OpenMed/multicare-articles huggingface dataset:
Mycobacterium tuberculosis-Associated Necrotizing Pneumonia With Adjunctive Corticosteroid Therapy
Authors: Ho Lam Nguyen, Huyen Duong Thanh, Thuong Vu Le, Ngoc Tran Van
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Necrotizing pneumonia induced by Mycobacterium tuberculosis is a rare but severe condition. It is difficult to distinguish between M. tuberculosis-associated and bacterial necrotizing pneumonia. The optimal treatment for this condition is controversial. Here, we report a case of M. tuberculosis-associated necrotizing pneumonia treated with the adjunctive corticosteroid and the antituberculosis drugs.
Early cholestasis in neonatal lupus erythematosus
Authors: Mozhgan Shahian, Amir Khosravi, Mohammad-Hossein Anbardar
Journal: Ann Saudi Med (2011)
MeSH terms: Cholestasis / complications, Lupus Erythematosus, Cutaneous / complications, Case Reports, Autoantibodies / blood, Glucocorticoids / therapeutic use, Heart Block / complications, Heart Block / congenital, Humans, Hyperbilirubinemia / complications, Infant, Newborn, Lupus Erythematosus, Cutaneous / diagnosis, Lupus Erythematosus, Cutaneous / immunology, Male, Prednisolone / therapeutic use, Serologic Tests, Thrombocytopenia / complications, Thrombocytopenia / drug therapy, Autoantibodies, Glucocorticoids, Prednisolone, Congenital heart block

Neonatal lupus erythematosus is an immune-mediated disease caused by transplacental passage of maternal autoantibodies, primarily anti-Ro (SSA) and anti-La (SSB). The major clinical manifestations are congenital heart block, cutaneous lupus lesions, and hematologic problems. Hepatic, pulmonary, and neurological involvements are rare. We report a 5-day-old male neonate, born to a clinically asymptomatic mother, presenting with conjugated hyperbilirubinemia, cutaneous lupus lesions, congenital heart block, and thrombocytopenia. Both the neonate and his mother had high titers of antinuclear antibodies (1:640), anti-Ro (SSA), and anti-La (SSB) antibodies. The thrombocytopenia improved with prednisolone (2 mg/kg/day) for 14 days. The skin lupus rashes and bilirubin resolved 2 months later, and liver enzymes were completely normal by 6 months.
Going beyond "bad news": A surgical case report and systematic review of the literature surrounding futile care
Authors: Scott Hickman, Antonio Gangemi
Journal: Int J Surg Case Rep (2019)
Keywords: case report, futile care, medical futility, surgical futility

Introduction:
Surgeons frequently deliver "bad news" to patients, but do they know how to address situations where further surgery is considered futile? Is there a clear definition of futile care in the literature? This paper explores these questions and seeks to start a conversation about how we can train future surgeons to deliver news of futile care.
Presentation of case:
This paper describes how one surgical team handled a difficult case of futile care and provides an interview from the perspective of a surgical resident.
Discussion:
The case report gives one example of how the news of futile care was delivered and how appropriate steps were taken to provide continued management of the patient and support to the family. A systematic review of the literature surrounding futile care reveals no consensus on how to define futile care within the medical community.
Conclusion:
There is a paucity of information surrounding how surgeons should manage cases of futile care. The literature focuses on the physician-patient relationship and includes methods for delivering bad news, yet it fails to identify a consensus definition of futile care and does not provide guidelines that future surgeons can follow when they encounter these cases. With this paper we seek to open a discussion about how to define futile care and how to teach future surgeons best practices when managing these cases.
Case report: Cardiac metastatic uterine intravenous leiomyomatosis excision with extracorporeal venous shunt under the guidance of 3-dimensional printing
Authors: Hong Chen, Yu Mao, Hongtao Xie, Dejun Liu, Shun Zhang, Yongcang Tian, Jian Yang, Benjian Bai
Journal: Front Cardiovasc Med (2023)
Keywords: 3-dimensional printing, extracorporeal venous shunt, intravenous leiomyomatosis (ivl), surgical treatment, uterine leiomyomatosis
MeSH terms: Case Reports

