OpenMed/multicare-articles huggingface dataset:
Case report: Evaluation of head trauma in a tawny owl (Strix aluco) with advanced imaging diagnostic, FVEP and BAER test
Authors: Alessandro Vetere, Nicola Della Camera, Ciro Cococcetta, Carlo Paoletti, Maurizio Dondi, Fabio Biaggi, Francesco Di Ianni
Journal: Front Vet Sci (2024)
Keywords: baer, fvep, advanced imaging, birds of prey, head trauma, raptors, tawny owl
MeSH terms: Case Reports

An adult pet tawny owl (Strix aluco) presented to a veterinary hospital at Parma University with a history of head trauma. After a critical care protocol including thermal, oxygen and fluid support aimed at stabilizing the patient, a neurological examination was performed. During neurological evaluation, marked lethargy and an inability to rise from a recumbent position was noted. Anisocoria was also present, with a mydriatic left pupil exhibiting no pupillary light response (PLR) even on direct illumination of both eyes. On ocular fundus examination, retinal hemorrhage and retinal detachment were observed. Based on these clinical findings, a complete work-up was performed, including hematological exams and total body X-ray studies followed by a computed tomography (CT) scan. Additional examinations, such as brainstem auditory evoked response (BAER) measurement and flash visual evoked potential (FVEP) recording, were performed. FVEP measurements performed on the left eye exhibited no peaks in either series of stimulations, indicating an altered functional integration within the visual pathway. A CT scan revealed a large hypoattenuating lesion within the right cerebral hemisphere, suspected to be intraparenchymal edema. The BAER test demonstrated an altered trace consistent with brainstem involvement and left hypoacusis due to cranial nerve VIII deficiency. Head trauma can result in significant neurological impairments in birds, impacting their behavior, mobility, and cognitive abilities. FVEP recordings, BAER tests and CT scans may be useful diagnostic tools in clinical practice. Understanding the causes and neurologic presentation of avian traumas is essential for effective prevention, diagnosis and treatment of affected birds.
A Case Report of Thoracic Ectopia Cordis in a Hospital in Zanjan, Iran
Authors: Mehdi Hosseini, Hassan Zamani, Shadi Moghimi, Aref Nekoufar
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Methods:
A 17-week-old female neonate with a history of prenatal diagnosis of congenital heart anomaly was admitted to Ayatollah Mousavi Hospital in Zanjan, Iran. For the diagnosis of thoracic ectopia, cordis fetal echocardiography and ultrasonography were performed. Moreover, the noninvasive prenatal testing (NIPT) genetic test performed in the 10th week of pregnancy was evaluated.
Results:
The neonate was diagnosed with thoracic ectopia cordis, with the heart located outside the thoracic cavity and covered by a thin membrane. The Z scores of the analyzed maternal venous blood chromosomes were between +6 and -6, and all chromosomes had a low risk in terms of the risk of birth defects. The results of this study revealed that genetic test analysis is not enough to diagnose and predict congenital anomalies and defects. Furthermore, the findings showed that the fetus's mother continued to take folic acid after the first 3 months of pregnancy. This can be one of the risk factors involved in causing this heart defect.
Conclusion:
One of the important results of this study was that the diagnostic findings of ultrasound were normal, but the findings of echocardiography were reported as abnormal. This shows that fetal echocardiography is better than ultrasound imaging in diagnosing ectopia cordis. In addition, it is recommended that pregnant women should avoid taking folic acid after the first trimester of pregnancy.
Case report: Overlapping anti-AMPAR encephalitis with anti-IgLON5 disease post herpes simplex virus encephalitis
Authors: Shihui Sun, Jiafeng Ren, Zhao Zhong, Xuxia Ma, Danqing Shang, Changjun Su, Xianchao Zhao
Journal: Front Immunol (2024)
Keywords: anti-ampar encephalitis, anti-iglon5 disease, autoimmune encephalitis, herpes simplex virus 1, overlap
MeSH terms: Brain Diseases, Encephalitis, Herpes Simplex / drug therapy, Hashimoto Disease, Herpesvirus 1, Human, Case Reports, Research Support, Non-U.S. Gov't, Cell Adhesion Molecules, Neuronal, Humans, Cell Adhesion Molecules, Neuronal, IgLON5 protein, human, Hashimoto's encephalitis

