OpenMed/multicare-articles huggingface dataset:
Neuroleptic malignant syndrome following catatonia: Vigilance is the price of antipsychotic prescription
Authors: Thomas J Reilly, Sean Cross, David M Taylor, Richard Haslam, Sophie C Tomlin, Benjamin Gaastra
Journal: SAGE Open Med Case Rep (2017)
Keywords: catatonia, antipsychotic agents, malignant syndrome, neuroleptic, schizophrenia
MeSH terms: Case Reports

Objectives:
To describe a case of neuroleptic malignant syndrome following antipsychotic treatment of catatonia, highlighting the potentially serious complications of this rare adverse drug reaction.
Methods:
We present a case report of a patient who developed this syndrome with various sequelae.
Results:
The patient developed neuroleptic after being treated with lorazepam and olanzapine for catatonia. He subsequently developed the complications of rhabdomyolysis, acute kidney injury, pulmonary embolism, urinary retention and ileus. He received high-dose lorazepam, anticoagulation and intravenous fluids. Antipsychotic medication in the form of haloperidol was reinstated with no adverse effect, and he went on to make a full recovery.
Conclusions:
This case illustrates the potential life-threatening complications of neuroleptic malignant syndrome and the need for a low index of clinical suspicion. It also highlights the lack of evidence for treatment of catatonia, including the use of antipsychotics.
Sensorineural Hearing Loss following Carbon Monoxide Poisoning
Authors: Joseph P Pillion
Journal: Case Rep Pediatr (2012)
MeSH terms: Case Reports

A case study is presented of a 17-year-old male who sustained an anoxic brain injury and sensorineural hearing loss secondary to carbon monoxide poisoning. Audiological data is presented showing a slightly asymmetrical hearing loss of sensorineural origin and mild-to-severe degree for both ears. Word recognition performance was fair to poor bilaterally for speech presented at normal conversational levels in quiet. Management considerations of the hearing loss are discussed.
Cardiac sarcoidosis culminating in severe biventricular failure
Authors: Takefumi Ozaki, Noritomo Ohnuma, Norihiro Shimizu, Atsushi Hasegawa, Masashi Horimoto
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

A 59-year-old woman with a history of lung sarcoidosis developed general edema and exertional dyspnea. An electrocardiogram showed first-degree atrioventricular block with complete right bundle branch block. Chest X-ray showed cardiomegaly. Echocardiography showed diffuse and severe hypokinesis of the left ventricle (LV) and biventricular enlargement with severe tricuspid regurgitation. Myocardial scintigraphy disclosed a perfusion defect at the ventricular septum and hypoperfusion at the posterior wall and the apex. On cardiac catheterization, pulmonary capillary wedge pressure, right ventricular, and right atrial pressures were elevated. Coronary angiograms were normal. Myocardial biopsy of the right ventricle histologically revealed epithelioid cell granuloma with infiltration of fibrous cells. The patient's symptom and LV function were improved with conventional medical therapy for heart failure. This is a rare case of cardiac sarcoidosis resulting in biventricular failure.
Neoadjuvant chemotherapy in locally advanced duodenal adenocarcinoma
Authors: Carlos Velandia, Rafael Delgado Morales, Carlos Coello, Armando Gil Mendoza, Gabriel Pérez, Emperatriz Aguero
Journal: Ecancermedicalscience (2018)
Keywords: duodenal adenocarcinoma, neoadjuvant therapy
MeSH terms: Case Reports

