OpenMed/multicare-articles huggingface dataset:
Psychomotor regression due to vitamin B12 deficiency
Authors: Amal Bousselamti, Brahim El Hasbaoui, Hanae Echahdi, Yamna Krouile
Journal: Pan Afr Med J (2018)
Keywords: vitamin b12 deficiency, breastfeeding, hyperhomocysteinemia, hypotonia, psychomotor regression
MeSH terms: Anemia, Macrocytic / etiology, Psychomotor Disorders / etiology, Vitamin B 12 / administration & dosage, Vitamin B 12 Deficiency / complications, Case Reports, Anemia, Macrocytic / diagnosis, Anemia, Macrocytic / drug therapy, Breast Feeding, Female, Humans, Infant, Mothers, Muscle Hypotonia / diagnosis, Muscle Hypotonia / drug therapy, Muscle Hypotonia / etiology, Psychomotor Disorders / drug therapy, Treatment Outcome, Vitamin B 12 Deficiency / diagnosis, Vitamin B 12

A vitamin B12 deficiency in infants is rare, but may sometimes be seen in breastfed babies of strict vegetarian mothers. Vitamin B12, also known as cobalamin, is only found in meat and other animal products. Most babies have a sufficient supply as long as the mother was not deficient herself. Symptoms and signs of vitamin B12 deficiency appear between the ages of 2 to 12 months and include vomiting, lethargy, failure to thrive, hypotonia, and arrest or regression of developmental skills. Urinary concentrations of methylmalonic acid and homocystine are characteristically elevated in vitamin B12 deficiency. Early treatment for a vitamin B12 deficiency in an infant involves immediate administration of vitamin B12 to the baby and the breastfeeding mother. The infant and mother will each receive an injection of vitamin B12 containing 1,000 mcg or more of the vitamin, and the mother will continue to receive injections every month to raise her own stores. After the initial injection, the baby will often receive future vitamin B12 through food sources. We present a case of vitamin B12 deficiency in a 9-month-old girl presented with psychomotor regression, hypotonia and lethargy. The child was exclusively breast-fed from birth by a mother who was on strict vegetarian diet and belong to a low socio-economic status. Laboratory data revealed bicytopenia with macrocytic anemia and methylmalonic acid in the urine, consistent with vitamin B12 deficient anemia. The Brain CT revealed a cerebral atrophy and delayed myelination. Vitamin B12 supply was effective on anaemia and psychomotor delay. This case figures out the importance of an early diagnosis in front of psychomoteur regression and hypotonia, given the risk of incomplete neurologic recovery due to vitamin B12 deficiency mainly in the setting of maternal nutritional deficiency.
Acute Hydrocephalus due to Secondary Leptomeningeal Dissemination of an Anaplastic Oligodendroglioma
Authors: Andreas M Stark, Heinz-Herrmann Hugo, H Maximilian Mehdorn, Friederike Knerlich-Lukoschus
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Secondary leptomeningeal dissemination of oligodendroglioma is very rare. We report the case of a 38-year-old Caucasian male who presented with acute hydrocephalus. 8 months before, the patient had undergone craniotomy for right frontal anaplastic oligodendroglioma, WHO grade III. By that time, there was no evidence of tumor dissemination. MRI now ruled out local tumor progression but revealed meningeal contrast enhancement along the medulla, the myelon, and the cauda equina. Repeated lumbar puncture revealed increased cerebro-spinal fluid (CSF) pressure and protein content. Malignant cells were not detectable. Surgical treatment consisted in (1) placement of an ommaya reservoir for daily CSF puncture, (2) Spinal dural biopsy confirming leptomeningeal oligodendroglioma metastasis, and (3) ventriculo-peritoneal shunt placement after CSF protein has decreased to 1500-2000 mg/l.
Case Report: Metagenomics Next-Generation Sequencing Can Be Performed for the Diagnosis of Disseminated Mucormycosis
Authors: Yi Sun, HuiLing Li, JiaJun Chen, ZhongHui Ma, Pin Han, YuChen Liu, Jing Wen, Fang Ren, XiaoXu Ma
Journal: Front Med (Lausanne) (2021)
Keywords: alveolar lavage, diabetes, metagenomics next generation, mucormycosis, pulmonary cavity
MeSH terms: Case Reports

