OpenMed/multicare-articles huggingface dataset:
A rare case of successful treatment of peritoneal dialysis patient with Serratia marcescens peritonitis without catheter removal: case report and literature review
Authors: Ruizhi Xie, Ying Ling, Yaru Huang, Lulu Qin, Kun Bao, Xindong Qin
Journal: Front Cell Infect Microbiol (2024)
Keywords: serratia marcescens, case report, infection route, peritoneal dialysis, peritonitis, treatment
MeSH terms: Anti-Bacterial Agents / administration & dosage, Anti-Bacterial Agents / therapeutic use, Peritoneal Dialysis / adverse effects, Peritonitis / drug therapy, Peritonitis / microbiology, Serratia Infections / microbiology, Serratia marcescens / isolation & purification, Case Reports, Review, Adult, Cefazolin / therapeutic use, Ceftazidime / administration & dosage, Ceftazidime / therapeutic use, Device Removal, Humans, Levofloxacin / therapeutic use, Male, Treatment Outcome, Anti-Bacterial Agents, Levofloxacin, Ceftazidime, Cefazolin

Serratia marcescens, as a Gram-negative opportunistic pathogen, is a rare cause of peritonitis and has worse clinical outcomes than Gram-positive peritonitis. In this case report, we describe a case of Serratia marcescens associated peritonitis that was successfully cured without catheter removal. A 40-year-old male patient with peritoneal dialysis who worked in the catering industry was admitted to the hospital for 16 hours after the discovery of cloudy peritoneal dialysate and abdominal pain. Ceftazidime and cefazolin sodium were immediately given intravenously as an empirical antibiotic regimen. After detecting Serratia marcescens in the peritoneal diasate culture, the treatment was switched to ceftazidime and levofloxacin. The routine examination of peritoneal dialysate showed a significant decrease in white blood cells, the peritoneal dialysate became clear, and the peritoneal dialysis catheter was retained. The patient was treated for 2 weeks and treated with oral antibiotics for 1 week. It is necessary to further strengthen the hygiene of work environment to prevent Serratia marcescens infection in peritoneal dialysis patients. We recommend that patients with Serratia marcescens associated peritonitis should be treated with a combination of antibiotics as early as possible empirically, and at the same time, the peritoneal dialysis fluid culture should be improved, and the antibiotic regimen should be timely adjusted according to the drug sensitivity results. For patients with clinical symptoms for more than 3 days, considering the strong virulence of Serratia marcescens, whether to use meropenem directly or not can provide a reference for clinical decision-making. Further clinical studies are needed to achieve more precise anti-infective treatment.
Successful pedicled vertical rectus abdominis myocutaneous flap reconstruction with negative-pressure wound therapy for deep sternal wound infection: a case report and comprehensive review
Authors: Dong Yun Lee, SuRak Eo, SooA Lim, Jung Soo Yoon
Journal: Front Surg (2023)
Keywords: cardiac injury, case report, deep sternal wound infection (dswi), negative-pressure wound therapy (npwt), vertical rectus abdominis myocutaneous (vram) flap
MeSH terms: Case Reports

Introduction:
Deep sternal wound infection (DSWI) is a serious complication that may occur after median sternotomy, with potentially devastating consequences. By reporting our case and analyzing the existing literature, this article aimed to provide a thorough understanding of the role of negative-pressure wound therapy (NPWT) and the importance of flap choice in managing DSWI accompanied by severe heart injury and high hemodynamic risk.
Case description:
A 60-year-old woman with severe aortic stenosis, aortic valve regurgitation, and heart failure underwent redo sternotomy, which resulted in an intraoperative right ventricle injury. She required extracorporeal membrane oxygenation support because of low blood pressure and subsequently developed complications, including surgical site hematoma, wound dehiscence, and fat necrosis. She was referred for wound closure, where a significant 10 × 20-cm soft tissue defect in the anterior chest wall was observed. A pedicled vertical rectus abdominis myocutaneous flap addressed the soft tissue defect. The wound showed remarkable improvement at the 8-month follow-up visit.
Conclusions:
DSWI management is a complex and multifaceted challenge. NPWT, when combined with appropriate surgical strategies, including wound debridement and flap selection, may promote successful wound healing. This case report highlights the successful management of a complex DSWI using a multidisciplinary approach, including debridement, appropriate antibiotic therapy, and free-flap reconstruction, which resulted in favorable outcomes.
The Impact of Headgear on Distalization in Class II Division I Malocclusion: A Case Report
Authors: Samer Mereani, Reaam K Indijani, Amjad Alotaibi
Journal: Cureus (2024)
Keywords: appliance, distalization, expansion, headgear, orthodontics
MeSH terms: Case Reports