Duodenal adenocarcinoma (ADC) represents only 0.3% of gastrointestinal neoplasms. With the frequency being higher between the ages of 40 and 60, it is predominantly located in the second part of the duodenum and around the periampullary region. Symptoms are nonspecific, so the majority of patients present with advanced disease. Neoadjuvant chemotherapy is a therapeutic option that has not been well studied. The global literature includes only isolated reports on this subject. This is why we are presenting the following case: a 60-year-old female patient with a locally advanced, inoperable duodenal ADC received neoadjuvant chemotherapy. Having presented a favourable response as observed in the post-neoadjuvant extension studies, a pancreaticoduodenectomy was performed without any perioperative complications and with satisfactory progress. The final biopsy reported a complete pathological response. After being monitored for 34 months, the patient was free from locoregional and distant metastatic disease. During the last weeks of monitoring, she developed a second primary breast tumour, which has been corroborated by immunohistochemistry.
Role of ultrasonography in early diagnosis of congenital extrahepatic portosystemic shunt
Authors: Kithir Mohamed Anwer Sadat
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A 1-year-old male presented to our unit for ultrasonography of the abdomen with a history of fever and diarrhoea for 2 days. The clinical examination was normal. Ultrasound of the abdomen showed a small portal vein and splenomesenteric venous shunt into the left renal vein that was consistent with a Type II congenital extrahepatic portosystemic shunt (CEPS). Doppler sonography confirmed the flow towards the left renal vein. No abnormal findings were observed in the liver and rest of the abdominal organs. CEPS is an uncommon anomaly in which the portomesenteric blood drains into a systemic vein, bypassing the liver through a complete or partial shunt. It is usually diagnosed incidentally during investigation for other causes. Morgan and Superina (Congenital absence of the portal vein: two cases and a proposed classification system for portasystemic vascular anomalies. J Pediatr Surg 1994; 29: 1239-41) proposed a classification for these shunts in 1994 that divided these anomalies into two types. In Type I CEPS, the intrahepatic portal venous supply is absent, whereas in Type II, the intrahepatic portal venous supply is preserved. This case highlights the role of ultrasonography in the early diagnosis of CEPS.
Dental Management of a Child with Incidentally Detected Hemophilia: Report of a Clinical Case
Authors: Ricardo Martínez-Rider, Arturo Garrocho-Rangel, Raúl Márquez-Preciado, María Victoria Bolaños-Carmona, Socorro Islas-Ruiz, Amaury Pozos-Guillén
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Children with hemophilia (A or B) are at risk for bleeding episodes, which rank from mild mucosal/soft tissues bleeding to life-threatening hemorrhages. This report describes the dental/medical management provided to an 8.10-year-old patient suffering from uncontrolled bleeding after a surgical procedure to expose both permanent upper central incisors, in which hemophilia was a pure incidental finding. Additionally, diverse precautions to be considered during the dental clinical treatment of hemophilic children are discussed.
Localized Chronic Form of Langerhans Cell Histiocytosis in the Femur of a 16-Year-Old Male Successfully Treated with Radiofrequency Ablation
Authors: Kyriakos Papavasiliou, Antonia Bintoudi, Apostolos Vlahodimos, Eleftherios Tsiridis, Prodromos Hytiroglou, Ioannis Tsitouridis, Fares Sayegh
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Only three cases of patients suffering from a localized chronic form of Langerhans cell histiocytosis (LCH) successfully treated with radiofrequency ablation (RFA) have been published so far. This is the first case report of a patient with a localized chronic form of LCH of the femur, which was successfully treated with percutaneous image-guided RFA, and who was evaluated pre-RFA and followed up post-RFA for a period of 48 months, in order to validate the safety and efficacy of this method and to obtain imaging studies depicting the actual in situ changes taking place post-RFA. RFA was proved to be a safe and efficient method when treating patients with a localized chronic form of LCH.
Case Report: Sporadic Burkitt lymphoma misdiagnosed as dental abscess in a 15-year-old girl
Authors: Marco Cabras, Paolo G Arduino, Luigi Chiusa, Roberto Broccoletti, Mario Carbone
Journal: F1000Res (2018)
Keywords: burkitt lymphoma, dental abscess, oral cavity, paediatric
MeSH terms: Case Reports

Background: Burkitt lymphoma (BL) is a non-Hodgkin's B-cell tumor that can be classified into three variants, based on clinical characteristics and epidemiology: endemic, human immunodeficiency-related and sporadic. Oral sporadic BL is quite an unusual entity, with the gastrointestinal trait being often the first site of appearance. Clinical finding: A 15-year-old patient that presented a symptomatic swelling of the right maxilla, unsuccessfully treated as a primary endodontic disease, displaying solid tissue on CT scan, "starry sky" pattern on oral biopsy, multifocal bone and lymph node uptake on PET. Diagnoses, interventions, and outcomes: A diagnosis of stage IV BL was formulated; Rituximab was then administered for three months according to Inter-B-NHL ritux 2010 protocol and CYM (cytarabine and methotrexate) chemotherapy. The patient was followed-up for three years, with no recurrence. Conclusion: It is important for general dental practitioners to suspect a malignancy in the differential diagnosis of unresponsive odontogenic infections in young healthy patients.
Efficacy of sildenafil and high-dose anakinra in an MIS-C patient with pulmonary vasculitis: A case report
Authors: Francesco La Torre, Gerolmina Calabrese, Katia Signorile, Francesca Bizzoco, Carla Mastrorilli, Antonella Strippoli, Doriana Amato, Francesco Carella, Ugo Vairo, Paola Giordano, Leonardo Milella, Fabio Cardinale
Journal: Front Pediatr (2023)
Keywords: covid-19, mis-c, anakinra, children, multisystem inflammatory syndrome in children, pulmonary hypertension, pulmonary vasculitis, sildenafil
MeSH terms: Case Reports

