OpenMed/multicare-articles huggingface dataset:
Lithium management of periodic mood fluctuations in behavioural frontotemporal dementia: a case report
Authors: Vicent Llorca-Bofí, Iolanda Batalla, Maria Ruiz-Julián, Marina Adrados-Pérez, Esther Buil-Reiné, Gerard Piñol-Ripoll, Xavier Gallart-Palau, Aurora Torrent
Journal: Front Psychiatry (2024)
Keywords: behavioural frontotemporal dementia, case report, lithium, manic-like episodes, mood fluctuations
MeSH terms: Case Reports

The behavioural variant of Frontotemporal Dementia (bvFTD) is a neurodegenerative condition characterized by behavioural and cognitive symptoms. Mood disturbances, including manic-like episodes, can occur in bvFTD, posing diagnostic and therapeutic challenges. This case report presents a 62-year-old male with bvFTD exhibiting weekly mood fluctuations alternating between manic and depressive-like states. While initial treatment with quetiapine and trazodone showed partial improvement, the periodicity of mood fluctuations persisted. Subsequently, lithium was introduced, resulting in a notable reduction in symptom severity for both manic and depressive episodes. This report highlights the potential use of lithium as a mood stabilizer in bvFTD patients with periodic mood fluctuations, refractory to standard treatments. Further research is needed to elucidate the mechanisms underlying lithium's efficacy in bvFTD and to establish treatment guidelines.
A case report of Pseudomonas citronellolis and Escherichia coli isolated from acute suppurative appendicitis: reveals the potential intestinal colonization and pathogenicity of Pseudomonas citronellolis
Authors: Yugui Lin, Yanfen Li, Chunxiu Lin
Journal: Front Cell Infect Microbiol (2024)
Keywords: pseudomonas citronellolis, acute suppurative appendicitis, infection, intestinal colonization, pathogenicity
MeSH terms: Appendicitis, Enterocolitis, Pseudomonas, Case Reports, Acute Disease, Aged, Escherichia coli / genetics, Humans, Intestines, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Virulence, Pseudomonas citronellolis

Human infections caused by Pseudomonas citronellolis, an environmental bacterium, are infrequent, with only two cases related to uncommon urinary tract infections and bacteremia reported in recent years. All these cases typically occurred in elderly patients with compromised or decreased immune function. Simultaneously, the epithelial barrier disruption induced by invasive biopsy procedures or gastrointestinal disorders such as gastroenteritis provided a pathway for Pseudomonas citronellolis to infiltrate the organism. In this study, we present the first report of a case where Pseudomonas citronellolis and Escherichia coli were isolated from the inflamed appendix of a patient without underlying conditions. Compared to the Escherichia coli, Pseudomonas citronellolis has never been isolated in patients with appendicitis. We identified the species using MALDI-TOF MS and genetic sequencing. Based on our findings, we highlight the perspective that Pseudomonas citronellolis can colonize the intestines of healthy individuals and may trigger infections like appendicitis.
Case report: Coexistence of triple-seronegative myasthenia gravis and pathology-proven cryptogenic organizing pneumonia
Authors: Shi-Qi Huang, Bin Wang, Lin Gao, Meng Wang, Hong-Dong Zhao, Jian-Quan Shi
Journal: Front Neurol (2023)
Keywords: antibody, coexistence, cryptogenic organizing pneumonia, myasthenia gravis, seronegative
MeSH terms: Case Reports

Objective:
Emerging evidence shows that patients with myasthenia gravis (MG) were at a higher risk for the co-occurrence of other autoimmune diseases, which reflects phenotypic heterogeneity in MG. The coexistence of MG and cryptogenic organizing pneumonia (COP) has rarely been reported. The present case is to report the coexistence of triple-seronegative MG and pathology-proven COP in a patient.
Methods:
The clinical data of the patient were derived from medical records of Nanjing First Hospital, Nanjing Medical University, China. Written informed consent was obtained from the patient.
Results:
We presented a 56-year-old man with acute respiratory syndrome, who was diagnosed with COP based on the intra-alveolar fibroinflammatory buds (Masson's bodies) in the pathology of bronchoscopy biopsy. Oral prednisone induced dramatic symptomatic improvement and complete resolution of previous lung lesions. After a stable course of no respiratory symptom for 2 months, he was referred to the neurology department with complaints of fluctuating generalized muscle weakness. He was diagnosed with triple-seronegative MG based on fluctuating weakness, neostigmine test-positivity and RNS-positivity. After three-month treatment with pyridostigmine in combination with tacrolimus, the symptoms gradually improved and he achieved minimal symptom expression.
Conclusions:
This case highlights the rare coexistence of triple-seronegative MG and pathology-proven COP. However, a causal association between COP and MG cannot be explicitly ascertained. In future, more data are needed to clarify the relationship, taking into account the limited number of cases reported with this coexistence of the diseases.
Application of Physiological Sperm Selection in Assisted Reproductive Technology (ART) for Patients With Diabetes Mellitus: A Case Report
Authors: Krushnali S Kadu, Akash More, Namrata Choudhary, Shilpa Dutta, Jarul Shrivastava, Gauri Gajabe
Journal: Cureus (2024)
Keywords: hyaluronic acid, infertility, macs, picsi, sperm dna fragmentation
MeSH terms: Case Reports