This report presents a case of a 16-year-old female patient with skeletal class II and dental class II division I malocclusion that was treated with fixed orthodontic appliances and through growth modulation. Two appliances were used: a Hyrax expander and a high-pull headgear with extraction. The treatment objectives of achieving a class I molar and canine relationship, resolving the crowding in the upper and lower arches, correcting the midline shift, and improving the patient's facial profile and lip position were achieved, resulting in a good occlusion with normal overbite and overjet.
De Novo Variant in the RPL27 Gene in a Second Infant with Diamond-Blackfan Anemia
Authors: Joshua Glass, Julia Weston, Amy Feldman Lewanda, Suvankar Majumdar
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

We describe a 10-month-old female with Diamond-Blackfan anemia (DBA) who presented with macrocytic anemia and reticulocytopenia. Whole exome sequencing revealed a de novo intronic variant in RPL27 (NM_000988.3:c.-2-1G > A p.?) previously reported in one individual with DBA. The existing literature suggests the RPL27 gene encodes for a ribosomal protein involved in pre-rRNA processing and erythropoiesis. Further research is needed to assess the functional significance of this variant and its implications for genetic testing and therapeutic strategies. This case expands the clinical spectrum of RPL27-associated DBA and highlights the importance of reclassifying this gene to likely pathogenic.
Case Report: Coronaro-bronchial fistula vascularizing a squamous cell lung cancer
Authors: Chloe Ntshaykolo, Thomas Fave, Clement Benic, Antoine Boizet, Margaux Geier, Pierre-Philippe Nicol, Renaud Descourt
Journal: Front Cardiovasc Med (2023)
Keywords: coronaro-bronchial fistula, coronaropathy, coronary fistula, immunotherapy, lung neoplasms
MeSH terms: Case Reports

Coronary fistulas are rare, having been described for the first time by Krauss in 1865 in postmortem. They are commonly asymptomatic and can be caused by congenital or acquired malformations. We present the case of a 65-year-old patient who was treated for squamous cell lung cancer with chemoimmunotherapy and presented with angina. The coronary angiography showed a coronaro-bronchial fistula that arises from a branch of the right coronary artery and is associated with lung cancer.
Case report: An atypical case of uterine adenosarcoma with extensive bizarre stromal cells and amplification of MDM2
Authors: Xiaoling Xiao, Ying He
Journal: Front Oncol (2024)
Keywords: mdm2, adenosarcoma, bizarre stromal cells, polypoid lesions, uterus
MeSH terms: Case Reports

Polypoid lesions in the uterus are very common. There are a lot of benign lesions and malignant tumor should be considered. Adenosarcoma, one of the differential diagnoses, is a rare mixed epithelial and mesenchymal tumor consisting of benign epithelial components and sarcoma stroma. Here, we present a case of atypical adenosarcoma that has never been reported. This tumor was composed of benign endometrial epithelium and hyperplastic stroma with extensive bizarre stromal cells. But the cleft-like spaces and papillary stomal fronds which were the typical histological images of adenosarcoma were absent. These stomal cells, including bizarre cells, were positive for vimentin, CD10, ER, PR, cyclin D1 and P16 but were immunonegative for caldesmon. Furthermore, this tumor harbored amplification of MDM2, as revealed by fluorescence in situ hybridization testing (FISH) and next-generation DNA sequencing (NGS).
Pediatric Autoimmune Neuropsychiatric Disorder Linked to Streptococcal Infections
Authors: Abdullah Nasser Alqifari, Benjamin Maxwell
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Pediatric acute-onset neuropsychiatric syndrome (PANS) is a clinical condition with abrupt onset of obsessive-compulsive symptoms and/or severe eating restrictions and at least two concomitant cognitive, behavioral, or neurological symptoms. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is a subtype of PANS with a controversial diagnosis. A case of a 12-year-old girl with severe eating restriction, obsessive-compulsive symptoms, anxiety, and neurological symptoms who initially was diagnosed with obsessive-compulsive disorder is presented. Published reports were reviewed for the evidence of diagnosis and treatment options of PANS/PANDAS. Studies show controversy regarding diagnosis. Moreover, study reports showed limited evidence for the treatment options. Selective serotonin reuptake inhibitors and psychotherapy are considered the main treatment with prompt infection treatment in the case of PANDAS.
Implementing the patient partnership approach to quality improvement of care and services: A multiple case study protocol
Authors: Tania Deslauriers, Isabelle Gaboury, Mathieu Jackson, Brigitte Vachon
Journal: PLoS One (2024)
MeSH terms: Quality Improvement, Delivery of Health Care / standards, Humans, Patient Participation, Quebec

