OpenMed/multicare-articles huggingface dataset:
A Combination of Surgical Techniques to Repair a Giant Traumatic Macular Hole
Authors: Soon Wai Ch'ng, Ibrahim Elaraoud, David Karl, Dimitrios Kalogeropoulos, Rynn Lee, Elisa Carreras
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

A 38-year-old man with a traumatic full-thickness macular hole (FTMH) presented to our eye casualty department with a sudden deterioration of his right eye vision to hand movements over the past one week. The suspected traumatic FTMH was present since he was 13 years old from a direct impact of a golf ball in his right eye and his best-corrected visual acuity (BCVA) has always remained at 1/60 Snellen vision. On examination, he had a very large FTMH measuring 1635 µm with central foveal retinal detachment. Pars plana vitrectomy combined with large inverted internal limiting membrane (ILM) peel flap, 5000 Cs silicone oil tamponade, and autologous platelets implantation was performed. Follow-up visits revealed that the FTMH was closed under silicone oil. The silicone oil was removed six months after the surgery and the FTMH remained close with the retina remaining attached. His BCVA was restored to his previous baseline level of 1/60 Snellen vision. With the advent of multiple techniques to repair FTMH such as the ILM flaps, we have combined this technique with older proven techniques such as silicone oil tamponade and autologous platelets implantation to close the giant traumatic FTMH. This case study demonstrates that combining techniques can help close a FMTH that is otherwise deemed impossible in the past.
Case report: First case of undifferentiated embryonal sarcoma of the liver in a child with neurofibromatosis type 1, treated by hepatic chemoperfusion with transcatheter arterial chemoembolization
Authors: Ksenia Sinichenkova, Ludmila Yasko, Dmitry Akhaladze, Anton Petrushin, Dmitry Konovalov, Ruslan Abasov, Yulia Mareeva, Olga Melekhina, Natalia Usman, Alexander Karachunsky, Galina Novichkova, Dmitry Litvinov, Alexander Druy
Journal: Front Oncol (2022)
Keywords: chemoperfusion, malignant peripheral nerve sheath tumor, neurofibromatosis type 1, transarterial chemoembolization, undifferentiated embryonal sarcoma of the liver
MeSH terms: Case Reports

Introduction:
In this report we firstly describe undifferentiated embryonal sarcoma of the liver (UESL) in a patient with neurofibromatosis type 1 (NF1), fatally complicated by synchronous malignant peripheral nerve sheath tumor (MPNST) with a highly aggressive metastatic course. The case also represents our first experience of chemoperfusion involving the transcatheter arterial chemoembolization (TACE) in a pediatric patient, applied as a treatment for UESL.
Case presentation:
A 13-year-old girl was diagnosed with NF1 and presented with a liver tumor identified as UESL by histological assessment. The tumor was refractive to the conventional first-line chemotherapy. The patient received hepatic chemoperfusion with TACE, which was efficacious; however, the overall curative outcome was unsatisfactory due to synchronous unresectable retroperitoneal MPNST with mesenteric metastases and ultimate progression of the UESL.
Conclusion:
This is the first reported case of UESL in a patient with NF1. The results demonstrate the efficacy of hepatic chemoperfusion with TACE in pediatric UESL.
Synchronous Renal Cell Carcinoma and Gastrointestinal Malignancies
Authors: Tamer J Dafashy, Cameron K Ghaffary, Kyle T Keyes, Joseph Sonstein
Journal: Case Rep Urol (2016)

