OpenMed/multicare-articles huggingface dataset:
Encephalitis and cytokine storm secondary to respiratory viruses in children: Two case reports
Authors: Pollyana C P Santos, Adrian J Holloway, Jason W Custer, Tomaz Alves, Liliana Simon
Journal: Front Pediatr (2023)
Keywords: children, cytokine storm, encephalitis (mesh), parainfluenza virus, respiratory syncytial virus
MeSH terms: Case Reports

Introduction:
Encephalitis is a syndrome characterized by brain damage secondary to an inflammatory process that is manifested by cognitive impairment and altered cerebral spinal fluid analysis; it may evolve with seizures and coma. Despite viral infections representing the main cause of encephalitis in children, respiratory syncytial virus (RSV) and parainfluenza virus are mostly associated with respiratory presentations. Uncommonly, the inflammatory phenomena from encephalitis secondary to viral agents may present with an exacerbated host response, the so-called cytokine storm. The link between these infectious agents and neurologic syndromes resulting in a cytokine storm is rare, and the underlying pathophysiology is still poorly understood.
Case presentation:
A 5-year-old girl and a 2-year-old boy infected with parainfluenza and RSV, respectively, were identified through nasopharyngeal polymerase chain reaction. They were admitted into the pediatric intensive care unit due to encephalitis and multiple organ dysfunction manifested with seizures and hemodynamic instability. Magnetic resonance imaging findings from the first patient revealed a bilateral hypersignal on fluid-attenuated inversion recovery in the cerebral hemispheres, especially in the posterior parietal and occipital regions. The girl also had elevated IL-6 levels during the acute phase and evolved with a fast recovery of the clinical presentations. The second patient progressed with general systemic complications followed by cerebral edema and death.
Conclusion:
Encephalitis secondary to respiratory viral infection might evolve with cytokine storm and multiorgan inflammatory response in children.
Tibial Tubercle Avulsion Fracture with Multiple Concomitant Injuries in an Adolescent Male Athlete
Authors: Avinesh Agarwalla, Richard Puzzitiello, Austin V Stone, Brian Forsythe
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Tibial tubercle avulsion fractures are an uncommon injury occurring due to strong contraction of the quadriceps femoris muscle during leg extension, ultimately causing failure of the physis at the patellar tendon insertion. This injury has been previously reported with various concomitant injuries, such as compartment syndrome from bleeding into the anterior compartment, vascular injury, patellar tendon avulsion, and meniscal injury-exhibited only with fracture types that extend intra-articularly. We report the case of a 14-year-old healthy adolescent male basketball player who sustained this injury as a result of a collision with another player. He initially reported to the emergency department and then presented to our practice, where he was diagnosed with a tibial tubercle avulsion fracture with patellar tendon rupture. During the operative management of these injuries, it was noted that fascial tissue avulsed through the injury site causing subacute extensive bleeding within the anterolateral compartments. Due to concerns of compartment syndrome, a fascial release was performed along the anterolateral compartments. By five months postoperatively, the patient demonstrated near-normal function, no evidence of extensor lag, and nearly full range of motion. Unlike previously reported cases, this is the first report of a patient who suffered such an injury with multiple concomitant injuries to the neighboring structures. Due to the severity of compartment syndrome and the variability in its temporal presentation from the initial injury, it is paramount that careful evaluation of vascular integrity and a low threshold for fasciotomy be in place to prevent vascular compromise.
The long wave of COVID-19: a case report using Imagery Rehearsal Therapy for COVID-19-related nightmares after admission to intensive care unit
Authors: Giada Rapelli, Giorgia Varallo, Serena Scarpelli, Giada Pietrabissa, Alessandro Musetti, Giuseppe Plazzi, Christian Franceschini, Gianluca Castelnuovo
Journal: Front Psychol (2023)
Keywords: covid-19, sars-cov-2, case report, imagery rehearsal therapy, intensive care unit, nightmare, sleep disorder
MeSH terms: Case Reports