Context:
Patient and family partners are being increasingly engaged worldwide in processes aimed at the quality improvement (QI) of healthcare services. There is also growing interest in documenting these engagement processes within organizations to share and improve them. To support the provincial implementation of this approach, the Quebec's ministry of health and social services published, in 2018, the "Framework for the partnership approach between patients, their families and health and social service stakeholders". However, while this framework provides guidelines by describing each partner's role and the ways in which patient and family partners should be engaged in QI processes, it remains unclear how these recommendations were actually used and implemented by different healthcare organizations. The aim of this paper is to present the protocol of a multiple case study that is being conducted to document how this approach was implemented in different large healthcare organizations in Quebec. This study is being conducted in partnership with a patient partner/co-researcher.
Methods:
This qualitative multiple case study will be conducted in four large healthcare organizations in Quebec. Twelve to 15 key respondents will be recruited for each case. Data will be collected from multiple sources: 1) semi-structured individual interviews with the key respondents, 2) non-participant observations of the meetings of the QI committee engaging PFPs and 3) analysis of documents describing the implementation context, vision, structures and/or processes. The framework method will be used to conduct intracase and intercase qualitative data analysis.
Discussion:
The multiple cases included will allow for comparisons between different ways of engaging PFPs in QI processes within an organization, the factors influencing these practices, their advantages and disadvantages, and their implementation outcomes. The conclusions drawn from this study will allow us to make recommendations regarding PFP engagement in the QI of care and services and to propose implementation examples for other organizations wishing to design and implement PFP engagement initiatives in their context in Quebec or elsewhere.
A case report of membrane induction combined with RIA technique for the repair of distal humerus segmentary bone defect
Authors: Guoliang Wang, Zhenfeng Zhu, Shuaikun Lu, Linhu Wang, Hao Gao, Congxiao Fu, Jun Ren, Xiang Liu, Yong Zhang, Yunfei Zhang
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: ria (reamer-irrigator-aspirator), bone defect, distal humerus, membrane induction technology, repair and reconstruction
MeSH terms: Fracture Fixation, Internal, Fractures, Bone / surgery, Humerus / injuries, Humerus / surgery, Case Reports, Female, Humans, Middle Aged, Osteogenesis

Bone nonunion and bone defect are common postoperative complications in clinic. Membrane induction or Ilizarov technique is often used to repair bone defect. Autologous bone is often used for bone defect repair and reconstruction, and the anterior superior iliac spine, posterior superior iliac spine or fibula bone is used as the donor area for bone extraction, but there are problems of donor area complications. In recent years, the development of bone marrow aspiration (RIA) has provided a new alternative way for the source of autogenous bone. We report a 48-year-old female patient with a comminuted supracondylar intercondylar fracture of the left humerus due to a car accident. After 8 months of emergency debridement and suture with Kirschner wire internal fixation, the fracture was found to be unhealed with extensive bone defects. We used membrane induction combined with RIA technology to repair and reconstruct the patients, and found good osteogenesis through late follow-up. In theory, membrane induction technique can realize the reconstruction of large segmental bone defects, but the scope of repair is often limited by the lack of autologous bone source. The emergence and development of RIA technology provides us with a new autologous bone donor area for bone repair and reconstruction surgery. It can provide a large amount of high-quality cancellar bone mud through minimally invasive means. Meanwhile, it can reduce patients' pain, infection, fracture, aesthetics and other problems caused by iliac bone extraction, and shorten patients' bed time. Maximize the preservation of the patient's autologous bone source. For the first time in the world, we reported the combination of membrane induction technology and RIA technology in the treatment of segmental bone defects, providing a new idea for the treatment of bone defects.
Pulsed Electric Field (PEF) treatment of progressive non-small cell lung cancer concurrently treated with immune checkpoint blockade: A case report
Authors: Marcelo Jimenez, Jose M Fernandez, William S Krimsky
Journal: Respir Med Case Rep (2024)
Keywords: case report, immune checkpoint blockade, nsclc, pulsed electric field (pef)
MeSH terms: Case Reports

