OpenMed/multicare-articles huggingface dataset:
Management of kikuchi-fujimoto disease using glucocorticoid: a case report
Authors: Selim Yalcin, Selami Kocak Toprak, Betul Erismis, Ozden Altundag, Handan Ozdemir, Nuray Topcuoglu
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis, is a self-limiting, benign, and rare systemic lymphadenitis with unknown etiology. The cardinal symptoms are fever, lymphadenopathy and night sweat; consequently, it is first necessary to rule out infectious, lymphoproliferative, and connective tissue diseases such as systemic lupus erythematosus. Histology can allow diagnosis by demonstrating necrotizing histiocyte lymphadenitis. Disease, which has no specific treatment, self-limits itself in 1 to 6 months clinically. However, non-steroid anti-inflammatory agents can be given for symptomatic treatment and there are reports using corticosteroids and antibiotics in complicated cases. This article concerns a 32-years-old female who diagnosed Kikuchi-Fujimoto disease and treated with glucocorticoid.
A Case Report of Tooth Wear Associated with a Patient's Inappropriate Efforts to Reduce Oral Malodor Caused by Endodontic Lesion
Authors: Masahiro Yoneda, Hatsumi Uchida, Nao Suzuki, Mariko Mine, Tomoyuki Iwamoto, Yosuke Masuo, Toru Naito, Yuko Hatano, Takao Hirofuji
Journal: Int J Dent (2009)
MeSH terms: Case Reports

Here, we report a case of severe tooth wear associated with a patient's inappropriate efforts to reduce oral malodor. A 72-year-old male patient visited our breath clinic complaining of strong breath odor. Former dentists had performed periodontal treatments including scaling and root planing, but his oral malodor did not decrease. His own subsequent breath odor-reducing efforts included daily use of lemons and vinegar to reduce or mask the odor, eating and chewing hard foods to clean his teeth, and extensive tooth brushing with a hard-bristled toothbrush. Oral malodor was detected in our breath clinic by several tests, including an organoleptic test, portable sulphide monitor, and gas chromatography. Although patient's oral hygiene and periodontal condition were not poor on presentation, his teeth showed heavy wear and hypersensitiving with an unfitted restoration on tooth 16. Radiographic examination of the tooth did not reveal endodontic lesion, but when the metal crown was removed, severe pus discharge and strong malodor were observed. When this was treated, his breath odor was improved. After dental treatment and oral hygiene instruction, no further tooth wear was observed; he was not concerned about breath odor thereafter.
Emergency correction of coagulation before major surgery in two elderly patients on oral anticoagulation
Authors: Marzia Angelo, Bernhard Gutmann, Michele Adami, Bernd Zagler, Anton Zelger, Christoph Pechlaner, Christian J Wiedermann
Journal: Thromb J (2007)

Recommendations for urgent reversal of oral anticoagulation with vitamin K1 antagonists are largely derived from case series employing empirical dosing regimens with vitamin K1 and prothrombin complex concentrates. Data on the use of prothrombin complex concentrates in this indication are scarce in the elderly who are at high risk of both hemorrhagic and thrombotic complications. The two cases presented here describe patients older than 75 years who underwent rapid International Normalized Ratio (INR) reversal with prothrombin complex concentrates for surgical treatment of a bleeding ruptured spleen and for emergency surgery of a dissecting aorta. Both patients had their INRs rapidly corrected to <or= 1.6 and underwent operation without complications. Evidence on treatment of patients who present with elevated INR and who have major bleeding or need to undergo emergency surgery is based mainly on observational studies. The two elderly patients presented here underwent successful emergency surgery after their INRs had been corrected with the intravenous use of vitamin K1 in combination with prothrombin complex concentrate that was administered according to current guideline recommendations.
A Case of Methotrexate Neurotoxicity Presented as Status Epilepticus, Encephalopathy, and High Fever
Authors: Itay Ayalon, Shirley Friedman, Yoav Binenbaum, Noga Oppenheimer, Shelly Shiran, Galia Grisaru-Soen, Shimrit Uliel-Sibony, Miguel Glatstein, Jennifer Melissa Kaplan, Efraim Sadot
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: aminophylline, fever, methotrexate, neurotoxicity, status epilepticus
MeSH terms: Antimetabolites, Antineoplastic / toxicity, Brain Diseases / chemically induced, Fever / chemically induced, Methotrexate / toxicity, Status Epilepticus / chemically induced, Case Reports, Review, Adolescent, Antimetabolites, Antineoplastic / therapeutic use, Bone Neoplasms / drug therapy, Emergency Service, Hospital, Humans, Male, Methotrexate / therapeutic use, Osteosarcoma / drug therapy, Antimetabolites, Antineoplastic, Methotrexate