While renal cell carcinoma is the most commonly diagnosed neoplasm of the kidney, its simultaneous diagnosis with a gastrointestinal malignancy is a rare, but well reported phenomenon. This discussion focuses on three independent cases in which each patient was diagnosed with renal cell carcinoma and a unique synchronous gastrointestinal malignancy. Case 1 explores the diagnosis and surgical intervention of a 66-year-old male patient synchronously diagnosed with clear cell renal cell carcinoma and a carcinoid tumor of the small bowel. Case 2 describes the diagnosis and surgical intervention of a 61-year-old male found to have clear cell renal cell carcinoma and a mucinous appendiceal neoplasm. Lastly, Case 3 focuses on the interventions and management of a 36-year-old female diagnosed with synchronous clear cell renal carcinoma and hereditary nonpolyposis colorectal cancer. This case series examines each distinct patient's presentation, discusses the diagnosis, and compares and contrasts the findings while discussing the literature on this topic.
Diagnosis of perinuclear anti-neutrophil cytoplasmic antibody-associated microscopic polyangiitis in silicotics: case report
Authors: Ji-Won Lee, Jun-Pyo Myong, Yeong-Jin Choi, Seyoung Lee, Bum Seak Jo, Jung-Wan Koo
Journal: Ann Occup Environ Med (2016)
Keywords: autoimmune disease, occupational exposure, silicon dioxide, silicosis
MeSH terms: Case Reports

Background:
An association between silica exposure and autoimmune diseases including rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, and anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis has been made.
Case presentation:
A 56-year-old male presented with silicosis and had an occupational history of precious metal processing for 30 years and a 30 pack-year smoking history. The patient was diagnosed with pneumoconiosis and received compensation. No other complications were reported for pneumoconiosis. The patient suddenly presented with a non-specific headache for several days and microscopic hematuria was identified upon examination in the outpatient clinic. Following several weeks, the patient presented with aggravated dyspnea and hemoptysis, and his Modification of Diet in Renal Disease estimated glomerular filtration rate indicated acute kidney injury. Diagnostic analysis revealed perinuclear ANCA-associated microscopic polyangiitis (p-ANCA-associated MPA).
Conclusion:
Exposure to silica dust was likely one of the cause of p-ANCA-associated MPA. Possible pathogenic mechanisms of autoimmune diseases in silicotics and emphasis of the necessity for early diagnosis are discussed.
Osteochondritis Dissecans of the Capitellum: A Case Report of Successful Arthroscopic Treatment
Authors: J Ribeiras Cabral, R Henriques, J Arvela Matoso, S Martins, M Sarmento
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Introduction. Osteochondritis dissecans (OCD) of the capitellum is a localized disorder of the subchondral bone, in a region with limited healing capacity. Although its aetiology is still unknown, it has been associated with repetitive microtrauma. The natural history of this disease involves the evolution for degenerative joint disease in approximately half of the patients, with early identification and treatment being critical to optimizing the outcome. Case Presentation. We present a rare case in our practice, illustrating a capitellar OCD in a fifteen-year-old White male without an identified cause of repetitive microtrauma. Conclusion. In this case prompt diagnosis and arthroscopic-assisted treatment led to a successful result.
Key Role of Left Atrial Appendage during Redo Ablation in a Case of Long-Standing Persistent Atrial Fibrillation
Authors: Shaohui Wu, Guangchen Zou, Xu Liu, Weifeng Jiang, Mu Qin, Daoliang Zhang
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Extrapulmonary vein focal sources have been recognized as the source of atrial fibrillation in some cases, and empiric electric isolation of the left atrial appendage has been proposed for long-standing persistent atrial fibrillation by some. Here, we present a case of redo ablation of long-standing persistent atrial fibrillation in which the left atrial appendage played a key role in maintaining AF during ablation, and atrial fibrillation was terminated by electrical isolation of the LAA. During the ablation, a rare phenomenon of half of the atria in atrial fibrillation while the other half of the atria in atrial flutter was seen.
Emergence of ST63 Pandrug-Resistant Acinetobacter pittii Isolated From an AECOPD Patient in China
Authors: Ling Yang, Ning Dong, Chen Xu, Lianwei Ye, Sheng Chen
Journal: Front Cell Infect Microbiol (2021)
Keywords: aecopd, acinetobacter pittii, blaoxa-58, pandrug-resistance, point mutations, whole genome sequencing
MeSH terms: Acinetobacter Infections / drug therapy, Acinetobacter baumannii, Acinetobacter / genetics, Pulmonary Disease, Chronic Obstructive, Case Reports, Research Support, Non-U.S. Gov't, Anti-Bacterial Agents / pharmacology, Anti-Bacterial Agents / therapeutic use, Bacterial Proteins / genetics, China, Humans, Microbial Sensitivity Tests, beta-Lactamases / genetics, Anti-Bacterial Agents, Bacterial Proteins, beta-Lactamases, Acinetobacter pittii