Mucormycosis is an infection caused by a group of filamentous molds with in the order Mucorales. In developing countries, most cases of mucormycosis occur in persons with poorly controlled diabetes mellitus or subjects with normal post-traumatic immune function. Mucormycosis exhibits a marked propensity for invading blood vessels. The mortality rate of invasive mucormycosis is very high (>30-50%), and 90% of mortality is related to disseminated diseases. We report a 62-year-old man with underlying diseases, such as diabetes and psoriatic arthritis, with a history of trauma before admission. Chest CT showed multiple cavities. Based on the suspected clinical manifestation of mucormycosis infection, the patient received a microbiological culture of bronchoalveolar lavage fluid, and metagenomics next generation sequencing (mNGS) was performed. The results suggested Klebsiella pneumoniae infection. However, Rhizopus microsporus strains were shown by the mNGS of transpulmonary puncture tissue. Therefore, we report a case in which rare pathogens are identified by mNGS.
Advanced Ovarian Pregnancy: A Case Report of Misdiagnosis and Surgical Outcomes
Authors: Noppamart Whangteeranon, Pang Pinyochotiwong
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Background:
Ovarian pregnancy is rare and difficult to diagnose preoperatively, especially in advanced gestational age. Misdiagnosis can increase the chance of emergent complications.
Case:
A misdiagnosed case of a 33-week ovarian pregnancy woman who underwent surgery due to a preoperative diagnosis of a dead fetus in utero, and transverse lie was reported with eventful surgical outcomes. This case resulted in the delivery of a dead fetus and a sudden massive hemorrhage that occurred after placental detachment. Oophorectomy could not be performed due to severe bowel adhesions and multiple feeding vessels from the bowel at the posterior part of the left ovary. The placental site was sutured at multiple sites, and local hemostatic agents were placed for hemostasis. Postoperatively, she received multiple transfusions and was safely discharged after 10 days.
Conclusion:
Obstetricians must be acutely aware of this condition, especially while performing sonography preoperatively, for better outcomes.
A Rare Case of a Solitary Fibrous Tumor of the Spermatic Cord
Authors: Moyosore Awobajo, Stefanie Hettwer, Sarah Hackman
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Solitary fibrous tumors (SFTs) are rare mesenchymal tumors, originally identified in the pleura. Even though they have subsequently been described in several extrapleural sites, the incidence of SFTs in the spermatic cord is particularly rare. Here, we report a case of a 27-year-old male that presented with a 3-year history of left scrotal swelling. Computed tomography (CT) and ultrasound demonstrated multiple solid, hypoechoic well-circumscribed masses that were separate from the testis. Surgical excision of the mass led to pathologic diagnosis of a solitary fibrous tumor involving the spermatic cord. Solitary fibrous tumors, although rare, are an important differential diagnosis for urogenital tumors.
Invasive Candidiasis Associated with Adenovirus Pneumonia
Authors: Guwani Liyanage, Madhusha Gonapaladeniya, Thushari Dissanayake
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Invasive Candida infections in immunocompetent children lead to high morbidity and mortality despite available treatment. Candida albicans and Candida parapsilosis are the most common pathogens; however, there are newly emerging pathogenic non-albicans species. Adenovirus accounts for at least 5-10% of respiratory infections in children, and specific serotypes are associated with severe pneumonia. To the best of our knowledge, invasive Candida infection complicating adenovirus-associated pneumonia in immunocompetent children has not been reported previously. Herein, we describe a preschool child with invasive candidiasis associated with adenovirus pneumonia.
Arsenic-induced pancreatitis
Authors: Sean Connelly, Krysia Zancosky, Katie Farah
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