Introduction:
The COVID-19 pandemic caused several psychological consequences for the general population. In particular, long-term and persistent psychopathological detriments were observed in those who were infected by acute forms of the virus and need specialistic care in the Intensive Care Unit (ICU). Imagery rehearsal therapy (IRT) has shown promising results in managing nightmares of patients with different traumas, but it has never been used with patients admitted to ICUs for severe COVID-19 despite this experience being considered traumatic in the literature.
Methods:
The purpose of this case study is to describe the application of a four-session IRT for the treatment of COVID-related nightmares in a female patient after admission to the ICU. A 42-year-old Caucasian woman who recovered from a pulmonary rehabilitation program reported shortness of breath, dyspnea, and everyday life difficulties triggered by the long-COVID syndrome. She showed COVID-related nightmares and signs of post-traumatic symptoms (i.e., hyperarousal, nightmares, and avoidance of triggers associated with the traumatic situation). Psychological changes in the aftermath of a trauma, presence, and intensity of daytime sleepiness, dream activity, sleep disturbances, aspects of sleep and dreams, and symptoms of common mental health status are assessed as outcomes at the baseline (during the admission to pneumology rehabilitation) at 1-month (T1) and 3-month follow-up (T2). Follow-up data were collected through an online survey.
Results:
By using IRT principles and techniques, the patient reported a decrease in the intensity and frequency of bad nightmares, an increase in the quality of sleep, and post-traumatic growth, developing a positive post-discharge.
Conclusion:
Imagery rehearsal therapy may be effective for COVID-19-related nightmares and in increasing the quality of sleep among patients admitted to the ICU for the treatment of COVID-19. Furthermore, IRT could be useful for its brevity in hospital settings.
Immune Myocarditis Overlapping With Myasthenia Gravis Due to Anti-PD-1 Treatment for a Chordoma Patient: A Case Report and Literature Review
Authors: Shujing Liang, Jingxian Yang, Yun Lin, Tong Li, Wenrong Zhao, Jun Zhao, Chunyan Dong
Journal: Front Immunol (2021)
Keywords: pd-1 blockade, chordoma, immune checkpoint inhibitor, myasthenia gravis, myocarditis, sintilimab
MeSH terms: Antineoplastic Agents, Immunological / adverse effects, Chordoma / complications, Myasthenia Gravis / complications, Myocarditis / diagnosis, Myocarditis / etiology, Case Reports, Research Support, Non-U.S. Gov't, Review, Aged, Antineoplastic Agents, Immunological / therapeutic use, Biomarkers, Chordoma / diagnosis, Chordoma / drug therapy, Heart Function Tests, Humans, Immunosuppressive Agents / therapeutic use, Kidney Function Tests, Liver Function Tests, Magnetic Resonance Imaging, Male, Molecular Targeted Therapy / adverse effects, Myocarditis / drug therapy, Positron-Emission Tomography, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Antineoplastic Agents, Immunological, Biomarkers, Immunosuppressive Agents, PDCD1 protein, human, Programmed Cell Death 1 Receptor

Immunotherapy begins to be widely used due to the increasing exploration and gratifying effects in multiple cancers. Chordoma, as a rare bone malignant tumor, often recurs and metastasizes after undergoing surgery and radiotherapy. Therefore, immunotherapy can be explored as an emerging, potentially effective treatment to improve the survival rate and clinical benefit of patients. However, a variety of immune-related adverse events (irAEs) cannot be avoided completely. And the immunotherapy-induced myocarditis, as a rare but fatal irAE, has been increasingly reported. Understanding the mechanism involved in irAEs can inform best practices for side effects management. Here, we firstly reported a case of immune myocarditis and subsequent myasthenia gravis (MG) following anti-PD-1 treatment for chordoma.
Case Report: Peripheral Ulcerative Keratitis in Systemic Solid Tumour Malignancies
Authors: Valencia Hui Xian Foo, Jodhbir Mehta, Anita Sook Yee Chan, Hon Shing Ong
Journal: Front Med (Lausanne) (2022)
Keywords: corneal, inflammation, malignancy, paraneoplastic, peripheral ulcerative keratitis
MeSH terms: Case Reports

