Kanaya, Ryoji Kagoya, Kenji Kondo, Tatsuya Yamasoba
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Chronic maxillary atelectasis (CMA) is characterized by a progressive decrease in maxillary sinus volume. The factors that promote the stage progression of CMA remain poorly understood. Here, we describe the time course of anatomical changes in a 40-year-old woman with stage II CMA that progressed to stage III disease. She did not show stage progression until she started to develop repetitive sinus-related symptoms. The stage progression was characterized by ocular symptoms. The repetitive inflammatory episodes may have increased the negative pressure in the affected sinus and weakened the bone walls, thereby promoting stage progression. Thus, a history of repetitive sinus-related symptoms may be a risk factor for stage progression in CMA.
Concurrent autoimmune pancreatitis and primary biliary cirrhosis: a rare case report and literature review
Authors: Aiqing Li, Yongjie Wang, Zheng Deng
Journal: BMC Gastroenterol (2014)
MeSH terms: Autoimmune Diseases / complications, Liver Cirrhosis, Biliary / complications, Pancreatitis / complications, Case Reports, Research Support, Non-U.S. Gov't, Review, Aged, Autoimmune Diseases / diagnosis, Humans, Liver Cirrhosis, Biliary / diagnosis, Male, Pancreatitis / diagnosis

Background:
Both autoimmune pancreatitis (AIP) and primary biliary cirrhosis (PBC) are related to various diseases. But the concurrence of AIP and PBC is extremely rare, with only 2 cases reported. Here we report the concurrence of AIP and PBC in a Chinese patient for the first time.
Case presentation:
A 65-year-old male was admitted to our hospital with jaundice, pruritus, mild abdominal pain and darkening urine. Serum alkaline phosphatase, γ-glutamyltransferase, bilirubin and IgG4 were prominently elevated. The antimitochondrial antibody was positive. Radiological examination revealed diffusive enlargement of the pancreas. Pancreatic biopsy showed lymphoplasmacytic infiltration, fibrosis and abundant IgG4+ plasma cells. The patient was diagnosed with AIP and PBC. Nasobiliary tube was placed to facilitate biliary drainage. A combination therapy of steroid and UDCA was administered and the patient was gradually recovered, during which the patient was complicated with biliary infecion, herpes zoster and pulmonary abscess.
Conclusion:
We present this case together with literature evidence to support the concurrence of AIP and PBC, share our experience of using combination therapy with steroid and UDCA, and raise the awareness of infectious complications in immunosuppressed patients.
Type I Gaucher disease with exophthalmos and pulmonary arteriovenous malformation
Authors: Chun-An Chen, Nelson L S Tang, Yin-Hsiu Chien, Wei-Min Zhang, Jou-Kou Wang, Wuh-Liang Hwu
Journal: BMC Med Genet (2005)
MeSH terms: Arteriovenous Malformations / etiology, Exophthalmos / etiology, Gaucher Disease / complications, Pulmonary Artery / abnormalities, Case Reports, Adult, Female, Humans

Background:
Gaucher disease type I, the non-neuropathic type, usually presents in adulthood with hepatosplenomegaly. We report here an adult with type I Gaucher disease presented with unusual and severe clinical manifestations.
Case presentation:
Hepatosplenomegaly, bone crisis and fractures occurred at early childhood, and splenectomy was performed at the age of 5. Exophthalmos with increase in retrobulbar space was noted when the patient was 30. Cerezyme infusion started at the age of 32; but unfortunately, pulmonary arteriovenous malformation with dyspnea and hypoxemia was found two years later. Gene analysis revealed V375L/L444P mutations in the beta-glucocerebrosidase gene.
Conclusion:
Although both eye and lung diseases have been associated with Gaucher disease, this is the first reported demonstration of exophthalmos and pulmonary arteriovenous malformation in the same patient. This case may therefore present an extremely severe and unusual form of type I Gaucher disease.
Case Report: Adenosine kinase deficiency diagnosed 10 years after liver transplantation: Novel phenotypic insights
Authors: Patryk Lipiński, Elżbieta Ciara, Dorota Jurkiewicz, Maciej Pronicki, Elżbieta Jurkiewicz, Anna Bogdańska, Rafał Płoski, Irena Jankowska
Journal: Front Pediatr (2022)
Keywords: s-adenosyl homocysteine, s-adenosylmethionine, adenosine kinase, adenosine kinase deficiency, liver transplantation
MeSH terms: Case Reports