The introduction of all-trans retinoic acid (ATRA) and arsenic trioxide has brought about tremendous advancement in the treatment of acute promyelocytic myelogenous leukemia (APML). In most instances, the benefits of these treatments outweigh the risks associated with their respective safety profiles. Although acute pancreatitis is not commonly associated with arsenic toxicity, it should be considered as a possible side effect. We report a case of arsenic-induced pancreatitis in a patient with APML.
Tram-track-like calcification in adult optic pathway glioma
Authors: Amalraj Sindhuja, Venkatraman Indiran, Rengarajan Santhanam, Prabakaran Maduraimuthu
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Gliomas of the optic pathways that occur in adults are rare tumours. The tram-track-like calcification of the optic nerve, which classically occurs with meningioma, has not been reported so far in optic pathway gliomas. Here, we present a case of high-grade glioma of the optic pathway with tram-track-like calcification of the optic nerve in a 42-year-old male. This case enhances our understanding of the MRI features of adult malignant optic pathway glioma.
Pregnancy outcome in patients with neuromyelitis optica spectrum disorder treated with rituximab: A case-series study
Authors: Maral Seyed Ahadi, Mohammad Ali Sahraian, Vahid Shaygannejad, Nassim Anjidani, Seyed Ehsan Mohammadiani Nejad, Nahid Beladi Moghadam, Hormoz Ayromlou, Gholam Ali Yousefi Pour, Sepideh Yazdanbakhsh, Mehrdad Jafari, Abdorreza Naser Moghadasi
Journal: Caspian J Intern Med (2021)
Keywords: neuromyelitis optica spectrum disorder, pregnancy, rituximab
MeSH terms: Case Reports

Background:
Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory disorder with a tendency to affect the spinal cord and optic nerves. As NMOSDs have a predilection for women of reproductive age and adopt an aggressive course during pregnancy, appropriate treatment strategies before conception and during pregnancy should be well-considered.
Case presentation:
In this report, the pregnancy outcome of eight pregnancies following rituximab treatment was assessed, which led to 50% live births with mean birth weight of 2777.50 (SD: 545.92) grams. Two patients had abortions due to doctor's recommendation. One pregnancy led to intrauterine fetal death (IUFD) due to nuchal cord. No spontaneous abortions were encountered. Two patients received rituximab during pregnancy. No major malformations or serious neonatal infections were encountered.
Conclusion:
Rituximab should be administered by caution in NMOSD patients who want to be pregnant and the probable adverse effects of the drug should be discussed by patients.
Hepatic Presentation of Late-Onset Multiple Acyl-CoA Dehydrogenase Deficiency (MADD): Case Report and Systematic Review
Authors: Maria Anna Siano, Claudia Mandato, Lucia Nazzaro, Gennaro Iannicelli, Gian Paolo Ciccarelli, Ferdinando Barretta, Cristina Mazzaccara, Margherita Ruoppolo, Giulia Frisso, Carlo Baldi, Salvatore Tartaglione, Francesco Di Salle, Daniela Melis, Pietro Vajro
Journal: Front Pediatr (2021)
Keywords: madd, case report, fatty liver, hypertransaminasemia, steatohepatitis
MeSH terms: Case Reports

Diagnosis of pediatric steatohepatitis is a challenging issue due to a vast number of established and novel causes. Here, we report a child with Multiple Acyl-CoA Dehydrogenase Deficiency (MADD) presenting with an underrated muscle weakness, exercise intolerance and an atypically severe steatotic liver involvement. A systematic literature review of liver involvement in MADD was performed as well. Our patient is a 11-year-old otherwise healthy, non-obese, male child admitted for some weakness/asthenia, vomiting and recurrent severe hypertransaminasemia (aspartate and alanine aminotransferases up to ×20 times upper limit of normal). Hepatic ultrasound showed a bright liver. MRI detected mild lipid storage of thighs muscles. A liver biopsy showed a micro-macrovacuolar steatohepatitis with minimal fibrosis. Main causes of hypertransaminasemia were ruled out. Serum aminoacids (increased proline), acylcarnitines (increased C4-C18) and a large excretion of urinary glutaric acid, ethylmalonic, butyric, isobutyric, 2-methyl-butyric and isovaleric acids suggested a diagnosis of MADD. Serum acylcarnitines and urinary organic acids fluctuated overtime paralleling serum transaminases during periods of illness/catabolic stress, confirming their recurrent nature. Genetic testing confirmed the diagnosis [homozygous c.1658A > G (p.Tyr553Cys) in exon 12 of the ETFDH gene]. Lipid-restricted diet and riboflavin treatment rapidly ameliorated symptoms, hepatic ultrasonography/enzymes, and metabolic profiles. Literature review (37 retrieved eligible studies, 283 patients) showed that liver is an extramuscular organ rarely involved in late-onset MADD (70 patients), and that amongst 45 patients who had fatty liver only nine had severe presentation. Conclusion: MADD is a disorder with a clinically heterogeneous phenotype. Our study suggests that MADD warrants consideration in the work-up of obesity-unrelated severe steatohepatitis.
A Case Report of Improved Palmoplantar Pustulosis following Periodontal Treatment and Possible Association with Diminished Systemic Subclinical Inflammation
Authors: Akiko Yamashita, Tomomi Sano, Misaki Iwashita, Fusanori Nishimura
Journal: Case Rep Dermatol Med (2021)
MeSH terms: Case Reports