Intravenous leiomyomatosis (IVL) is relatively rare, and the incidence of cardiac IVL is even lower. The case report introduces a 48-year-old woman with two episodes of syncope in 2021. Echocardiography showed a cord-like mass in the inferior vena cava (IVC), right atrium (RA), right ventricle (RV) and pulmonary artery. Computed tomography venography and magnetic resonance imaging showed strips in RA, RV, IVC, right common iliac vein, and internal iliac vein, as well as a round-like mass in the right uterine adnexa. Combined with the patient's prior surgical history and rare anatomical structures, surgeons used cardiovascular 3-dimensional (3D) printing technology to create patient-specific preoperative 3D printed model. The model could help surgeons to visually and accurately understand the size of IVL and its relationship to adjacent tissues. Finally, surgeons successfully performed a concurrent transabdominal resection of cardiac metastatic IVL and adnexal hysterectomy with off-cardiopulmonary bypass. Preoperative evaluation and guidance of 3D printing may play a critical role to ensure this surgery for the patient with rare anatomical structures and high surgical risk. Clinical Trial Registration: [ClinicalTrials.gov], Protocol Registration System [NCT02917980].
Reconstruction of critically-sized perineal defect with perforator flap puzzle technique: a case report
Authors: D Kosutic, N Tsapralis, P Gubbala, M Smith
Journal: Case Reports Plast Surg Hand Surg (2019)
MeSH terms: Case Reports

Extensive defects in perineal reconstruction cannot be effectively reconstructed with only a single perforator flap or other conventional techniques. We present a combination of three different types of flaps including pedicled ALT-rectus-vastus lateralis, gracilis-PAP flap and two IGAP flaps as an alternative option for reconstructing a critically-sized perineal defect.
A Case of Atrial Tachycardia Circulating around a Left Atrial Roof Scar with Diabetes Mellitus and Renal Failure on Hemodialysis
Authors: Naoko Hijioka, Masashi Kamioka, Hitoshi Suzuki, Yasuchika Takeishi
Journal: Case Rep Med (2016)

Introduction. Little is known about the effects of volume change by hemodialysis (HD) and mechanical stress caused by an anatomical structure being in contact with the left atrium on the progression of atrial remodeling. We experienced a case of atrial tachycardia (AT) in a patient who had left atrial (LA) scarring at the LA roof and a low-voltage area with slow conduction around the LA scar as components of AT circuit. Here, we present the conceivable hypothesis of the LA scar and the low-voltage area formation. Our concept can be useful in developing a strategy for ablation in a patient with chronic renal failure (CRF) on HD. Case Report. A 65-year-old man with CRF on HD was referred for AT ablation. Three-dimensional electroanatomical mapping revealed that the AT conducted around an LA scar in a counterclockwise fashion. There was a slow conduction area at the superior side of the LA scar, where the AT was terminated during the ablation. Computed tomography indicated a close relationship between the LA and the anatomical structures (ascending aorta and pulmonary artery). Conclusion. Volume change by HD and close contact of anatomical structures to the LA can promote atrial remodeling, resulting in AT occurrence.
Absent Right Side Iliac Arterial System, an Intraoperative Surprise during Live Related Recipient Renal Transplantation
Authors: Vijay Radhakrishnan, Rana Kumar, Datson George, G P Abraham
Journal: Case Rep Transplant (2015)