Acinetobacter sp. is among the ESKAPE organisms which represent the major nosocomial pathogens that exhibited a high resistance rate. A. pittii, frequently associated with antimicrobial resistance particularly to carbapenems, is one of the most common Acinetobacter species causing invasive infection. Pandrug resistant A. pittii has rarely been reported. Here, we report the case of a patient with acute exacerbations of chronic obstructive pulmonary disease three years after double lung transplantation and developed severe pneumonia associated with pandrug resistant A. pittii infection. Phenotypic and genomic characteristics of this pandrug resistant isolate (17-84) was identified, and the mechanisms underlying its resistance phenotypes were analyzed. Isolate 17-84 belonged to ST63, carried a non-typable and non-transferable plasmid encoding multiple acquired resistance genes including carbapenemase gene blaOXA-58. Point mutations and acquired resistance genes were identified which were associated with different drug resistance phenotypes. To our knowledge, this is the first detailed phenotypic and genomic characterization of PDR A. pittii causing severe infections in clinical settings. Findings from us and others indicate that A. pittii could serve as a reservoir for carbapenem determinants. The emergence of such a superbug could pose a serious threat to public health. Further surveillance of PDR A. pittii strains and implementation of stricter control measures are needed to prevent this emerging pathogen from further disseminating in hospital settings and the community.
Case report: Mitral valve replacement for Libman-Sacks endocarditis and cerebral embolism of primary antiphospholipid syndrome
Authors: Huili Liang, Chunyan Ma, Xin Chen
Journal: Front Cardiovasc Med (2022)
Keywords: libman-sacks endocarditis, antiphospholipid syndrome, cerebral embolism, mitral regurgitation, mitral valve
MeSH terms: Case Reports

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by recurrent arteriovenous thrombosis and/or morbid pregnancy. Valve involvement is the most common cardiac manifestation of APS, with lesions characterized by valve thickening and vegetations known as Libman-Sacks endocarditis (LSE). This report discussed a rare case of a 26-year-old young woman diagnosed with primary APS with multiple cerebral infarctions and right middle cerebral artery occlusion that occured 3 years ago. During the investigation, transthoracic echocardiography (TTE) revealed vegetations on both leaflets of the mitral valve with mild to moderate mitral regurgitation. One year following corticosteroid and anticoagulant treatment, mitral valve fibrosis and moderate to severe regurgitation were noted, after which mitral mechanical valve replacement was finally performed. Accordingly, this report suggests that LSE occurrence should be alerted during the examination of APS patients especially in those with cerebrovascular disease. Furthermore, establishing an early diagnosis and conducting close follow-ups are necessary for its timely intervention and treatment.
Psychiatric Disorders after Switching to Dolutegravir: A Case Report of a 59-Year-Old Virosuppressed HIV-1 Positive Woman
Authors: Daniele Mengato, Raffaella Binazzi, Ivan Unterholzner, Elke M Erne, Alicia Tavella
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