Palmoplantar pustulosis (PPP) is a recurrent pustular dermatosis located on the palms and soles. Focal infection may exacerbate the symptoms of PPP, but the etiology is not fully clear. A 56-year-old woman with PPP was diagnosed with severe chronic periodontitis. Initial treatment for periodontitis combined with topical application of antibiotics and surgical treatment was performed. In this case, attention was paid to the relevance of systemic inflammation caused by periodontitis with the clinical symptoms of PPP. With periodontal treatment, the symptoms of PPP and periodontitis, high-sensitivity C-reactive protein (hs-CRP) level, and periodontal inflamed surface area (PISA) improved. This case highlights the importance of comprehensive dental examinations, including those for oral infections, such as periodontitis and other unrecognized sources of infection, and dental treatment in the overall management of PPP.
Mapping and surgical ablation of focal epicardial left ventricular tachycardia
Authors: Arif Elvan, Hauw T Sie, Anand R Ramdat Misier, Andre C Linnenbank, Peter Paul H M Delnoy, Jacques M T de Bakker
Journal: Case Rep Cardiol (2011)
MeSH terms: Case Reports

We describe a technical challenge in a 17-year-old patient with incessant epicardial focal ventricular arrhythmia and diminished LV function. Failure of ablation at the earliest activated endocardial site during ectopy suggested an epicardial origin, which was supported by specific electrocardiographic criteria. Epicardial ablation was not possible due to the localization of the origin of the ventricular tachycardia adjacent to the phrenic nerve. Minimal invasive surgical multielectrode high-density epicardial mapping was performed to localize the arrhythmia focus. Epicardial surgical RF ablation resulted in the termination of ventricular ectopy. After 2 years, the patient is still free from arrhythmias.
Foreign Body Granuloma in the Tongue by a Pequi Spine
Authors: Rafael Martins Afonso Pereira, Patrícia Cristine de Oliveira Afonso Pereira, Vitor Carvalho Rodrigues, Luiz Fernando Braga de Andrade, Elisa Morais de Carvalho, Helvécio Marangon Júnior
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Substances considered foreign to the human organism can penetrate it due to local trauma, initially causing an acute inflammatory response against these substances, involving a neutrophilic infiltrate that, when it fails to deal with these foreign bodies, ends up generating a granulomatous inflammatory response. Granuloma formation has been associated with a variety of conditions. The correct clinical and imaging diagnoses are extremely important for the dentist to choose an appropriate therapeutic approach, aiming at the best possible treatment. This work is aimed at describing a case report of a foreign body granuloma, formed on the tongue, from the penetration of a pequi spine, in a 76-year-old patient, in whom, after an imaging diagnosis with ultrasound, surgical removal of the lesion was performed, and the piece was sent for histopathological examination, which confirmed the initial diagnostic hypothesis of a foreign body granuloma. The initial diagnosis of foreign body granulomas is challenging. For this reason, more sophisticated means of diagnosis such as tomography and magnetic resonance become important in the diagnosis, as they can show with greater clarity and reliability the nature of the lesion and its relationship with adjacent anatomical structures. In the case in question, an ultrasound examination was chosen, which was extremely important as an aid to diagnosis, considerably improving surgical planning. In addition, after surgical removal, the result of the histopathological analysis is essential to determine the definitive diagnosis, as it determines the granulomatous characteristic of the lesion.