Introduction. Renal transplantation has become the standard of care for patients with end stage renal disease. We present a rare case of an absent right sided iliac arterial system encountered during recipient renal transplantation. The presence of such vascular anomaly intraoperatively can present a technically challenging situation to the surgeon. Case Presentation. During a routine renal transplantation of a 34-year-old man, we encountered a complete absence of right side iliac arterial system and a prominent branch arising from left hemipelvis and coursing to the right lower limb and the urinary bladder. The artery to the bladder was divided and anastomosed end to end to the donor renal artery. Intraoperatively the renal perfusion and the urine output were good. A posttransplant magnetic resonance angiogram done six weeks later revealed good vascular supply to the kidney and the lower limb. Conclusion. Absent iliac artery on one or both sides is a rare phenomenon. The presence of it during an unanticipated renal transplant surgery can pose a significant technical challenge to the surgeons. We advocate routine assessment of pelvic vasculature before recipient renal transplant surgery so as to avoid a difficult situation like this.
Neurologic Imaging in a Patient with Cirrhosis and Altered Mental Status: To CT or Not to CT
Authors: Alexander Polyak, Serguei Bannykh, Andrew Klein, Vinay Sundaram
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Hepatic encephalopathy represents a continuum of neuropsychiatric symptoms among patients with end-stage liver disease. When a patient with cirrhosis presents with altered mental status (AMS), routine neurologic imaging is not typically recommended, due to low diagnostic yield. Guidance from the American Association for the Study of Liver Disease states that, on initial presentation, brain imaging is not required unless there are other signs of intracranial pathology, including focal neurologic deficits. We present a case of a 61-year-old female with cirrhosis presenting with AMS without focal deficits, in whom neurological imaging revealed a meningioma and subsequent resection led to symptom improvement.
A Rare Case of Retrogastric Abscess Occurring Six Months after N-Butyl-2-Cyanoacrylate Injection into Gastric Varices
Authors: Ikram Hussain, Andrew Eu Boon Kwek, Veeraraghavan Meyyur Aravamudan, Chern Hao Chong, Tiing Leong Ang
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Background. Injection with N-butyl-2-cyanoacrylate is a proven and successful therapeutic modality for treatment of patients with bleeding gastric varices. However, a variety of complications have also been associated with its use. Here, we report a rare case of retrogastric abscess which occurred almost six months after this therapy. This abscess was attributed to the hampered microbial clearance caused by the venous obliterations from N-butyl-2-cyanoacrylate. The abscess was successfully treated with 3 months of antibiotics.
Marchiafava-Bignami and Alcohol Related Acute Polyneuropathy: The Cooccurrence of Two Rare Entities
Authors: Samine Boloursaz, Sirous Nekooei, Farrokh Seilanian Toosi, Hossein Rezaei-Dalouei, Behrooz Davachi, Sahar Kazemi, Bita Abbasi
Journal: Case Rep Neurol Med (2016)

Objectives. The aim of this article is to represent the first reported case with cooccurrence of two rare alcohol related complications. Case Report. We report a 38-year-old man with chronic alcoholism who presented with both cranial and peripheral nerve palsy. On MRI examination characteristic findings of Marchiafava-Bignami disease were recognized. Discussion. Marchiafava-Bignami disease (MBD) is a rare complication of long-term, heavy alcohol abuse that has characteristic MRI findings. Acute alcohol related polyneuropathy (AARP) is another rare and not-well-understood complication of chronic alcohol abuse. We could not find any previous report of the cooccurrence of these two complications in the literature.
Superior thyroid cornu anatomical variation causing globus pharyngeous and Dysphagia
Authors: Jiannis K Hajiioannou, Vasiliki Florou, Panagiotis Kousoulis
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Objective. Rare case presentation of thyroid cartilage variation causing globus sensation and dysphagia. Method. Case report and review of the literature concerning thyroid cartilage variant of clinical significance. Results. Middle-aged male patient presented with globus sensation and painful swallow without previous injury of the larynx. Clinical examination and diagnostic procedures revealed a rare anatomic aberrance of the thyroid cartilage. Surgical treatment was declined by the patient who accepted a yearly followup. Conclusion. Morphometric studies do not report the dislocation of the superior thyroid cornu, and very few cases have been described either of which were attributed to trauma or to unknown cause. The present case is to be added to the very few cases of superior thyroid cornu dislocation of unknown aetiology. Clinicians should be aware of this rare variation using CT neck as the imaging study of choice. Direct endoscopy rules out any synchronous disease or malignancies.
Ruptured gastric artery aneurysms: two cases and emergency imaging findings
Authors: Simon McQueen, John Vedelago, John Velkovic, Mark Page, Elizabeth Dick
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

A ruptured gastric artery aneurysm is a rare but important possible cause of massive intra-abdominal or gastrointestinal haemorrhage, and carries a high risk of mortality. Although aneurysms of the gastric arteries are uncommon, emergency radiologists and clinicians should be familiar with the clinical presentation, imaging findings and pathophysiology. We present two cases of massive intra-abdominal haemorrhage and haemodynamic shock secondary to acute rupture of previously occult gastric artery aneurysm and review the relevant anatomy, imaging findings and pathophysiology of gastric and other visceral artery aneurysms. By virtue of its location in the lesser omentum, a ruptured gastric artery aneurysm may result in a typical pattern and distribution of adjacent haematoma in the upper abdomen. Our description of imaging findings highlights a characteristic epicentre of intraperitoneal haemorrhage, and its typical mass effect displacement of surrounding viscera, to aid the emergent diagnosis of gastric artery aneurysm rupture.
A turner syndrome patient carrying a mosaic distal x chromosome marker
Authors: Roberto L P Mazzaschi, Juliet Taylor, Stephen P Robertson, Donald R Love, Alice M George
Journal: Case Rep Genet (2014)