High-dose methotrexate is used to treat a range of adult and childhood cancers including osteosarcoma. Significant neurotoxicity is reported in 1% to 4.5% of patients treated with high-dose methotrexate and can present in a wide variety of symptoms. We present a case of a 14-year-old boy with a recent diagnosis of osteosarcoma who presented to the emergency department with status epilepticus, altered mental status, and very high fever secondary to methotrexate neurotoxicity. We review current literature and discuss some controversies related to this state. We also describe high fever as one of the possible symptoms associated with this condition and suggest using specific magnetic resonance imaging sequence to uncover abnormal findings related to this state. Since high-dose methotrexate is not a rare treatment in this era, we believe that in addition to oncologists, emergency department and intensive care providers should be aware of the potential role of methotrexate in causing significant neurotoxicity and include it in the differential diagnosis when treating a patient presenting with new neurological symptoms in the setting of recent high-dose methotrexate treatment.
Total Hip Arthroplasty in a Patient with Mucopolysaccharidosis Type IVB
Authors: Yannick N T van den Eeden, Niklas Unter Ecker, Holger Kleinertz, Thorsten Gehrke, Tobias M Ballhause
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Introduction. Morquio syndrome or mucopolysaccharidosis (MPS) type IV is a rare autosomal recessive lysosomal storage disease, characterized by abnormal metabolism of glycosaminoglycans associated with specific skeletal deformities, also known as dysostosis multiplex. Case Presentation. We present the case of a 23-year-old patient with advanced osteonecrosis of the femoral head (ONFH) on both sides due to Morquio syndrome. A diagnosis of mucopolysaccharidosis type IVB was made after extensive genetic profiling. The patient had the condition for a long time. At 7 years old, the patient was treated with bilateral pelvic Salter's osteotomy. Afterward, the patient was able to walk freely but could never take part in sports. At 22 years old, pain in the hip increased, and magnetic resonance imaging showed a bilateral femur head necrosis. Hence, the patient underwent cementless total hip arthroplasty (THA). Intraoperatively, a periprosthetic fracture occurred. Therefore, revision surgery with internal fixation was performed on the next day. Postoperatively, a weight-bearing restriction of 20 kg on the left leg was imposed for 6 weeks. The patient made a full recovery and was able to move without residual complaints. Annual orthopedic evaluation in patients treated with surgical intervention is recommended. Discussion. Orthopedic challenges for mucopolysaccharidoses and corresponding bone alterations, known as dysostosis multiplex, involving trunk and limbs with typical radiological findings have been well described. The hip is invariably involved, with dysplasia affecting the femoral neck (coxa valga), femoral epiphysis (loss of sphericity, osteonecrosis), and a flared hypoplastic iliac wing. Symptomatic therapy consists, on the one hand, of a surgical procedure and, on the other hand, a variety of supportive measures. However, the management of joint replacement in lysosomal storage diseases has not been well reported. All patients with MPS should be considered at high risk for surgical intervention requiring anesthesia because of airway and cardiac disease manifestations. In the case of a need for THA, we recommend cemented stem fixation because of the overall poor bone quality in patients with Morquio syndrome.
Anterior Impingement Syndrome of the Ankle Caused by Osteoid Osteoma in the Talar Neck Treated with Arthroscopy and 3D C-Arm-Based Imaging
Authors: Masachika Ikegami, Takumi Matsumoto, Song Ho Chang, Hiroshi Kobayashi, Yusuke Shinoda, Sakae Tanaka
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Osteoid osteoma in periarticular lesions tends to have an unusual presentation that likely leads to a delayed or missed diagnosis compared with a typical osteoid osteoma in the metaphysis or diaphysis of the long bone. In cases that are unresponsive to conservative treatment, surgical interventions including en bloc resection, computed tomography-guided percutaneous treatment, and arthroscopic resection have been performed; however, these methods frequently result in inadequate tumor resection and recurrence. Here we present a case of a 16-year-old girl with osteoid osteoma in the talar neck presenting as anterior impingement syndrome due to marked synovitis in the ankle joint which was successfully treated without complications by arthroscopic synovectomy and tumor resection followed by intraoperative 3D C-arm-based imaging confirming complete tumor lesion removal. Her pain was relieved immediately after the surgery, and there was no recurrence at 12 months of follow-up. This is the first case report of the surgical treatment of the osteoid osteoma in the talar neck with the combination methods of arthroscopy and 3D C-arm-based imaging.
Long-Term Medical Follow-Up (for More than 15 Years) of a Patient with Stage IA Mycosis Fungoides Originally Presenting in Childhood: Remission for >15 Years with Localised Electron Beam Therapy
Authors: Eric Bessell, Martin Dalton, John David Parry
Journal: Case Rep Dermatol Med (2021)
MeSH terms: Case Reports