This case report revolves around a 35-year-old woman and her 39-year-old husband, who have been married for 10 years and were seeking treatment for their secondary infertility. The husband had been diagnosed with diabetes mellitus (DM) for the past seven years and had been on continued medication. Both partners underwent medical evaluations, and the husband was found to have normozoospermia. The wife had a normal ovarian reserve but was still facing difficulties in conception. Previous medical history showed that the husband's DM had been treated with metformin, and the woman had a history of unsuccessful in vitro fertilization (IVF) cycles and one miscarriage upon investigation. Our initial treatment attempt had failed, and upon assessment of the semen, it revealed a significantly increased sperm DNA fragmentation index, leading us to consider physiological intracytoplasmic sperm injection (PICSI). The couple then opted for a rescheduled ovum pick-up with PICSI over traditional ICS. PICSI involves selecting mature sperm with hyaluronic acid affinity, aiming to avoid immature, morphologically defective spermatozoa during microinjection. The couple then followed up for treatments; the husband continued with diabetes treatment, and the woman was advised to take progesterone supplements to ensure optimum uterine thickness. The PICSI procedure was followed by a successful embryo transfer, which subsequently led to a positive clinical pregnancy. This report highlights the importance of utilizing advanced technologies like PICSI in infertility cases after considering factors such as sperm quality to enhance the chances of a successful clinical pregnancy.
IgG4-associated hypophysitis coexisting with MALT lymphoma and gangliocytoma: first case report and literature review
Authors: Dongbo Zou, Li Jiang, Tao Yang, Jingmin Cheng, Yuan Ma
Journal: Front Neurol (2023)
Keywords: igg4-related hypophysitis, malt lymphoma, gangliocytomas, headaches, sellar region, vision loss
MeSH terms: Case Reports

IgG4-related or IgG4-associated hypophysitis is a rare disease characterized by the infiltration of IgG4-positive plasma cells into pituitary gland tissue. Gangliocytomas in the sellar region are also extremely rare and are associated with pituitary adenomas in the majority of cases. Sellar mucosa-associated lymphoid tissue (MALT) lymphoma is an exceedingly rare condition. In this study, we present a case of IgG4-associated hypophysitis coexisting with MALT lymphoma and gangliocytoma. However, to elucidate the potential pathophysiological relationship, it is imperative to gather additional cases of IgG4-related hypophysitis accompanied by MALT lymphoma and gangliocytoma.
Terson Syndrome Diagnosed by Ocular Point of Care Ultrasound on the Medical Floor
Authors: Mark Johnson
Journal: POCUS J (2024)
Keywords: internal medicine, ocular ultrasound, pocus, subarachnoid haemorrhage, terson syndrome, viterous haemorrhage
MeSH terms: Case Reports

In acute care environments, accurately assessing complications of intracranial pathology can be challenging. Ocular complications in acute intracranial disease are not consistently evaluated despite their high morbidity. We report on a case of monocular diplopia in a 63-year-old man with subacute traumatic brain injury with localized subarachnoid hemorrhage. Ocular point of care ultrasound (POCUS) identified features of vitreous hemorrhage in one globe, leading to a diagnosis of Terson syndrome and a timely referral to ophthalmology. This finding was made on the medical floor days after the initial presentation during rehabilitation when ophthalmoscopy was not possible, and vitreous hemorrhage had not been identified on presentation. Terson syndrome is a seldom discussed but important complication of intracranial hemorrhage generally associated with poor patient outcomes. Ocular POCUS can provide a useful alternative in assessing ocular complications of acute intracranial disease on the medical floor, particularly when the practicalities of performing ophthalmoscopy are challenged.
Case report: Diagnosis and treatment of pulmonary choristoma in a newborn calf
Authors: Noriyo Usaki, Takeshi Tsuka, Midori Hatanaka, Yuji Sunden, Aoi Imamura, Takehito Morita
Journal: Front Vet Sci (2024)
Keywords: doppler ultrasonography, bronchi-like structures, calf, feeding arterial vessel, pulmonary choristoma
MeSH terms: Case Reports