Adenosine kinase (ADK) deficiency is a rare inborn error of methionine and adenosine metabolism. So far, a total of 27 patients with ADK deficiency have been reported. Here, we describe the first Polish patient diagnosed with ADK deficiency, aiming to highlight the clinical presentation of disease, emphasize diagnostic difficulties, and report the long-term follow-up. Six-month-old patient presented with cholestatic liver disease, macrocytic anemia, developmental delay, generalized hypotonia, delayed brain myelination, and elevated levels of serum methionine. A decrease of mitochondrial respiratory chain complex II and III activity were found in the postnuclear supernatants obtained from skeletal muscle biopsy. The patient underwent living-donor liver transplantation (LTx) at 14 months of age. Ten-year follow-up after LTx revealed a preserved good liver function, persistent regenerative macrocytic anemia, progressive neurological disease but disappearance of brain MR changes, short stature, and cortisol deficiency. Whole exome sequencing revealed the patient to be affected with two novel ADK variants, which pathogenicity was confirmed biochemically by demonstration of elevated concentration of S-adenosylhomocysteine.
Recurrence Leiomyosarcoma of the Popliteal Vein: A Rare Soft Tissue Sarcoma
Authors: Thanate Poosiripinyo, Sermsak Sukpanichyingyong, Krits Salang, Chat Sumananont, Thanapon Chobpenthai
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Background:
Leiomyosarcoma (LMS) is a soft tissue sarcoma that originates from smooth muscle cells and constitutes approximately 5-10% of all soft tissue sarcomas. Vascular LMS is the least common subtype of LMS. About one-third of vascular LMS is located in the extremities, most commonly in the saphenous vein (25%). Vascular LMS originating from the popliteal vein is very rare, and to the best of our knowledge, only nine cases have been reported to date. Case presentation. We herein report a case of a 49-year-old woman who presented with recurrence of a mass that was located at the posterior aspect of the right proximal leg and extended to the popliteal fossa. She had mild pain and intermittent claudication without a history of an edematous leg. The tissue diagnosis was LMS. Wide en bloc resection of the tumor, including the segment of the involved popliteal vein, was performed without venous reconstruction. The patient received no other adjuvant treatments. At the 16-month follow-up, she had good oncologic and functional outcomes.
Conclusion:
Vascular LMS at the popliteal vein is uncommon but should be considered as a differential diagnosis in a patient who presents with a mass at the popliteal fossa. The magnetic resonance imaging (MRI) and core needle biopsy were needed for a definite diagnosis. The mainstay of treatment is wide en bloc resection of the tumor, including the involved segment of the vein. Venous reconstruction after resection is unnecessary in chronic cases without a history of an edematous leg. Radiotherapy is an important adjuvant for local control when the surgical margins are close or positive. The role of chemotherapy in systemic management remains unclear.
Use of Next Generation Sequencing and Synergy Susceptibility Testing in Diagnosis and Treatment of Carbapenem-Resistant Klebsiella pneumoniae Blood Stream Infection
Authors: Yuetian Yu, Fupin Hu, Cheng Zhu, Erzhen Chen, Liangjing Lu, Yuan Gao
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Early diagnosis and appropriate treatment for carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infection is a big challenge for clinicians due to its high mortality. Every effort has been made to improve its clinical outcomes. However, treatment according to synergy susceptibility testing has never been reported in the literature. We reported a 29-year-old systemic lupus erythematosus female with CR-Kp blood stream infection. We highlighted the identification by next generation sequencing and treatment according to synergy susceptibility testing in the case.
Nonabsorbable-suture-induced osteomyelitis: a case report and review of the literature
Authors: Cheng Hong Yeo, Nick C Russell, Tom Sharpe
Journal: Case Rep Orthop (2012)