Autoimmune encephalitis (AE) is the result of an autoimmune process that occurs as a rapidly advancing encephalopathy. Autoimmune encephalitis was commonly linked to herpes simplex virus 1 (HSV-1) as the most frequently identified virus. The main areas affected by this invasion are the temporal lobe, frontal lobe, and limbic system. Limbic encephalitis is a highly uncommon occurrence involving anti-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) encephalitis and anti-IgLON family member 5 (IgLON5) disease, both belonging to the rare category. As far as we know, this is the first report showing that a patient diagnosed with AMPAR encephalitis overlapped with anti-IgLON5 disease post herpes simplex virus encephalitis (HSE), which helps to broaden the range of this uncommon autoimmune disease. We recommend autoantibody testing in all patients with HSE, particularly those involving neurological relapses or progression.
COVID-19-Induced Refractory Symptomatic Hypocalcemia in a Patient With Parathyroid Gland Reimplantation
Authors: Crystal Tse, Ho-Man Yeung
Journal: Case Rep Endocrinol (2024)
Keywords: covid-19, hypocalcemia, parathyroid hormone interference
MeSH terms: Case Reports

Background: Several cases of severe hypocalcemia in the setting of COVID-19 have been reported. The proposed mechanisms include direct viral interaction with ACE2 receptors in the parathyroid gland, viral chelation of calcium, worsening hypovitaminosis D, critical illness leading to unbound fatty acids binding calcium, and inflammatory cytokines leading to PTH resistance. Given the life-threatening nature of hypocalcemia, this underrecognized phenomenon should be on the forefront of the clinician's attention. This case highlights a rare manifestation of COVID-19 and further complicated by the patient's reimplanted parathyroid gland. Presentation: A 73-year-old female with primary hyperparathyroidism status post parathyroidectomy with reimplantation in the left forearm presented with 4 days of viral syndrome, found to have tetany and Chvostek's sign on physical exam. Pertinent laboratory abnormalities included calcium 5.3 mg/dL, ionized calcium 0.44 mmol/L, magnesium 1.4 mg/dL, phosphorous 5.5 mg/dL, PTH 242 pg/mL, and 25-OH vitamin D 56 ng/mL. Chest CT revealed multifocal pneumonia consistent with positive COVID-19 testing. She was subsequently admitted to the ICU for severe, symptomatic hypocalcemia and was initiated on a continuous calcium infusion, remdesivir, baricitinib, and steroids. Tetany resolved after 9 g calcium repletion, and she was transferred to the medical floor with an ionized calcium of 0.83 mmol/L. On hospital day 3, repeat ionized calcium was 0.78 mmol/L despite ongoing repletion. Given the persistence of hypocalcemia, a repeat PTH level was obtained which remained high at 487 pg/mL, suggesting ongoing PTH interference in the setting of COVID-19. PTH was obtained from the right (nonimplanted) arm which was normal at 74 pg/mL. This indicated an appropriate PTH response from the reimplanted gland, and that ongoing hypocalcemia may be due to insufficient PTH function to maintain systemic calcium levels or a peripheral interference with PTH level. With continued calcium supplementation and treatment of COVID-19, the patient's calcium stabilized at 8.6 mg/dL. She was discharged on oral calcium supplementation with endocrinology follow-up. Conclusion: Acute hypocalcemia strongly correlates with a profound inflammatory response in COVID-19 patients. This case corroborates the cytokine/PTH hypothesis. This patient had a high PTH sampled near the reimplanted gland but an inappropriately normal PTH from the nonimplanted arm, indicating that direct viral interaction interfering with PTH release is an unlikely mechanism. This case represents a scenario where PTH can be sampled directly from the source and this type of model could aid in the process of determining the etiology of hypocalcemia in COVID-19.
Acute Pancreatitis as an Unusual Culprit of Diabetic Ketoacidosis in a Nondiabetic: A Case-Based Review
Authors: Steven Imburgio, Apurva Vedire, Harshavardhan Sanekommu, Anmol Johal, Sobaan Taj, Christopher Lesniak, Arman Mushtaq
Journal: Case Rep Endocrinol (2023)
MeSH terms: Case Reports

Acute pancreatitis has been associated with a multitude of complications including pancreatic necrosis, pseudocysts, abscesses, acute respiratory distress syndrome, disseminated intravascular coagulation, and hyperglycemia. To date, only rare case reports have demonstrated diabetic ketoacidosis (DKA) as a rare sequela of acute pancreatitis. We report a case of a 34-year-old female with no prior history of diabetes who was subsequently diagnosed with DKA after presenting with severe acute pancreatitis. This case serves as a framework to not only highlight DKA as a rare complication of acute pancreatitis but also to explore the potential pathophysiology that underlies this phenomenon including stress hyperglycemia and post-pancreatitis diabetes mellitus.
Washed microbiota transplantation: a case report of clinical success with skin and gut microbiota improvement in an adolescent boy with atopic dermatitis
Authors: Wan-Ying Deng, Wen-Jia Chen, Hao-Jie Zhong, Li-Hao Wu, Xing-Xiang He
Journal: Front Immunol (2023)
Keywords: atopic dermatitis, case report, intestinal microbiota, microbiome, skin, washed microbiota transplantation
MeSH terms: Dermatitis, Atopic, Gastrointestinal Microbiome, Case Reports, Research Support, Non-U.S. Gov't, Comment, Adolescent, Humans, Male, Pruritus, Skin / pathology, Staphylococcus aureus