A 4-day-old female Holstein calf presented with a large-sized, protruding mass in its back, at birth. Radiography identified the deformed spinous process in the second and third lumbar vertebras, suggesting spina bifida. Ultrasonography of the back mass revealed anechoic bronchi-like structures and large vessels with rich blood flow running parallel within the homogenous echogenic mass's parenchyma. Doppler ultrasonography also revealed pulsatile vessels entering into the deeper side of the transverse process of the lumbar vertebras at the right-sided base of the protruding mass. These imaging results were helpful for surgical planning, in which a large arterial vessel was sutured at the right-sided mass's base, followed by resection of the mass itself. The mass's resection could be carried out according to the planned surgical procedure, though its invasion was too deep to be resected completely. Histopathology for the resected specimens revealed that the mass mainly had lung-tissue-like structures comprised of bronchi-, bronchiole- and alveoli-like structures, and large vessels, allowing the diagnosis of pulmonary choristoma. Doppler ultrasonography could contribute to the differentiation between the bronchi-like tubular structure and the large arterial vessels on the same images, aiding diagnosis of this disease.
Cerebral tumor with hemi-dural enhancement as unique presentation of multiple myeloma: A case report
Authors: Rick H G J van Lanen, Sandra M H Huijs, Alida A Postma, Roel H L Haeren
Journal: Brain Spine (2023)
Keywords: case report, dura mater, intracranial, multiple myeloma, plasmacytoma
MeSH terms: Case Reports

Introduction:
Intracranial multiple myeloma (MM) is a rare manifestation of MM, a malignant plasma cell disorder that primarily affects bone marrow. Dural involvement in MM is even rarer and can manifest as a dural mass. We present a case of MM presenting as an intracranial dural tumor with primary hemi-dural involvement.
Research question:
This case report aims to investigate the clinical presentation, diagnostic challenges, and treatment approaches for intracranial multiple myeloma, with a focus on the extensive hemi-dural thickening and enhancement seen in this case.
Material and methods:
A 73-year-old male presented with progressive dysphasia and weakness. MRI revealed a solid left frontal mass with significant mass-effect. Hemi-dural thickening and enhancement was present along with invasion of the skull. The patient underwent surgical resection of the tumor with dural and bone reconstruction.
Results:
Histopathological examination confirmed MM diagnosis. Chemotherapy was started. Follow-up MRI showed complete tumor resection, but extensive hemi-dural thickening and enhancement persisted. Postoperative radiation therapy was considered.
Discussion and conclusion:
MM with primary dural involvement is rare and poses diagnostic challenges. Postoperative treatment involves chemotherapy, the role of surgery and radiotherapy is not established. The extensive hemi-dural thickening and enhancement observed in this case require further investigation, and a wait-and-scan policy was recommended instead of radiotherapy.
The Reversed Halo Sign in Pulmonary Infarction due to Acute Pulmonary Embolism
Authors: Thalinne Schueremans, Margot Versavel, Adriana Dubbeldam
Journal: J Belg Soc Radiol (2023)
Keywords: atoll sign, ct angiography, hrct, rhs, pulmonary embolism, pulmonary infarction, reversed halo sign
MeSH terms: Case Reports

The reversed halo sign, or atoll sign, is a specific sign with ring-shaped consolidation and central lucency, which is historically considered typical for cryptogenic organising pneumonia. The presence of this sign in subpleural, posterior basal parts of the lower lobes, especially when solitary, should however raise suspicion for other causes, such as pulmonary infarction. Here, we present a case of pulmonary embolism with pulmonary infarction that was detected on HRCT without contrast. Teaching Point: The presence of a reversed halo sign, especially when solitary and located in the periphery of the lower lobes, should raise suspicion of a pulmonary infarction.
Waldenström Macroglobulinemia-Associated Peripheral Neuropathy in the Brachial Plexus With Bing-Neel Syndrome Diagnosed Through Repeated Cerebrospinal Tests
Authors: Misaki Hatasa, Naoto Imoto, Shota Komori, Yasunobu Nosaki, Shingo Kurahashi
Journal: Cureus (2024)
Keywords: bing-neel syndrome, bruton’s tyrosine kinase inhibitor, central nervous system disease, tirabrutinib, waldenström macroglobulinemia-associated peripheral neuropathy
MeSH terms: Case Reports