We are reporting a case of nonabsorbable suture-induced osteomyelitis in patient who had an open rotator cuff repair with nonabsorbable Ethibond anchor suture. Patient in this case presented with very subtle clinical features of osteomyelitis of the left proximal humerus 15 years after initial rotator cuff repair surgery. Literature had shown that deep infection following rotator cuff repairs, although rare, can be easily missed and can cause severe complications. Absorbable suture had been demonstrated to be more superior, in terms of rate of deep infection, as compared to nonabsorbable suture when used in rotator cuff repair surgery. Both absorbable and nonabsorbable suture had been demonstrated to have similar mechanical properties by several different studies. The case demonstrated that initial presentation of deep infection can be subtle and easily missed by clinicians and leads to further complications.
Pregnancy and delivery in woman with implantable cardioverter-defibrillator: what we should know
Authors: Mohamed Amine Bouslama, Fehmi Ferhi, Faten Hacheni, Kaabia Ons, Khlifi Abdeljelil, Khaled Ben Jazia, Hedi Khairi
Journal: Pan Afr Med J (2018)
Keywords: pregnancy, anesthesia, implantable cardioverter-defibrillator
MeSH terms: Cardiomyopathy, Hypertrophic / physiopathology, Cesarean Section, Defibrillators, Implantable, Pregnancy Complications, Cardiovascular / physiopathology, Case Reports, Adult, Cardiomyopathy, Hypertrophic / therapy, Female, Humans, Perioperative Care / methods, Pregnancy, Pregnancy Complications, Cardiovascular / therapy

We report the observation of a 25-year-old pregnant patient of 39 weeks of amenorrhea proposed for elective cesarean section. This patient suffers from hypertrophic cardiomyopathy since the age of 12. She has an implantable cardioverter defibrillator (ICD). The peculiarities of the ICD in the parturient and the perioperative management of the patient are being reported in this paper.
Successful surgical management of non-perforating acute appendicitis with septic disseminated intravascular coagulation: A case report and review of the literature
Authors: Toshiaki Komo, Toshihiko Kohashi, Yoshirou Aoki, Jun Hihara, Koichi Oishi, Noriaki Tokumoto, Mikihiro Kanou, Akira Nakashima, Manabu Shimomura, Masashi Miguchi, Hidenori Mukaida, Naoki Hirabayashi
Journal: Int J Surg Case Rep (2019)
Keywords: disseminated intravascular coagulation (dic), non-perforating appendicitis, septic, uncomplicated appendicitis

Introduction:
Perforating appendicitis and abscess-forming appendicitis may cause septic disseminated intravascular coagulation (DIC). However, non-perforating acute appendicitis with septic DIC is extremely rare.
Presentation of case:
A 67-year-old man was referred to our hospital one day after starting oral antibiotic treatment for acute appendicitis. Physical examination revealed only slight spontaneous abdominal pain without tenderness and peritoneal irritation. Contrast-enhanced computed tomography demonstrated an enlarged appendix (10 mm in diameter) without fecalith, ascites, intraperitoneal free air, and abscess. There was no evidence of perforating appendicitis. Laboratory analysis revealed septic DIC. The patient was diagnosed with non-perforating acute appendicitis with septic DIC. The patient was distressed regarding whether he should be treated conservatively with an antibiotics-first strategy or undergo an appendectomy. Ultimately, a laparoscopic appendectomy was performed. Histopathological examination showed non-perforating gangrenous appendicitis. He required DIC therapy for 2 days postoperatively. He was discharged on postoperative day 9, and remained in good health 1 month after surgery.
Discussion:
There is no absolute index of conversion to surgery with an antibiotics-first strategy of appendicitis treatment. Judging the limit of conservative treatment and determining the best moment to perform surgery is a critically important matter for patients with acute appendicitis.
Conclusions:
The incidence of conservative treatment preceding an antibiotics-first strategy for acute appendicitis is increasing. However, it is thought that appendectomy should be performed when acute appendicitis is complicated with septic DIC, even if it is a non-perforating appendicitis in which improvement with conservative treatment is anticipated.
Sclerosing Epithelioid Fibrosarcoma of the Thoracic Vertebrae: An Fairly Unusual Case Report With a Short Review of Literature
Authors: Changhong Wei, Yili Ma, Dengqiang Wu, Xiaoyu Chen, Chunjun Li, Jun Chen, Sufang Zhou
Journal: Front Med (Lausanne) (2022)
Keywords: ewsr1, fish, immunohistochemistry, sclerosing epithelioid fibrosarcoma, soft tissue sarcoma
MeSH terms: Case Reports