Atopic dermatitis (AD) is a chronic, recurrent inflammatory disease characterized by itching. The gut microbiome can help maintain skin immune homeostasis by regulating innate and adaptive immunity. Here, we report a case of AD in a 15-year-old adolescent boy who benefited from washed microbiota transplantation (WMT). WMT was performed for three courses, with each course lasting for three consecutive days and an interval of one month between two courses. Clinical assessments were conducted at each WMT course, and skin, blood, and stool samples were collected for microbial analysis. After three months of WMT treatment, the boy's itchiness was effectively controlled: his skin showed noticeable improvement, with reduced Staphylococcus aureus in the skin lesions. The scores of SCORAD (SCORing Atopic Dermatitis), EASI (Eczema Area and Severity Index), NRS (Numerical Rating Scale), and DLQI (Dermatology Life Quality Index) significantly decreased compared to the baseline. Serum levels of eosinophil ratio, tumor necrotic factor-α, and interleukin-6 also reduced to the normal levels. There was a significant decrease in S. aureus in the skin lesions. Additionally, the intestinal flora became more diverse, and the abundance of Bifidobacterium species, significantly increased after WMT. No adverse events were reported during the treatment and the 1-year follow-up period. This case report provides direct clinical evidence for WMT as a novel promising treatment strategy for AD, and preliminary experimental data suggests the existence of an intestinal-skin axis in terms of the gut microbiota and the skin immune homeostasis.
Use of the Prompts for Reestructuring Oral Muscular Phonetic Targets (PROMPT) in Autism Spectrum Disorder: a case study
Authors: Denise Miranda de Oliveira Donadio, Marcia Simões-Zenari, Thaís Helena Ferreira Santos, Maria Gabriela Sanchez, Daniela Regina Molini-Avejonas, Daniela Cardilli-Dias
Journal: Codas (2023)
MeSH terms: Autism Spectrum Disorder, Autistic Disorder / diagnosis, Case Reports, Communication, Humans, Phonetics, Speech

Autism Spectrum Disorder (ASD) is classified by Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a neurodevelopmental disorder, whose characteristics are mainly deficits in social communication and a restricted range of interests. There are several studies about autism, speech, and language in the literature, but few correlate speech and autism. This study aims to carry out a case study that will address autism, speech, and PROMPT (Restructuring Oral Muscular Phonetic Targets) and also to describe the speech improvement in the participant with autism using the method. The target words were defined for the entire intervention according to the System Analysis Observation (SAO) and Motor Speech Hierarchy (MSH), which are parts of the PROMPT evaluation. After the evaluation, the participant was attended for 16 sessions, once weekly, with the objective of improving their speech. After analyzing the data, it was possible to observe improvement in all aspects outlined according to the pre-treatment evaluation of the method such as phonatory control, mandibular control, lip-facial control and lingual control as well as in the sequenced movement although this was not the aim outlined in the evaluation. It was also possible to measure the improvement of an adequate number of words, an adequate number of phonemes, percentages of correct consonants - revised (PCC-R), and intelligibility.
Pulmonary interstitial glycogenosis in two neonates: Early recognition and use of corticosteroids
Authors: Eric Hamberger, Yolanda Yu, Hyo-Jung Choi
Journal: Respir Med Case Rep (2024)
MeSH terms: Case Reports

Pulmonary interstitial glycogenosis (PIG) is known to be associated with a wide variety of congenital conditions, though the extent to which PIG contributes to clinical presentation and outcomes in infants remains controversial. We describe two cases of infants with congenital anomalies and respiratory distress at birth who were diagnosed with PIG with differing clinical courses and response to methylprednisolone therapy. These cases highlight the importance of improved recognition of PIG and uncertainties about which patients may benefit from treatment.
Overcoming Double Jeopardy: Successful Orthotopic Heart Transplant in a Recipient With Bacterial and Fungal Infections
Authors: Paopat Munthananuchat, Bundit Naratreekoon, Narongrit Kantathut, Piya Samankatiwat, Akeatit Trirattanapikul, Teerapat Yingchoncharoen
Journal: Case Rep Cardiol (2024)
Keywords: cardiac assist devices, heart transplant, infection, invasive pulmonary aspergillosis
MeSH terms: Case Reports