In Waldenström macroglobulinemia (WM), confirming the presence of Bing-Neel syndrome (BNS) is important because drugs that penetrate the central nervous system (CNS) must be selected. We report the case of a 75-year-old man for whom tirabrutinib, a second-generation Bruton's tyrosine kinase inhibitor (BTKi), was useful in treating WM-associated peripheral neuropathy (PN) with BNS. Numbness and muscle weakness in the fingers occurred three years after the initial treatment of WM. WM-associated PN due to demyelinating disease was diagnosed based on the results of a nerve conduction study and magnetic resonance imaging showing bilateral symmetric swelling of the brachial plexus. The cerebrospinal fluid (CSF) cytology results were initially negative; however, the CSF test was repeated because of extremely high protein levels (984 mg/dL) and slightly elevated leukocyte counts (14/µL). The second test revealed abnormal lymphoplasmacytic cells (189/µL), indicating BNS. Rituximab and high-dose methotrexate-containing chemotherapy were administered. Despite the subsequent negative CSF cytology results, his neurological symptoms persisted but subsided soon after the initiation of tirabrutinib. The therapeutic effects of tirabrutinib persisted for 25 months. This case suggested that a careful search for concurrent BNS is important when lesions are close to the CNS or when atypical CSF findings are obtained in patients with WM-associated PN, especially when BTKi options are available.
Case Report: Scalp pityriasis versicolor may be a neglected problem
Authors: Ya Bin Zhou, Jin Jing Chao, Lin Ma, Yuan Yuan Xiao
Journal: Front Pediatr (2024)
Keywords: malassezia, children, pityriasis versicolor, scalp, tinea versicolor
MeSH terms: Case Reports

Pityriasis versicolor, a common skin fungal infection, is typically observed on trunk and limb skin. Here, we highlight an unusual presentation: scalp involvement, often overlooked due to its asymptomatic, mildly scaly patches. We report four pediatric cases, emphasizing the potential underestimation of this scalp variant. This case series underscores the importance of considering this diagnosis in patients with unexplained scalp hypopigmentation, especially in males with short hair who may readily notice these subtle changes. The report contributes to the understanding of this variant's clinical presentation and emphasizes the need for awareness among clinicians to ensure accurate diagnosis and appropriate management.
Diagnosis of Cutaneous Larva Migrans using Point of Care Ultrasound
Authors: Daniella Lamour, Robert A Farrow, Jean Pierre, Daniel Puebla, Paul Khalil
Journal: POCUS J (2024)
Keywords: cutaneous larva migrans, point of care ultrasound, soft tissue ultrasound
MeSH terms: Case Reports

Larva migrans is a cutaneous parasitic infection that occurs when an immature hookworm larva inadvertently penetrates the dermis of a human, typically on the extremities. Traditionally, a clinical diagnosis is made when a tortuous/serpiginous eruption is seen superficially in the skin with complaints of intense pruritus. Point of care ultrasound (POCUS) is a useful diagnostic tool for soft tissue complaints in the emergency department (ED). We describe a case of an 18-year-old woman who presented to the ED with foot pruritis four days after walking on the beach barefoot. POCUS examination revealed several motile structures in the dermis of the patient's foot, confirming our suspicion of cutaneous larva migrans. The patient was then placed on an oral anthelmintic and her symptoms resolved shortly after.
Spontaneous Bladder Rupture in a Catatonic Schizophrenia Patient
Authors: Megumi Miyakoshi, Takayuki Arai, Shin Kurose, Masataka Kaji, Jun Nakane, Mitsumoto Onaya, Akihiro Koreki
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Catatonia is a psychiatric emergency in schizophrenia that often leads to excessive activation of the sympathetic nervous system. Urinary retention in catatonia is often underestimated but has potentially detrimental consequences. Herein, we present the case of a woman in her 40s with schizophrenia treated for catatonia during a relapse. When treated as an inpatient, the patient suddenly complained of severe abdominal pain. Computed tomography revealed a spontaneous rupture of the posterior wall of the bladder, requiring emergency repair surgery in the urology department. The patient was readmitted to our hospital following surgery and ultimately discharged 1 month later. Bladder rupture is life-threatening, and delayed diagnosis and treatment can be fatal. This case report serves as a warning that psychiatrists should not overlook urinary retention in patients with catatonia and should consider bladder rupture in the differential diagnosis when these patients have abdominal pain.
Co-existence of KMT2A:: SEPTIN6 fusion and DIS3 variant in a pediatric case with acute myeloid leukemia: a case report and literature review
Authors: Liang Wang, Fangzhou Qiu, Yongming Shen, Sen Chen, Ping Si
Journal: Front Oncol (2023)
Keywords: dis3, kmt2a, septin6, acute myeloid leukemia, gene fusion
MeSH terms: Case Reports