A skin sample from a 17-year-old female was received for routine karyotyping with a set of clinical features including clonic seizures, cardiomyopathy, hepatic adenomas, and skeletal dysplasia. Conventional karyotyping revealed a mosaic Turner syndrome karyotype with a cell line containing a small marker of X chromosome origin. This was later confirmed on peripheral blood cultures by conventional G-banding, fluorescence in situ hybridisation and microarray analysis. Similar Turner mosaic marker chromosome cases have been previously reported in the literature, with a variable phenotype ranging from the mild "classic" Turner syndrome to anencephaly, agenesis of the corpus callosum, complex heart malformation, and syndactyly of the fingers and toes. This case report has a phenotype that is largely discordant with previously published cases as it lies at the severe end of the Turner variant phenotype scale. The observed cytogenetic abnormalities in this study may represent a coincidental finding, but we cannot exclude the possibility that the marker has a nonfunctioning X chromosome inactivation locus, leading to functional disomy of those genes carried by the marker.
A Rare but Fascinating Disorder: Case Collection of Patients with Schnitzler Syndrome
Authors: Maaman Bashir, Brittany Bettendorf, Richard Hariman
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

Background:
Schnitzler syndrome is a rare disorder characterized by a chronic urticarial rash and monoclonal gammopathy (IgM in more than 90% of the cases). It is difficult to distinguish from other neutrophilic urticarial dermatoses, and diagnosis is based on the Strasbourg criteria. Interleukin-1 is considered the key mediator, and interleukin-1 inhibitors are considered first line treatment. Here, we present two cases of Schnitzler syndrome, both successfully treated with anakinra.
Objectives:
To increase awareness regarding clinical presentation, diagnosis, and treatment of this rare disorder.
Cases:
We describe the clinical features and disease course of two patients with Schnitzler syndrome, diagnosed using the Strasbourg criteria. Both were treated with anakinra with remarkable response to therapy.
Conclusion:
Schnitzler syndrome is a rare and underdiagnosed disorder. High suspicion should be maintained in patients with chronic urticaria-like dermatoses, intermittent fevers, and arthralgias. A serum protein electrophoresis and immunofixation should be performed in these patients. The diagnosis is important to recognize as Schnitzler syndrome is associated with malignancy. A lymphoproliferative disorder develops in about 20% of patients at an average of 7.6 years after onset of symptoms. Thus, patients warrant long-term follow-up. IL-1 inhibitors are extremely effective in relieving symptoms and are considered first line therapy.
Idiopathic, serial coronary vessels dissection in a young woman with psychological stress: a case report and review of the literature
Authors: Alessio Arrivi, Caterina Milici, Carlo Bock, Attilio Placanica, Enrico Boschetti, Marcello Dominici
Journal: Case Rep Vasc Med (2012)

Spontaneous coronary artery dissection (SCAD) is a very rare disease, associated with high mortality rate, whose etiology and pathogenesis are poorly understood. Its sporadic nature and the varied angiographic extent make firm recommendations regarding revascularization impossible. The case described is that of a young, otherwise healthy woman, without a known underlying condition which may lead to SCAD, but with a history of intense psychological stress. We managed the patient with a conservative approach based on watchful waiting, medical therapy, and plain old balloon angioplasty (POBA) with low inflation atmospheres.
Unusual cause of filling defect in pulmonary artery: pulmonary artery sarcoma
Authors: Cisel Yazgan, Hakan Ertürk, Aysenaz Taskin
Journal: Pan Afr Med J (2020)
Keywords: pulmonary artery, intimal sarcoma, pulmonary thromboembolism
MeSH terms: Pulmonary Artery / pathology, Pulmonary Embolism / diagnosis, Sarcoma / diagnosis, Vascular Neoplasms / diagnosis, Case Reports, Computed Tomography Angiography, Diagnosis, Differential, Diagnostic Errors, Female, Humans, Middle Aged, Pulmonary Artery / diagnostic imaging, Sarcoma / complications, Sarcoma / physiopathology, Vascular Neoplasms / complications, Vascular Neoplasms / physiopathology