A man now aged 80 years has received specialist care for stage 1A mycosis fungoides for 58 years. The disease developed in childhood. Long-term follow-up (>30 years) of patients with mycosis fungoides is infrequently described in the world literature. The disease in this patient was limited to 5 areas, but these were large (up to 25 cm in diameter). The rest of the skin was normal clinically. All 5 areas were treated separately with electron beam therapy (3-4 MeV) to a dose of 30 Gy in 15 fractions over 3 weeks between 2000 and 2005. Complete regression was obtained in all 5 areas, and the patient has been in complete remission for 15 years after living with the disease previously for over 40 years.
Acute myeloid leukaemia presenting as acute liver failure-a case report and literature review
Authors: Kai Sun, Ryan J Reynolds, Tiffany G Sheu, Jessica A Tomsula, Lara Colton, Lawrence Rice
Journal: Ecancermedicalscience (2019)
Keywords: acute liver failure, acute myeloid leukaemia, obstructive jaundice
MeSH terms: Case Reports

A 75-year-old woman presented with rapidly progressive fatigue, abdominal pain and jaundice. Physical examination revealed tender abdomen and splenomegaly. Magnetic resonance cholangiogram showed marked hepatomegaly, splenomegaly and scattered nodules or masses in the liver and spleen. The patient expired from multiorgan failure. Autopsy revealed infiltration of the liver, spleen and bone marrow by acute myeloid leukaemia.
Syndrome of Reduced Sensitivity to Thyroid Hormones: Two Case Reports and a Literature Review
Authors: Anastasios Anyfantakis, Dimitrios Anyfantakis, Irene Vourliotaki
Journal: Case Rep Endocrinol (2016)

Resistance to thyroid hormone (RTH) is an extremely rare dominantly inherited condition of impaired tissue responsiveness to thyroid hormone (TH). Most patients with RTH have mutations in the gene that encodes the β isoform of the receptor of thyroid hormone (THR-β gene). Mutant receptors are unable to activate or repress target genes. The majority of them are asymptomatic or rarely have hypo- or hyperthyroidism. RTH is suspected by the finding of persistent elevation of serum levels of free T3 (FT3) and free T4 (FT4) and nonsuppressed TSH. We present two cases of RTH diagnosed after total thyroidectomy. The first patient was initially diagnosed with primary hyperthyroidism due to toxic multinodular goiter. The second patient had undergone thyroidectomy for multinodular goiter 16 years before diagnosis of RTH. After thyroidectomy, although on relatively high doses of levothyroxine, both of them presented with the laboratory findings of RTH. Genetic analysis revealed RTH.
Rare brain and pulmonary abscesses caused by oral pathogens started with acute gastroenteritis diagnosed by metagenome next-generation sequencing: A case report and literature review
Authors: Minhua Chen, Zhiyi Lai, Mingjun Cheng, Tianyu Liang, Zongbin Lin
Journal: Front Cell Infect Microbiol (2022)
Keywords: brain abscess, diagnosis, metagenomic next generation sequencing, odontogenic infection, treatment
MeSH terms: Gastroenteritis, Lung Abscess, Case Reports, Review, Research Support, Non-U.S. Gov't, Adult, Anti-Bacterial Agents, Brain / diagnostic imaging, High-Throughput Nucleotide Sequencing / methods, Humans, Male, Metagenome, Young Adult, Anti-Bacterial Agents