Multisystem inflammatory syndrome in children (MIS-C) is a newly identified clinical entity still not very well known in terms of epidemiology, pathogenesis, and long-term outcome. Pulmonary involvement with acute respiratory failure is an unusual life-threatening complication of MIS-C, often a reason for admission to the pediatric intensive care unit (PICU) and the use of mechanical ventilation. We present a case of a 7-year-old male patient, previously healthy, hospitalized for MIS-C, treated with intravenous immunoglobulins (IVIG), high dose methylprednisolone, and anakinra. After 2 days of the aforementioned therapy, the patient presented with hypoxia (SatO2: 85% in ambient air room) and breathing difficulties. A chest computed tomography (CT) scan showed the presence of multiple bilateral basal parenchymal thickening and small basal pleural effusion and an arterial blood gas analysis revealed severe hypoxia (PaO2/FiO2 ratio, 170 mmHg). Because of a worsening of respiratory distress, the patient was transferred to the PICU, where invasive mechanical ventilation and a continuous infusion of anakinra (12 mg/kg/day) were started. An echocardiogram was performed, which showed an increase in pulmonary pressure (40 mmHg) with normal heart ejection fraction (55%), and the hypothesis of pulmonary vasculitis involving the pulmonary arterioles was made. Therefore, therapy with sildenafil (0.15 mg/kg/day) was promptly set up, with an immediate improvement of the clinical picture of respiratory failure, reduction of pulmonary pressure (23 mmHg), and subsequent extubation at 36 h with a regular clinical course until discharge. As far as we know, our case represents the first report of pulmonary vasculitis in an MIS-C patient. The use of sildenafil and high-dose continuous anakinra may represent a rescue therapy in cases of MIS-C with pulmonary vasculitis or with difficulty in extubation, allowing a short-term hospitalization in intensive care and improving the long-term outcome in these patients.
ANCA-associated pauci-immune glomerulonephritis in a patient with bacterial endocarditis: a challenging clinical dilemma
Authors: Andrea Cervi, Dylan Kelly, Iakovina Alexopoulou, Nader Khalidi
Journal: Clin Nephrol Case Stud (2017)
Keywords: anti-neutrophil cytoplasmic antibodies, glomerulonephritis, immunosuppression, infective endocarditis
MeSH terms: Case Reports

Purpose:
We report the case of a 59-year-old man with chronic hepatitis B and C infection presenting with acute kidney injury and enterococcus faecalis-infective endocarditis (IE). An elevated proteinase-3 (PR3)-ANCA and pauci-immune glomerulonephritis (GN) on renal biopsy were discovered, corresponding to ANCA-mediated GN. We conducted a literature review to assess the role of ANCA in IE and treatment implications.
Methods:
On systematic review of the literature, we found five previous cases whereby IE caused by streptococcus and bartonella species were related to ANCA vasculitis-associated GN.
Results:
Most reports of IE-related GN are mediated by immune complex deposition and resolve following microbial clearance. Of the 5 cases of ANCA GN in the setting of IE, all had markedly elevated levels of PR3-ANCA with either a subacute or chronic course of infection. Patients were treated with a combination of steroids and cyclophosphamide (2/5), steroids and antibiotics alone (1/5), or with valvular replacement (2/5). Renal function was recovered in 4/5 patients.
Conclusion:
Infection is a major etiologic player in the formation of ANCA; however, the role of PR3-ANCA in IE remains unclear. Kidney biopsy is essential in differentiating IE-related GN due to infection and immune complex deposition versus ANCA-associated vasculitis. A paucity of reports on the development of GN in IE-associated ANCA vasculitis exists, highlighting the rarity of our case and lack of clear therapeutic strategies in a patient with active infection requiring immunosuppression. In this case, the patient's chronic hepatitis B and C coinfection presented a unique challenge.
Anoxic Brain Injury Presenting as Pseudosubarachnoid Hemorrhage in the Medical Intensive Care Unit
Authors: O'Dene Lewis, Samina Afreen, Supo Folaranmi, Marie Fidelia-Lambert, Vishal Poddar, Alicia Thomas
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Anoxic encephalopathy is frequently encountered in the medical intensive care unit (ICU). Cerebral edema as a result of anoxic brain injury can result in increased attenuation in the basal cisterns and subarachnoid spaces on computerized tomography (CT) scans of the head. These findings can mimic those seen in acute subarachnoid hemorrhage (SAH) and are referred to as pseudosubarachnoid hemorrhage (pseudo-SAH). Pseudo-SAH is a diagnosis critical care physicians should be aware of as they treat and evaluate their patients with presumed SAH, which is a medical emergency. This lack of awareness could have important clinical implications on outcomes and impact management decisions if patients with anoxic brain injury are inappropriately treated for SAH. We describe three patients who presented to the hospital with anoxic brain injury. Subsequent CT head suggested SAH, which was subsequently proven to be pseudo-SAH.
Bilateral Inflammatory Aural Polyps: A Manifestation of Samter's Triad
Authors: Robert Brobst, Nichole Suss, Stephanie Joe, Saadia Redleaf
Journal: Int J Otolaryngol (2009)
MeSH terms: Case Reports