Purpose:
To describe a case series of peripheral ulcerative keratitis (PUK) as a paraneoplastic condition in three patients with known underlying systemic solid tumor malignancies.
Observations:
Three patients with different systemic malignancies (1 recurrent breast cancer, 1 metastatic thyroid cancer, and 1 metastatic gastric adenocarcinoma) were identified to have PUK with significant corneal stromal melt. Autoimmune and infective work up for other etiologies were all negative. They all responded well to topical steroids and intravenous methylprednisolone. One patient had recurrences of her PUK and required repeated amniotic grafts and tectonic keratoplasties before her corneal condition stabilized.
Conclusions and importance:
PUK can be a rare manifestation of systemic solid tumor malignancies. Although PUK may not be an indicator of progression of the underlying malignancy, it can be sight-threatening. This case series highlights the necessity for clinicians to refer patients with systemic malignancies presenting with inflamed eyes for an early ophthalmological review. This facilitates the detection of this blinding disease, allowing for early therapeutic interventions and potentially better visual outcomes for these patients.
Parenchymal Infiltration in Primary Diffuse Leptomeningeal Gliomatosis: Dynamic Changes in Brain MRI
Authors: Yun Jiang, Juan Chen, Jing He, Ao Pei, Jinsong Zhang, Yinhong Liu
Journal: Front Oncol (2017)
Keywords: brain magnetic resonance imaging, dynamics, infiltration, parenchyma, primary leptomeningeal gliomatosis
MeSH terms: Case Reports

Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare and fatal disease with no special clinical manifestations. Here, we report the dynamic brain magnetic resonance imaging (MRI) changes in a 30-year-old female PDLG patient over a 10-month period. MRI showed aggressive dilation of the subarachnoid space and the ventricular system, numerous encapsulated cysts in the subarachnoid space and the dilated cerebral sulci, diffuse reticulated or focal nodular enhancement in the subarachnoid space, as well as overall enhancement in the cystic walls. In addition to the aforementioned PDLG pathological findings, MRI also revealed non-contrasted solid lesions and a contrasted cyst-like lesion in the paraventricular areas. The dynamic and multiform neuroradiological changes help us to understand the pathological process of PDLG. Of particular interest is the discovery that parenchymal infiltration can occur in PDLG.
Arthroscopy-Assisted Reduction and Fixation of a Transversal Glenoid Fracture: About a Case
Authors: David Zbili, Eric Sali, Julien Serane, Edouard Lefèvre, Lior Amsallem
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

An articular glenoid fracture is an uncommon injury. Usually significantly displaced intra-articular glenoid fractures are treated with open reduction surgery. Conventional open surgery techniques involve high morbidity. Here we describe an arthroscopy-assisted reduction and fixation method of an Ideberg type III glenoid fracture. This method provides good articular reduction without extensive exposure or soft tissue dissection and without nerve and/or vascular lesion.
Femur Fracture Associated with Knee Brace Wear in the Motocross Athlete: A Report of Two Cases and Review of the Literature
Authors: Amalie Erwood, Jacob M Wilson, Andrew M Schwartz, Mara L Schenker, Thomas Moore Jr
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

The sport of motocross entails off-road motorcycle racing and is associated with a high incidence of traumatic injury. While prophylactic knee braces are routinely worn, there has been anecdotal concern that brace use is linked to femoral shaft fractures. While this risk remains unreported in the medical literature, preventing this complication has played a role in new commercial knee brace designs. We present two cases in which two motocross riders sustained transverse femoral shaft fractures at the proximal portion of each respective knee brace. The fracture locations measured on anterior-posterior radiograph were 22 and 21.1 cm proximal to the center of the knee, which is also the recommended proximal extent of motocross knee braces. We propose that the rigid knee brace protects the ligamentous knee structures but may focus undue force on the proximal aspect of the brace. New knee brace designs have incorporated features to dissipate the potentially injurious force to prevent femur fracture. While knee braces undoubtedly help prevent ligamentous knee injury, these cases question the safety of standard brace design and highlight the need for further brace development to better protect the patient's bony structures, in addition to the knee joint.
Sudden Tracheal Collapse during EGD and Subsequent Anesthetic Management with Dexmedetomidine-Ketamine in a Patient with Achalasia and Tracheomalacia
Authors: Joshua H Atkins, Jeff E Mandel, David C Metz
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