Odontogenic brain and pulmonary abscesses are extremely rare infectious diseases. It is mainly caused by the upward or downward transmission of local infection or blood-borne spread. In recent years, with the wide application of some novel testing methods in clinical practice, the diagnosis of unexplained infections such as odontogenic abscesses in different organs has gradually become clear. We report a case of a 21-year-old male who was healthy and had not received any oral treatment before onset. He started with acute gastroenteritis-related symptoms, then developed meningitis-related symptoms seven days later with septic shock. No obvious abscess lesions were found on head computed tomography (CT) at admission, and the etiology was not clear by routine examination, which was very easy to misdiagnose as a serious infection caused by intestinal pathogens. But odontogenic pathogens were found both in his blood and cerebrospinal fluid through metagenomic next-generation sequencing (mNGS) analysis. Subsequently, rechecked imaging examination displayed multiple brain and pulmonary abscesses. Finally, it was diagnosed as an odontogenic brain and pulmonary abscess. After an extremely lengthy anti-infection course (13 weeks of intravenous antibiotics plus 2 weeks of oral antibiotics) and surgery, the patient was improved and discharged from the hospital. From this case, we could see that the development of new diagnostic technologies such as mNGS plays an important role in the early and confirmed diagnosis of diseases previously difficult to diagnose such as odontogenic polymicrobial infections and ultimately helps to improve the prognosis of these patients.
Ipsilateral Salpingopexy in a Case of Isolated Tubal Torsion
Authors: Shweta Mittal, Bhawani Shekhar
Journal: Cureus (2023)
Keywords: detorsion, isolated tubal torsion, laparoscopy, prompt diagnosis, salpingopexy
MeSH terms: Case Reports

Isolated fallopian tube torsion (IFTT) is a rare emergency condition affecting young females. Due to the diagnostic dilemma, diagnosis of IFTT is often delayed leading to tubal necrosis and salpingectomy as the only choice of treatment. If diagnosed early, it can be managed conservatively by detorsion. Salpingopexy is an option described in the literature to prevent recurrence of this condition; however, evidence is scarce. This case report highlights the role of prompt diagnosis and management of IFTT. It describes a case of IFTT with paratubal cysts and a long tube in a young female, which was timely diagnosed and managed conservatively by laparoscopic detorsion, paratubal cystectomy, and ipsilateral salpingopexy.
Refractile superficial retinal crystals and chronic retinal detachment: case report
Authors: Maged S Habib, Sinead Byrne, John H McCarthy, David H W Steel
Journal: BMC Ophthalmol (2006)
MeSH terms: Macula Lutea / metabolism, Retinal Detachment / complications, Retinal Detachment / metabolism, Retinal Diseases / complications, Retinal Diseases / metabolism, Case Reports, Adult, Chronic Disease, Crystallization, Fundus Oculi, Humans, Male, Middle Aged, Retinal Detachment / diagnosis, Retinal Diseases / diagnosis, Scattering, Radiation, Tomography, Optical Coherence

Background:
Few previous reports have described the presence of retinal refractile opacities at the macular area in patients presenting with longstanding peripheral retinal detachment. The exact nature of these opacities is unknown.
Case presentation:
Two patients were referred with an abnormal appearance of refractile opacities in the macular area noted during routine examination. Both were found to have longstanding peripheral retinal detachments. Subretinal fluid analysis of one patient revealed the presence of multiple birefringent crystals. We hypothesise that these crystals are the origin of the refractile macular opacities noted.
Conclusion:
This report describes the rare presentation of asymptomatic peripheral retinal detachment by the detection of refractile macular opacities on routine examination. It highlights the importance of meticulous peripheral retinal examination in these cases. The article also describes the findings of the subretinal fluid analysis and discusses the possible hypothesis behind their appearance.
Acute hydrocephalus caused by intraspinal neurocysticercosis: case report
Authors: Seok-Won Kim, Hui Sun Wang, Chang Il Ju, Dong-Min Kim
Journal: BMC Res Notes (2014)
MeSH terms: Hydrocephalus / etiology, Neurocysticercosis / complications, Spinal Diseases / complications, Case Reports, Albendazole / therapeutic use, Brain Damage, Chronic / etiology, Combined Modality Therapy, Decompression, Surgical, Dexamethasone / therapeutic use, Drug Therapy, Combination, Gait Disorders, Neurologic / etiology, Headache / etiology, Humans, Hydrocephalus / surgery, Magnetic Resonance Imaging, Male, Middle Aged, Neurocysticercosis / drug therapy, Neurocysticercosis / surgery, Spinal Diseases / drug therapy, Spinal Diseases / parasitology, Spinal Diseases / surgery, Urinary Incontinence / etiology, Ventriculoperitoneal Shunt, Dexamethasone, Albendazole