We report an unusual case of bilateral inflammatory aural polyps in a patient with Samter's triad. This 52-year-old patient had a history of chronic rhinosinusitis with sinonasal polyps, asthma, and aspirin sensitivity, with progressive right-sided hearing loss, otorrhea, and aural fullness. She was found to have bilateral aural polyps, with the larger obstructing lesion on the right. A computed tomography supported these findings and revealed bilateral opacification of the middle ear cleft and mastoid air cells. An initial right tympanomastoidectomy was performed with the specimen histologically resembling a typical sinonasal polyp. We speculate that this patient's middle ear polyposis is secondary to the inflammatory changes of Samter's triad. This has not been described previously in the literature.
Aquaporin 4-positive neuromyelitis optica spectrum disorder with meningoencephalitis-like onset: A case report
Authors: Yi Bu, Heng Liu, XuDong Qian, Fan Sun, ChengBo Li, Jingzhe Han
Journal: Front Immunol (2022)
Keywords: aquaporin, area postrema syndrome, autoimmune inflammatory demyelinating disease, central nervous system, neuromyelitis optica spectrum disease
MeSH terms: Meningitis, Aseptic / complications, Meningoencephalitis / complications, Meningoencephalitis / diagnosis, Neuromyelitis Optica / diagnosis, Optic Neuritis, Case Reports, Research Support, Non-U.S. Gov't, Aquaporin 4, Humans, Aquaporin 4

Neuromyelitis optica spectrum disease (NMOSD) is a debilitating autoimmune inflammatory demyelinating disease of the central nervous system. The relationship between harboring an infection and NMOSD is currently unclear and needs further investigation. This article reports meningoencephalitis-like manifestations, including fever, headache, neck resistance, seizures, and pleocytosis, accompanied by nausea and vomiting, in a patient with serum AQP4 antibody-positive area postrema syndrome (APS). In the presence of aseptic meningitis combined with clinical symptoms such as optic neuritis and myelitis, the possibility of NMOSD diagnosis can be considered. However, for patients with unknown causes, especially combined with aseptic meningitis, a probable differential diagnosis of NMOSD is considered.
Torque teno mini virus driven childhood acute promyelocytic leukemia: The third case report and sequence analysis
Authors: Xue Chen, Fang Wang, Xiaosu Zhou, Yang Zhang, Panxiang Cao, Xiaoli Ma, Lili Yuan, Jiancheng Fang, Mingyue Liu, Ming Liu, Jiaqi Chen, Qihui Chen, Ping Wu, Yue Lu, Xiujuan Ma, Hongxing Liu
Journal: Front Oncol (2022)
Keywords: rara, ttmv
MeSH terms: Case Reports

In this manuscript, we report torque teno mini virus (TTMV) as a cause of acute promyelocytic leukemia (APL) lacking PML::RARA in a 3-year-old boy. Astolfi et al. firstly identified partial integration of the TTMV genome into RARA intron 2, which resulted in in-frame TTMV::RARA fusion in two APL-like pediatric cases without PML::RARA in November 2021. This fascinating report identified an unexpected exogenous genetic cause of APL and could be of great importance for diagnosing and managing APL. Here we report the third childhood APL-like case caused by TTMV integration and investigate the location and structure of the integrated TTMV sequence. These findings suggest TTMV::RARA is a recurrent cause of APL lacking PML::RARA. Considering the widespread prevalence of TTMV in the population, more TTMV::RARA positive APL-like cases might remain to be identified. Establishing a bioinformatic analysis strategy optimized for the highly variable TTMV genome sequence may facilitate the identification of TTMV::RARA by whole transcript sequencing. An effective PCR protocol to identify TTMV::RARA based on a profound analysis of the conservation of TTMV segments in the fusion transcript is also expected. Also, further investigation is needed to elucidate the oncogenic mechanisms of TTMV integration and the clinical features of TTMV::RARA positive patients.
Hemodynamic Instability after Low-Energy Thigh Contusion Caused by Injury to the Femoral Artery: A Case Report and Literature Review
Authors: Juan Miguel Rodríguez-Roiz, José Ballesteros-Betancourt, Raquel García-Tarriño, Victor Antonio Rodríguez-Roiz, Manuel Llusa
Journal: Case Rep Orthop (2016)