Although active infection is generally a contraindication before an orthotopic heart transplant, a 16-year-old man diagnosed with dilated cardiomyopathy successfully underwent an orthotopic heart transplant despite having active probable invasive pulmonary aspergillosis and bacterial pneumonia in the presence of septic and cardiogenic shock.
Unique endoscopic features of primary biliary diffuse large B-cell lymphoma: A case report with literature review (with video)
Authors: Tomoya Nakamura, Yoshiharu Masaki, Naohiro Kameyama, Yujiro Kawakami, Keisuke Ishigami, Yumemi Takada, Shuji Satoh, Taro Sugawara, Shintaro Sugita, Hiroshi Nakase
Journal: DEN Open (2024)
Keywords: biliary malignant lymphoma, diffuse large b‐cell lymphoma, endoscopic ultrasonography, intraductal ultrasonography, malignant biliary obstruction
MeSH terms: Case Reports

A 67-year-old man visited our hospital complaining of dark-colored urine and upper abdominal pain. Magnetic resonance cholangiopancreatography showed stricture of the distal bile duct, and contrast-enhanced computed tomography showed irregular thickening of the distal bile duct wall. However, no enlarged lymph nodes, pancreatic tumors, or other neoplastic lesions were apparent around the bile duct. Endoscopic ultrasonography and intraductal ultrasonography showed irregular thickening of the inner hypoechoic layer without the disappearance of the innermost thin hyperechoic layer. On the basis of these findings, we considered that the bile duct lesion was of non-epithelial origin. Thus, we repeatedly performed bile duct biopsies from the same site under fluoroscopy to obtain a sample of the submucosal tissue. The pathological diagnosis was diffuse large B-cell lymphoma, and the patient received systemic chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). After six courses of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, positron emission tomography-computed tomography showed the disappearance of 18-fluorodeoxyglucose uptake in the bile duct and endoscopic retrograde cholangiography showed improvement of the bile duct stricture. Endoscopic findings and repeated biopsies were useful in making the diagnosis of primary biliary diffuse large B-cell lymphoma.
Severe Neurotoxicity due to Atropa belladonna Poisoning: A Case Report and Literature Review
Authors: Seyed Javad Boskabadi, Sima Ramezaninejad, Zakaria Zakariaei
Journal: Case Rep Neurol Med (2024)
MeSH terms: Case Reports

Atropa belladonna (A. belladonna), commonly known as deadly nightshade, is a poisonous plant belonging to the Solanaceae family. The toxic effects of A. belladonna are attributable to its alkaloid content, which possesses potent anticholinergic properties. These alkaloids are responsible for the plant's toxicity and can cause a range of adverse effects in humans and animals upon ingestion or contact. In this report, we describe two atypical cases of A. belladonna poisoning resulting from accidental ingestion of the plant's raw leaves, which were referred to the emergency room of a poisoning center in northern Iran. Both patients presented with symptoms of anticholinergic toxicity, including dry mouth, mydriasis, tachycardia, and delirium. The patients were managed conservatively with supportive measures, including hydration and administration of benzodiazepines to control agitation and delirium. With appropriate treatment, both patients showed improvement and were discharged from the hospital. A. belladonna intoxication is associated with a range of clinical manifestations, primarily due to its neurotoxic effects. These manifestations may include flushing, mydriasis, tachycardia, ataxia, agitation, delirium, and urinary retention. The severity of symptoms can vary depending on the amount of the toxin ingested and the individual's susceptibility. In severe cases, A. belladonna toxicity can lead to seizures, coma, and even death. These cases highlight the importance of awareness regarding the potential toxicity of A. belladonna and the necessity of prompt and appropriate management of its toxicity. In severe cases, physostigmine may be considered for the treatment of neurological symptoms due to the plant's anticholinergic effects.
Enhancing socio-communicative functions in an MCI patient with intra-nasal insulin: a case report
Authors: Sara Schatz, Grace Rose Gutiérrez
Journal: Front Psychiatry (2024)
Keywords: alzheimer’s dementia, mci (mild cognitive impairment), cognitive improvement, intranasal insulin, socio-communicative abilities
MeSH terms: Case Reports