Background:
Intraspinal neurocysticercosis is an uncommon manifestation that may present as an isolated lesion. Furthermore, acute hydrocephalus caused by isolated intraspinal neurocysticercosis without concomitant cerebral involvement is extremely rare.
Case presentation:
A 64-year-old man presented with a history of severe headache, an unsteady gait, and occasional urinary incontinence. Magnetic resonance imaging of the thoraco-lumbar spine revealed multiple, cystic, contrast-enhancing intraspinal lesions. A computed tomographic scan of the brain showed marked ventricular dilatation but no intraparenchymal lesions or intraventricular cysticercal lesions. This case of acute hydrocephalus was found to be caused by isolated intraspinal neurocysticercosis and was treated by ventriculoperitoneal shunt placement and surgical removal of the intraspinal lesions (which were histologically confirmed as neurocysticercosis), followed by administration of dexamethasone and albendazole.
Conclusion:
Isolated spinal neurocysticercosis should be considered in the differential diagnosis of acute hydrocephalus when no explanation is found in the brain, particularly in geographical regions endemic for cysticercosis.
The First Reported Case of Majocchi's Granuloma with Malbranchea sp. in an Immunocompetent Patient
Authors: Anusha Govind, Nathan L'Etoile, Gustavo Vasquez
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Majocchi's granuloma is a rare condition in which a dermatophyte invades the deeper layers of the dermis and subcutaneous tissue and can often be misidentified and treated as eczema. It has a variable presentation ranging from cutaneous lesions to deeper infections in immunocompromised patients. No prior cases have described the formation of Majocchi's granuloma with the deuteromycetes, Malabranchea.
A big mesenteric rupture after blunt abdominal trauma: A case report and literature review
Authors: Christos K Stefanou, Stefanos K Stefanou, Kostas Tepelenis, Stefanos Flindris, Thomas Tsiantis, Spyridon Spyrou
Journal: Int J Surg Case Rep (2019)
Keywords: blunt abdominal trauma, mesentery trauma, small bowel trauma, urgent laparotomy

Introduction:
A blunt abdominal trauma especially in organs less commonly injured (such as small bowel and mesentery injury), are difficult to diagnose.
Presentation of case:
We report a case of a blunt abdominal trauma, in a 43 year old male presented in the Emergency Department after a truck vehicle accident. He sustained a chest injury, a pelvic fracture and diffuse abdominal tenderness. The patient had tachycardia (120 pulses/min) and normal blood pressure (120/90mmHg). The computed tomography (CT) showed only free fluid. We placed two chest tubes (due to pneumothorax and hemothorax at both sides) and the patient went to the operating room (OP). An external pelvic osteosynthesis was performed first and then we did an exploratory laparotomy, which revealed a big mesenteric rupture. Finally, an enterectomy (circa 2m) with a fist stage side to side anastomosis was performed.
Discussion:
Mesentery and bowel injury constitutes 3-5% of blunt abdominal injuries. The main diagnostic challenge is to identify lesions that require surgery. Diagnostic delay over 8h can lead to high morbidity and mortality rates. Laparotomy is the standard of care in hemodynamically unstable patients.
Conclusion:
In polytrauma cases with abdominal pain and unclear CT findings the decision to proceed with exploratory laparotomy is better than a conservative treatment, because any surgical delay can lead to severe complications.
Lipomatous Hypertrophy: An Accidental Finding in Heart
Authors: F Petrelli, L Spagnoli, S Aversa, S Tripodi, C Bellan
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Lipomatous hypertrophy is an uncommon benign lesion of the atrium, generally asymptomatic, characterized by unencapsulated accumulation of adipose tissue entrapping cardiomyocytes. This pathology generally remains unnoticed and often emerges as an occasional finding. Here, we report two cases from our hospital including a review of the available literature.