Sclerosing epithelioid fibrosarcoma (SEF) is a rare subtype of soft tissue tumors, and SEF originating from the side of the spine is even rarer. We report that a 28-year-old young woman suffered from chest pain and back pain for 3 years, and thereafter she went to see a doctor because her condition deteriorated. Enhanced CT showed that the right posterior upper chest wall mass invaded the adjacent bone, and the boundary between the lesion and the surrounding tissues was relatively clear. She then underwent posterior tumor removal surgery. The pathological examination confirmed the diagnosis of SEF. In histomorphology, the tumor displayed a typical epithelioid clear cell morphology, accompanied by extensive vitrification and fibrosis, which better helped to differentiate the tumor from low grade fibromyxoid sarcoma, solitary fibrous tumor and other entities. The immunohistochemical analysis showed a diffuse positive reaction to MUC4, a highly specific marker of SEF, which was detected by Immunohistochemistry (IHC), and fluorescence in-situ hybridization (FISH) confirmed that the EWSR1 gene was rearranged, while the FUS gene was not rearranged. This is the first time that we have encountered such this rare case and thus report this case with updated literature related to this tumor.
Multidisciplinary Approach for Full-Mouth Rehabilitation of a Young Adult Patient with Ameloblastoma
Authors: Hung-Yi Liao, May-Show Chen, Ya-Fen Yang, Pei-Bang Liao, Sheng-Wei Feng, Po-Kai Juan
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Ameloblastoma is a benign but locally invasive neoplasm of the odontogenic epithelium that tends to grow slowly in the mandible or maxilla. It can be highly destructive to the surrounding dental anatomy and can cause death by progressive spread to nearby vital structures in rare cases. Marginal resection is the most effective method of eliminating the tumor, but treatment can further contribute to oral and dental deformity and malfunction. This clinical report describes the dental rehabilitation of a young adult patient diagnosed with ameloblastoma and underwent preliminary marsupialization, segmental mandibulectomy, and fibula free flap reconstruction, followed by mandibular dental implant placements. Orthodontic and rapid palatal expansion for maxillary arch correction was also performed. The treatment goal of regaining dental function and a satisfactory appearance was accomplished.
Calcifying odontogenic cyst associated with the impacted third molar: a case report
Authors: Tuğçenur Uzun, Ertunç Çinpolat
Journal: Pan Afr Med J (2019)
Keywords: calcifying odontogenic cyst, cone beam computed tomography, impacted third molar
MeSH terms: Molar, Third / diagnostic imaging, Odontogenic Cyst, Calcifying / diagnosis, Tooth, Impacted / complications, Case Reports, Adult, Follow-Up Studies, Humans, Male, Odontogenic Cyst, Calcifying / diagnostic imaging, Odontogenic Cyst, Calcifying / etiology, Tooth, Impacted / diagnostic imaging

Calcifying odontogenic cyst (COC) is a benign, locally aggressive, slow-growing lesion. Its occurrence constitutes about 2% of all odontogenic cysts. The most frequent sign is painless, slow growing swelling. Radiographically it appears as a well-defined unilocular radiolucency. The microscopical features of lesion showed well-delineated cystic proliferation of odontogenic epithelium with ghost cells and fibrous connective tissue wall. In the present study, 42 years old man who has COC associated with the impacted third molar treated with enucleation is reported after 6 months follow-up.