This report examines extended intra-nasal insulin treatment [INI] for an Insulin Resistant early Mild Cognitive Impairment [MCI] patient. Patient [EJ] also had medial temporal lobe [MTL] damage, poor short-term memory, significant irritability, and social and linguistic withdrawal at treatment start. Compared to baseline, nine months INI treatment increased grey matter volume, lowered beta-amyloid levels, and improved MCI and FAS scores. Patient also increased pragmatic capacities in social conversation and procedural memory. These findings align with results from prior clinical trials on INI and suggest that treatment can slow neurodegenerative disease progression in early MCI patients.
Atypical neurological manifestations in anti-IgLON5 disease: a case report
Authors: Yun Chen, Jingyao Chen, Zhaohua Pei, Wei Qian
Journal: Front Neurol (2024)
Keywords: iglon5, anti-iglon5 disease, autoimmune encephalitis, case report, cognitive impairment
MeSH terms: Case Reports

Anti-IgLON5 disease is a recently discovered autoimmune encephalopathy with sleep disorder as a hallmark in the majority of reported cases. Additional neurological manifestations include bulbar dysfunction, gait problems, movement disorders, oculomotor abnormalities, and hyperexcitability of the nervous system. At present, an increasing number of publications have dealt with the course and possible treatment options for anti-IgLON5 disease, and its clinical spectrum has expanded wider and more heterogeneous. Here, we report a case of a 66-year-old female with cognitive impairment accompanied by slow reaction, impaired memory, and decreased orientation. A positive cerebral MRI change and serum and cerebrospinal fluid (CSF) antibodies against IgLON5 were found during the diagnostic course. Subsequently the patient received immunotherapy and was generally in good health with no new symptoms during follow-up. Early testing for IgLON5 antibodies should be considered in patients with atypical neurological symptoms such as cognitive impairment, slow reaction, or decreased orientation. In clinical practice, immunotherapy should be considered in all cases of anti-IgLON5 encephalopathies.
Upper helical reconstruction during aesthetic facelift procedure: a case report
Authors: Zachary N Goldberg, David S Goldberg
Journal: Case Reports Plast Surg Hand Surg (2024)
Keywords: helix, ear reconstruction, facelift, pre-auricular flap, random pattern flap, trauma
MeSH terms: Case Reports

We present a case of a two-stage reconstruction of a traumatic right upper helix deformity using a random pattern layover skin flap in conjunction with an aesthetic facelift procedure. This serves to encourage reconstructive surgeons to be mindful about seeking opportunities to address additional patient concerns when appropriate and safe.
Talaromycosis from Wuhan: two-case report and literature review
Authors: Zhiyuan Yao, Zhou Pan, Guang Li, Zhaomin Liao, Zhen Yu, Liying Zhan, Wenfang Xia
Journal: Front Cell Infect Microbiol (2024)
Keywords: talaromyces marneffei, talaromycosis, acquired immune deficiency syndrome, glucose-6-phosphate dehydrogenase deficiency, renal transplantation
MeSH terms: Acquired Immunodeficiency Syndrome / drug therapy, Liver Diseases, Mycoses / diagnosis, Review, Case Reports, Antifungal Agents / therapeutic use, Humans, Tomography, X-Ray Computed, Antifungal Agents, talaromycosis

Background:
Talaromycosis is a serious opportunistic infectious disease caused by Talaromyces marneffei, which mostly occurs in immunocompromised patients. The disease is mainly prevalent in tropical countries and regions of Southeast Asia and South Asia, but non-endemic areas also have patients with Talaromycosis. The disease has no characteristic clinical manifestations and is difficult to diagnose. Delayed diagnosis often leads to death.
Case presentation:
Both patients had cellular immunodeficiency. Case 1 had a history of acquired immune deficiency syndrome, and case 2 had a history of renal transplantation and glucose-6-phosphate dehydrogenase deficiency. They all had fever, anemia, fatigue, and skin lesions. Case 1 had gastrointestinal bleeding, enlarged lymph nodes, and hepatosplenomegaly. Case 2 had cough and dyspnea. Both patients had thrombocytopenia and hypoalbuminemia; an increased neutrophil ratio, procalcitonin, and C-reactive protein; and abnormal liver function and coagulation dysfunction. Case 1 sputum culture, blood culture, and bronchoalveolar lavage fluid were positive for T. marneffei. T. marneffei was detected in the blood culture of case 2, with infection of Candida parapsilosis and Pneumocystis jirovecii. Chest computed tomography scan mainly showed pulmonary exudative lesions. Although these two patients were actively treated, they died of poor efficacy.
Conclusion:
Talaromycosis has an insidious onset, long course, atypical clinical symptoms, imaging performance and laboratory results, difficult diagnosis, and high mortality. Therefore, it is important to promptly consider and treat Talaromycosis in immunocompromised patients upon infection in order to reduce mortality.