Pulmonary artery (PA) sarcoma is an extremely rare malignant tumor of pulmonary artery. It is often misdiagnosed as pulmonary thromboembolism (PTE) because of its clinical and imaging features which are quite similar to PTE. Multimodality diagnostic imaging and recognition of specific imaging characteristics with appropriate clinical suspicion are required to make correct diagnosis. In this report, we present a case of PA sarcoma with imaging and clinical features as well as emphasize significance of using multimodality imaging.
Achieving Better Function through Combining Orthodontics and Restorative Dentistry in the Case of Dental Abrasions
Authors: Laís C Giacobbo, Lara Karolina Guimarães, Isabelle Adad Fornazari, Eduardo Monteiro Meda, Orlando Motohiro Tanaka
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

This case report describes the orthodontic treatment used to prepare for restorative dentistry, aimed at the functional rehabilitation of an adult patient with Class I malocclusion, right posterior crossbite, and significant tooth wear on the palatal face of the maxillary canine to canine. The orthodontic treatment was performed with a total fixed appliance mini-expandex-type expander, associated with vertical elastics. Good dental intercuspation was obtained and enabled conditions for the restoration of the abrasions on the palatal surfaces of the maxillary incisors and canines and the tips of the buccal cusps of the maxillary right premolars and first molar. Excellent results were found during a 37-month follow-up.
A Case of Wellens Syndrome in a 30-Year-Old Woman From Sub-Saharan Africa: A Perplexing Clinical Entity With Invaluable Lessons
Authors: Pedro Pallangyo, Smita Bhalia, George Longopa, Kawajika Mwinyipembe, Jalack Millinga, Nsajigwa Misidai, Happiness Judical Swai, Zabella Seif Mkojera, Naairah Rashid Hemed, Rydiness Mulashani, Polycarp Seraphine, Regan Valerian Massawe, Alice Kaijage, Peter Kisenge, Mohamed Janabi
Journal: J Investig Med High Impact Case Rep (2020)
Keywords: lad coronary t-wave syndrome, lad stenosis, wellens syndrome, anterior myocardial infarctions, biphasic t-wave inversions, preinfarction stage, unstable angina
MeSH terms: Anterior Wall Myocardial Infarction / diagnosis, Chest Pain / etiology, Coronary Stenosis / diagnostic imaging, Electrocardiography, Case Reports, Adult, Angioplasty, Anterior Wall Myocardial Infarction / complications, Anterior Wall Myocardial Infarction / therapy, Cardiac Catheterization, Coronary Angiography, Coronary Stenosis / complications, Coronary Stenosis / therapy, Female, Humans, Syndrome, Tanzania

With an estimated contribution of up to 6% of all acute coronary events, young adults are experiencing an escalating burden and mortality attributable to coronary artery disease (CAD) worldwide. Wellens syndrome, a preinfarction clinical entity with distinctive electrocardiographic (ECG) features and high propensity for extensive anterior wall infarctions, affects about 15% of unstable angina subpopulation. We report challenges and lessons learnt from the first ever documented case of Wellens syndrome in Tanzania. A 30-year-old female of African descent was referred to us from an upcountry zonal referral hospital for etiological determination of chest pain and expert management. Her medical history was unremarkable, and she had no apparent risk factors for CAD. She presented with a 7-day history of ongoing sharp central chest pain that was radiating to the neck and jaws and relieved momentarily by morphine. She had stable vitals with an unremarkable systemic examination; however, a 12-lead ECG revealed deeply inverted T-waves on leads V2 through V4. Based on our extensive history and physical examination we came up with a diagnosis of type B Wellens syndrome with impending anterior wall myocardial infarction. She underwent cardiac catheterization that revealed a nonthrombogenic severe subocclusive (>95%) mid left anterior descending artery stenosis. Subsequently, angioplasty was performed successfully with a resolute integrity stent, and TIMI III flow was achieved. To conclude, despite its relative frequency, physicians' awareness of Wellens syndrome pathognomonic ECG features is of paramount importance to curb its attributable morbidity and mortality.