Pulsed Electric Field (PEF) energy was delivered at the time of confirmational biopsy to ablate recurrent NSCLC in the right upper lobe (RUL) of the lung after recurrence while on durvalumab consolidation. The patient tolerated the procedure and exhibited stable disease at 6 and 12 months from time of durvalumab discontinuation and PEF treatment, respectively. This report represents the first use of the Aliya™ PEF system as a minimally invasive modality with potential to re-sensitize disease to immune checkpoint blockade (ICB) upon progression.
Clinicaltrialsgov identifier:

NCT04773275.
Case report: A case of piriformis pyomyositis and pyogenic sacroiliitis due to non-typhoidal Salmonella bacteremia in an immunocompetent healthy adult
Authors: Atsuhiro Kanno, Kohei Suzuki, Daiki Narai, Akinobu Aihara, Takehito Ito, Takahiro Ohara, Kazuhiro Sumitomo, Katsutoshi Furukawa
Journal: Front Med (Lausanne) (2024)
Keywords: bacterial translocation, fat suppressed t2 weighted image, non-typhoidal salmonella bacteremia, piriformis pyomyositis, pyogenic sacroiliitis
MeSH terms: Case Reports

Non-typhoidal Salmonella (NTS) rarely causes bacteremia and subsequent focal infections as an extraintestinal complication, even in immunocompetent adults. A 25-year-old man was hospitalized for several days with difficulty moving due to fever, acute buttock pain, and shivering. He had no recent or current respiratory symptoms and no clear gastrointestinal symptoms. Physical examination revealed mild redness around the left buttock and difficulty raising the left lower extremity due to pain, in addition to which blood tests showed high levels of inflammatory markers. His clinical course and laboratory findings suggested sepsis, and magnetic resonance imaging revealed a high-intensity area in the left piriformis muscle on diffusion-weighted imaging; therefore, acute piriformis pyomyositis was strongly suggested. Cephazolin was started upon hospitalization; however, blood and stool cultures proved positive for NTS, and the antibiotics were changed to ceftriaxone. Follow-up MRI showed a signal in the left piriformis muscle and newly developed left pyogenic sacroiliitis. On the 25th hospital day, a colonoscopy was performed to identify the portal of entry for bacteremia, which revealed a longitudinal ulcer in the sigmoid colon in the healing process. His buttock pain gradually improved, and the antibiotics were switched to oral levofloxacin, which enabled him to continue treatment in an outpatient setting. Finally, the patient completed seven weeks of antimicrobial therapy and returned to daily life without leaving any residual disability. Invasive NTS infection due to bacteremia is rare among immunocompetent adults. Piriformis pyomyositis and subsequent pyogenic sacroiliitis should be added to the differential diagnosis of acute febrile buttock pain. In the case of NTS bacteremia, the entry site must be identified for source control. Additionally, the background of the host, especially in such an immunocompetent case, needs to be clarified; therefore, the patient should be closely examined.
Primary Conjunctival Basal Cell Carcinoma Mimicking an Ocular Surface Squamous Neoplasia in a Young Adult Filipino: A Case Report and Literature Review
Authors: Lorenz Jacob Mangahas, Rowena Wea Reyes, Richmond Siazon
Journal: Case Rep Ophthalmol Med (2024)
Keywords: basal cell carcinoma, conjunctival tumors, immunohistochemistry, ocular surface squamous neoplasia
MeSH terms: Case Reports