We present a patient who experienced airway obstruction during an elective esophagogastroduodenoscopy (EGD) under anesthesia secondary to previously undiagnosed tracheomalacia. Physiology of airway obstruction with forced breathing maneuvers is discussed along with the potential advantages of dexmedetomidine-ketamine sedation for management of patients with achalasia undergoing outpatient endoscopic procedures.
Symptomatic synovial herniation pit-MRI appearances pre and post treatment
Authors: Liam Kavanagh, Caoimhe Byrne, Eoin Kavanagh, Stephen Eustace
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Herniation pits are small benign lucent oval lesions within the anterior aspect of the superolateral femoral neck and were first described in 1982 by Michael J. Pitt. They are widely believed to occur as a result of mechanical forces from the overlying capsule resulting in herniation of soft tissues and synovium through a small bony defect. More recently, there has been evidence to suggest that femeroacetabular impingement may have a role in their aetiology. We present a case of a 59 -year -old male patient who developed hip pain following a jump from a wall. MRI was performed following failure of conservative management and demonstrated a small herniation pit with surrounding bone oedema. Following flouroscopic intra-articular steroid injection there was complete resolution of the patient's symptoms and the bone oedema surrounding the herniation pit. We review the potential causes, imaging appearances and potential treatment of synovial herniation pits with an emphasis on the role of radiologically guided intra-articular steroid injection.
Conservative Management of a Second-Trimester Cervical Ectopic Pregnancy
Authors: Katelyn F Handley, Lauren M Bergeron, Joseph R Biggio Jr
Journal: Ochsner J (2020)
Keywords: amniocentesis, dilatation and curettage, fertility preservation, pregnancy–ectopic, ultrasonography, uterine artery embolization
MeSH terms: Case Reports

Background: Cervical ectopic pregnancy is a rare condition, historically treated by hysterectomy. Case Report: A 33-year-old female at 13 weeks 3 days' gestation was diagnosed with a cervical ectopic pregnancy. She underwent a uterine artery embolization, fetal intrathoracic potassium chloride injection, amniocentesis, and ultrasound-guided suction dilation and curettage with the use of intracervical vasopressin, flowable gelatin with thrombin, and cervical cerclage. Conclusion: Advanced cervical ectopic pregnancy can be successfully managed in a conservative fashion in a patient who strongly desires future fertility.
Aspiration of Aluminum Beverage Can Tab: Case Report and Literature Review
Authors: Alhasan N Elghouche, Brian C Lobo, Jonathan Y Ting
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

We describe the case of a 16-year-old male who aspirated a beverage can tab resulting in significant functional impairment. Since the introduction of beverage can opening tabs ("pop-tops" or "pull-tabs") nearly 50 years ago, five cases of their aspiration have been reported in the literature and this is the first case to report tracheal lodgment. We describe the clinical course for this patient including the inadequacy of radiographic evaluation and a significant delay in diagnosis. We highlight unique features of small aluminum foreign bodies that require consideration and mention a potential change in epidemiology associated with evolving product design. Our primary objective is increased awareness among otolaryngologists that radiography is unreliable for diagnosis or localization of small aluminum foreign bodies. The patient history must therefore be incorporated with other imaging modalities and/or endoscopic evaluation. Also, given the marked prevalence of aluminum beverage cans, we suspect that the inadvertent aspiration of can tabs is more common than indicated by the paucity of published reports.
Severe Hypocalcemia and Hypomagnesemia with Denosumab in Advanced Chronic Kidney Disease: Case Report and Literature Review
Authors: Christina F Marlow, Shailendra Sharma, Faizan Babar, Jianqing Lin
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Background:
Denosumab has become the preferred agent over zolendronic acid to help prevent skeletal-related events in patients with metastatic bone disease and multiple myeloma because it is approved for use in those with kidney dysfunction. However, denosumab has been linked to cases of hypocalcemia, particularly in those with advanced kidney disease.
Case presentation:
We present the case of a patient with metastatic prostate cancer and chronic kidney disease due to obstructive nephropathy who developed severe hypocalcemia and hypomagnesemia after denosumab injection, which required intensive care unit admission, aggressive calcium supplementation, and hemodialysis assistance. We reviewed the evidence behind the safety profile of denosumab in chronic kidney disease, and we also looked at additional factors that may precipitate severe hypocalcemia with denosumab in advanced kidney disease.
Conclusion:
We believe that denosumab should be avoided in advanced chronic kidney disease due to the potential life-threatening, severe hypocalcemia that has been observed.
An Uncommon Case of Acute Coronary Stent Thrombosis
Authors: Kyle Coombes, Guarina Molina, Rafael Contreras, Andrew Jacobson, Robert Jarrett
Journal: Cureus (2023)
Keywords: acute myocardial infarction, cardiovascular intervention, coronary artery thrombosis, drug eluting stents (des), drug-eluting stent, dual anti-platelet therapy, myocardial infarction
MeSH terms: Case Reports