The lysine(K)-specific methyltransferase 2A gene (KMT2A), previously known as mixed lineage leukemia (MLL), frequently rearranged in acute leukemia, belongs to one of the most promiscuous genes and has been found fused to more than 80 different partners. KMT2A::SEPTIN6 fusion is a relatively uncommon rearrangement observed in pediatric acute myeloid leukemia (AML) patients, some of which may harbor other mutations. We herein report a case of AML-M4-infant with KMT2A::SEPTIN6 fusion and DIS3 variant. The 8-month-old girl presented with leukocytosis, anemia and thrombocytopenia. A bone marrow smear disclosed that 64% of the total nucleated cells were blasts. Karyotype analysis showed 46,X,t(X;11)(q24;q23)[10]/46,XX[10]. Fluorescence in situ hybridization analysis suggested a possible break in the KMT2A gene. After whole transcriptome sequencing, Exon 9 of KMT2A was fused in-frame with Exon 2 of SEPTIN6. This is a typical type of chromosomal rearrangement leading to the KMT2A::SEPTIN6 fusion. Meanwhile, DIS3 variant [c.2065C>T, p.R689X, variant allele frequency (VAF): 39.8%] was identified. KMT2A::SEPTIN6 fusion has been associated with the pathogenesis of AML, whereas DIS3 variants are relatively rare genetic events in pediatric AML. Regrettably, the relatives disagreed with the combination chemotherapy, and the patient eventually died of progressive disease. In conclusion, our findings provide a foundation for a better understanding of the genotypic profile of KMT2A::SEPTIN6 associated AML, and the co-existence of KMT2A::SEPTIN6 and DIS3 variant might contribute to the disease progression and transformation of AML.
Case report: Squamous cell carcinoma of the prostate-a clinicopathological and genomic sequencing-based investigation
Authors: Caixin Zhang, Yong Jia, Qingnuan Kong
Journal: Pathol Oncol Res (2023)
Keywords: scc, gene mutation, prostate adenocarcinoma, squamous cell carcinoma, whole exome sequencing
MeSH terms: Carcinoma, Squamous Cell / pathology, Prostatic Neoplasms / genetics, Prostatic Neoplasms / therapy, Case Reports, Androgen Antagonists, Genomics, Humans, Male, Prostate / pathology, Androgen Antagonists

Squamous differentiation of prostate cancer, which accounts for less than 1% of all cases, is typically associated with androgen deprivation treatment (ADT) or radiotherapy. This entity is aggressive and exhibits poor prognosis due to limited response to traditional treatment. However, the underlying molecular mechanisms and etiology are not fully understood. Previous findings suggest that squamous cell differentiation may potentially arise from prostate adenocarcinoma (AC), but further validation is required to confirm this hypothesis. This paper presents a case of advanced prostate cancer with a combined histologic pattern, including keratinizing SCC and AC. The study utilized whole-exome sequencing (WES) data to analyze both subtypes and identified a significant overlap in driver gene mutations between them. This suggests that the two components shared a common origin of clones. These findings emphasize the importance of personalized clinical management for prostate SCC, and specific molecular findings can help optimize treatment strategies.
Hodgkin Lymphoma Presenting as Cardiac Tamponade in a Young Female
Authors: Georgia Kaiafa, Stylianos Daios, Stavroula Bountola, Triantafyllia Koletsa, Michail Makris, Charikleia Chatzikosma, Antonia Loukousia, Vasileios Perifanis, Antonios Ziakas, Christos Savopoulos
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

Hodgkin lymphoma (HL) is an uncommon malignancy that is characterized by Hodgkin or Reed-Sternberg cells. Cardiac implications of HL remain one of the least investigated subjects. There are few case reports in the literature of cardiac tamponade in HL patients. We describe a case of a 21-year-old female patient who presented with cardiac tamponade as an initial presentation of HL. Any pericardial effusion significant for tamponade requires immediate drainage and fluid analysis for thorough investigation. Prompt identification and timely intervention are crucial in effectively addressing these complex situations. Therefore, clinicians should maintain heightened awareness in such cases.