Acute vascular injuries have been described in relation to high-energy trauma accidents or in patients undergoing surgery in the femoral area. We describe a healthy patient who sustained a direct, low-energy contusion in the thigh and presented haemodynamic instability. Arteriography was used to locate the point of bleeding, and embolisation and vessel occlusion were carried out to stop the haemorrhage. The genetic study identified the COL3A1 gene mutation; accordingly, the patient was diagnosed with the Ehlers-Danlos syndrome type IV (vascular type).
Severe Drug-Induced Agranulocytosis Successfully Treated with Recombinant Human Granulocyte Colony-Stimulating Factor
Authors: Yohei Kubota, Ezekiel Wong Toh Yoon
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

When elderly patients are prescribed many different medications, the risk for developing serious adverse events should be kept in mind. One of these adverse events is agranulocytosis, which, although rare, can be life-threatening if left untreated. The majority of agranulocytosis cases are caused by drugs, including antibiotics. Here, we report a case of severe agranulocytosis in a 96-year-old woman following antibiotic therapy which was successfully managed using recombinant human granulocyte colony-stimulating factor (rhG-CSF) and the appropriate choice of antibiotics to treat her concomitant infection.
Fine-needle aspiration cytology of parathyroid carcinoma mimic hürthle cell thyroid neoplasm
Authors: Chutintorn Sriphrapradang, Pattana Sornmayura, Niramol Chanplakorn, Objoon Trachoo, Pattarana Sae-Chew, Rangsima Aroonroch
Journal: Case Rep Endocrinol (2014)

Background. Fine-needle aspiration (FNA) can cause misdiagnosis of cytomorphological findings between parathyroid and thyroid lesions. Case Presentation. A 31-year-old man presented with a palpable neck mass on the right thyroid lobe. FNA cytology was reported as intrathyroidal lymphoid hyperplasia. After 5 years, repeated FNA was done on the enlarged nodule with result of Hürthle cell lesion. Prior to right lobectomy, laboratories revealed elevated serum calcium and parathyroid hormone (PTH). Careful history taking revealed chronic knee pain and ossifying fibroma at the maxilla. Ultrasonography showed a 2.8 cm mass inferior to right thyroid lobe. Pathology from en bloc resection was parathyroid carcinoma and immunohistochemical study revealed positivity for PTH. Genetic analysis found somatic mutation of CDC73 gene in exon1 (c.70delG) which caused premature stop codon in amino acid 26 (p.Glu24Lysfs*2). The final diagnosis was hyperparathyroidism-jaw tumor syndrome. Conclusions. FNA cytology of parathyroid can mimic thyroid lesion. It is important to consider and correlate the entire information from clinical history, laboratory, imaging, and FNA.
Clinical Misdiagnosis of COVID-19 Infection with Confusing Clinical Course
Authors: Hamid Eshaghi, Vahid Ziaee, Mahmood Khodabande, Moeinadin Safavi, Elmira Haji Esmaeil Memar
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Background:
Similarities in the febrile course and other manifestations of some diseases may lead to clinical misdiagnosis of COVID-19 infection. Here, we report a case in a young child with a potentially confusing clinical course. Case Presentation. A 29-month-old boy presented with a 2-month history of fever. His PCR test for COVID-19 was positive, and there was pleural effusion plus positive findings in the lower left lobe of the lung on computed tomography scan. Mid-sized splenomegaly was found on abdominal ultrasound, and laboratory tests disclosed pancytopenia. In light of the atypical lymphocyte counts in laboratory tests, he underwent bone marrow aspiration. The suggested diagnosis was hemophagocytic lymphohistiocytosis, and prednisolone was initiated. Subsequently, Leishman-Donovan bodies were seen in the bone marrow aspirate, and treatment was started with amphotericin, which led to clinical improvement.
Conclusion:
In cases with vague clinical symptoms in tropical countries where other infectious diseases occur, possible simultaneous infection should be considered even during a pandemic. Familiarity with the possible differential diagnoses and appropriate, step-by-step consideration to rule out other possible causes are needed in all situations, and the coexistence of infectious disease should be considered in evaluating the clinical conditions of patients in tropical countries.