Coronary stent thrombosis is an uncommon complication of percutaneous coronary intervention, which can result in myocardial infarction and often death. We present a case of acute stent thrombosis in a patient with newly diagnosed triple vessel coronary artery disease occurring within less than an hour of stent placement along with a review of the literature.
Monoclonal Gammopathy of Renal Significance with Deposits of Peculiar Morphology and Injuries of Secondary Thrombotic Microangiopathy: A Case Report and Review of the Literature
Authors: José C De La Flor, Marina Alonso, Edna Sandoval, Alexander Marschall, Miguel Rodeles
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

We present the case of an 82-year-old woman diagnosed with monoclonal gammopathy of renal significance (MGRS) with the presence of different and peculiar kidney lesions, who began treatment with bortezomib and dexamethasone, presenting during her evolution a relapse. Although the bone marrow biopsy in this case showed plasma cells as pathologic clone and there was also a reduction after chemotherapeutic treatment, rituximab was proposed as a second line. We suspected that the relapse was possibly due to another precursor as B-cell or lymphoplasmacytic cell clone. We review the literature and suggest that the treatment for MGRS should be patient-tailored, preferably by consulting a multidisciplinary team. Future research is needed to better understand the disease course and establish the efficacy and safety of the therapeutic approach for the relapse of MGRS.
Epidemiological profile of measles in Niger: analysis of measles case-based surveillance data from 2010 to 2019
Authors: Habibatou Amadou Idé, Pauline Kiswendsida Yanogo, Djibril Barry, Ousmane Boua Togola, Eric Adehossi, Nicolas Meda
Journal: Pan Afr Med J (2022)
Keywords: measles, niger, database, surveillance
MeSH terms: Asteraceae, Measles / epidemiology, Case Reports, Female, Humans, Male, Niger / epidemiology, Retrospective Studies, Vaccination

Measles is a rapidly growing disease in the world with 869,770 cases and 207,500 deaths recorded in 2019. Niger continues to record epidemic outbreaks despite the actions taken. This study aims to analyze the national database from 2010 to 2019 to characterize the epidemiology of measles in Niger. This is a descriptive retrospective study. Our sample is exhaustive of suspected and positive measles cases from the database of the department of surveillance and response to epidemics for 10 years. Data extraction and analysis was done using Epi Info 7.2.3.1 software. In our study we found n=11,784 suspected measles cases notified from 2010 to 2019 with 37.2% of positive cases (IgM+). All regions are concerned. The female/male sex ratio was 1.1. The 1-to-5-year age group was the most representative (44.44%); 28.3% received at least one dose of vaccine; 62.22% lived in urban areas. The number of deaths was 225 (1.9%). The proportion of samples received at the laboratory within 3 days is 70.38%. The baseline analysis allowed us to find that all regions recorded cases and deaths with a low vaccination rate of 28.3%. Improved response and immunization strategies are recommended.
Gigantomastia and Macroprolactinemia Responding to Cabergoline Treatment: A Case Report and Minireview of the Literature
Authors: Fatma Dilek Dellal, Didem Ozdemir, Cevdet Aydin, Gulfem Kaya, Reyhan Ersoy, Bekir Cakir
Journal: Case Rep Endocrinol (2016)

Background. Macroprolactinemia is defined as predominance of high molecular weight prolactin forms in the circulation. Although macroprolactin is considered as a biologically inactive molecule, some authorities suggest treatment in symptomatic cases. Gigantomastia is defined as excess breast tissue and most cases in the literature were treated by surgical intervention. Case. A 44-year-old woman was admitted to our clinic with gigantomastia and galactorrhea. The patient had a demand for surgical therapy. In laboratory examination, she had hyperprolactinemia and macroprolactinemia. Pituitary imaging revealed 6 mm microadenoma in right side of the hypophysis. Since she was symptomatic, cabergolin treatment was started. Macroprolactin became negative, breast circumference decreased significantly, and galactorrhea resolved after treatment. Conclusion. Gigantomastia might be the presenting symptom in patients with macroprolactinemia. In these patients medical treatment with cabergoline may be used initially as an alternative to surgical approach.