Objective: To describe the morphological and histopathological features of primary conjunctival basal cell carcinoma (BCC) in a young adult Filipino. Introduction: Malignant conjunctival tumors arise from different cells, the most common of which are squamous cell carcinomas (SCCs), (including ocular surface squamous neoplasia [OSSN]), melanomas, and lymphomas. Primary conjunctival BCC is rare and can mimic the clinical features of OSSN. Only seven reported cases were published. Most cases are in the 6th-8th decades of life, and we report the first case in a young adult male. Case Summary: A 37/M, HIV-seronegative, presenting with a 3-year history of enlarging fleshy, pedunculated mass on the right eye measuring 8.5 mm × 8.0 mm at the superonasal limbus encroaching on the cornea, with prominent feeder vessels. Whitish-to-grayish plaques were observed on the surface of the lesions. Wide excision of the mass using the no-touch technique was performed under local anesthesia. Four cycles of mitomycin C (0.02%) were administered as chemoadjuvant therapy. Histopathology showed basaloid cells with peripheral palisading, most consistent with BCC. Immunohistochemistry was positive for Bcl-2 and CD10 markers and negative for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), confirming conjunctival BCC. Eight weeks postoperatively, fibrovascular tissue proliferation was noted at the excision site. Anterior segment-optical coherence tomography (AS-OCT) revealed a thickened hyperreflective band that was continuous with the epithelium, indicating possible recurrence. Resection with rush frozen section revealed fibrotic tissue that was negative for tumor cells. The bare sclera was covered with conjunctival autograft. There was no recurrence of the lesion after 16 months of follow-up. Conclusion: Primary BCC of the conjunctiva is rarely encountered, especially in young individuals, mimicking squamous neoplasia both in morphology and histopathology. Therefore, this should be considered in the differential diagnosis of OSSN. Immunostaining is crucial in differentiating between the two conditions and confirming the diagnosis. In most cases, wide surgical excision is sufficient. In addition, adjuvant therapies may be beneficial in preventing tumor recurrence.
An "Awakener" Patient Suffering From Treatment-Resistant Depression Following Adjunctive Cariprazine
Authors: Konstantinos Bonotis
Journal: Cureus (2024)
Keywords: add-on treatment, atypical antipsychotics, augmentation agents, cariprazine, d3 receptors, treatment-resistant depression
MeSH terms: Case Reports

This report presents a case of particular interest in terms of course and therapeutic outcomes, concerning a patient suffering from treatment-resistant depression in whom adjunctive cariprazine to medication brought about an immediate overall improvement in symptomatology. Informed written consent was obtained from the subject for publication of the case.
Rapid resolution of non-segmental vitiligo in a patient treated with abrocitinib: A case report
Authors: Seyyon Satkunanathan, Mina Boshra, Janis Chang, Reetesh Bose
Journal: SAGE Open Med Case Rep (2024)
Keywords: janus kinase inhibitors, vitiligo, abrocitinib, depigmentation
MeSH terms: Case Reports

Vitiligo is a common, autoimmune, depigmenting disorder of the skin. Janus Kinase inhibitors have emerged as promising topical and oral therapeutic options for vitiligo. There have been no reports of vitiligo being treated with oral Abrocitinib, a selective Janus Kinase 1 inhibitor approved for the treatment of moderate to severe atopic dermatitis. Here, we present a 61-year-old male with acrofacial vitiligo who had repigmentation plateau with twice daily tacrolimus 0.1% ointment, oral ginkgo biloba, and oral minipulse prednisone × 4 months; however, they had significant improvement after taking abrocitinib 100 mg per day for 2 months. He was able to transition topical tacrolimus twice weekly monotherapy for maintenance. This report shows that oral Janus Kinase inhibitors may be a useful option for the treatment of recalcitrant vitiligo. Results of ongoing randomized control trials are needed to determine the durability and safety of oral Janus Kinase inhibitors long-term.
Isolated Extensor Hallucis Longus Compartment Syndrome: A Case Report
Authors: Daniel P McKenna, Cathal McCarthy, Tony Higgins
Journal: Cureus (2024)
Keywords: compartment, extensor, hallucis, isolated, syndrome
MeSH terms: Case Reports

We present the case of an isolated extensor hallucis longus compartment syndrome following a diaphyseal fibular fracture. Our subject underwent syndesmotic fixation and experienced ongoing pain post-procedure. This was associated with an isolated loss of power in extension of the hallux. A diagnosis of an isolated extensor hallucis longus compartment syndrome followed. Our case highlights the vulnerability of this muscle belly to ischemia and reiterates the value of complete clinical examination in the postoperative patient.