We report a case of a woman who experienced psychiatric disorders after switching her antiretroviral therapy (c-ART) to dolutegravir (DTG). She is a 59-year-old HIV-1 positive woman with a recent story of cardiovascular disorders treated with beta-blockers, clopidogrel, and rosuvastatin. She underwent a c-ART switch from darunavir/cobicistat and maraviroc to emtricitabine/tenofovir alafenamide fumarate in association with dolutegravir due to drug-drug interactions. One week later, she started to show psychiatric symptoms that required admission to the psychiatric unit. These disorders resolved within a couple of days after DTG discontinuation to allow a regular discharge. With this case-report, we would like to analyse the possible correlation between integrase inhibitor and severe psychiatric disorders in order to confirm the evidences already published in literature.
Endocrine therapy for metastatic solid pseudopapillary neoplasm of the pancreas: A case report
Authors: Anna Kornietskaya, Sevindzh Evdokimova, Andrei Kachmazov, Alexander Fedenko, Larisa Bolotina, Dmitriy Sidorov, Nadezhda Volchenko, Natalia Goeva, Anastasia Govaleshko, Andrey Kaprin
Journal: Front Oncol (2022)
Keywords: case report, endocrine therapy, pancreas, solid pseudopapillary neoplasm (spn), tamoxifen
MeSH terms: Case Reports

Solid pseudopapillary neoplasm (SPN) of the pancreas is an extremely rare tumor, associated with favorable prognosis and long-term survival in patients with advanced disease. However, limited data exist on systemic therapy for such patients. Herein, we present a case of a young woman with a history of SPN, who progressed after multiple surgical resections and chemotherapy regimens. The immunohistochemistry (IHC) showed overexpression of estrogen receptors (ER) and progesterone receptors (PR) in tumor tissue. The patient started to receive tamoxifen and showed a durable response to endocrine therapy.
Severe Insulin Resistance Improves Immediately After Sleeve Gastrectomy
Authors: Rahul Sharma, Chandra Hassan, Joumana T Chaiban
Journal: J Investig Med High Impact Case Rep (2016)
Keywords: homa-ir, insulin resistance, sleeve gastrectomy, type 2 diabetes

Introduction. Obese individuals exhibit insulin resistance often leading to adverse health outcomes. When compared with intensive medical therapy, bariatric surgery has shown better outcomes mainly in terms of insulin resistance and glycemic control. Using the Homeostasis Model Assessment of insulin resistance (HOMA-IR), we report herein a case illustrating a drastic improvement in severe insulin resistance after sleeve gastrectomy in the immediate postoperative period. Case Report. A patient with long-standing history of morbid obesity, type 2 diabetes, obstructive sleep apnea, hypertension, and severe insulin resistance (requiring approximately 2 units of insulin per kg per day) was enrolled in the medical weight management program for 6 months during which he lost 40 lbs and his insulin requirements decreased. He then underwent a sleeve gastrectomy and did not require insulin therapy as of postoperative day 1. His HOMA-IR improved by about 76% between day 1 and day 14 postoperatively. Conclusion. Sleeve gastrectomy leads to a drastic improvement in severe insulin resistance as early as the first postoperative day.
Changes in the Size of a Ruptured Pheochromocytoma after Transcatheter Arterial Embolization
Authors: Takahiro Ichikawa, Chikako Oyabu, Megumi Minamida, Yusuke Ichijo, Yoshitaka Hashimoto, Mai Asano, Hiroya Iwase, Toru Tanaka, Michiaki Fukui
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

The spontaneous rupture of a pheochromocytoma is rare and can be potentially fatal. We report a case of a tumor size reduction of a ruptured pheochromocytoma after transcatheter arterial embolization (TAE). A 60-year-old Japanese woman was referred to the emergency department of another hospital with a sudden onset of left lateral pain. Computed tomography of the abdomen revealed adrenal hemorrhage with a 5.7 cm adrenal mass, and she was transferred to our hospital for treatment. Considering that she had marked hypertension (193/115 mmHg), we made a provisional diagnosis of left lateral pain due to a ruptured pheochromocytoma. She underwent TAE, and the hemorrhage was successfully controlled. She was started on oral doxazosin for hypertension. The dose of doxazosin was increased to the extent that orthostatic hypotension did not develop, and blood pressure was well controlled. After discharge, the tumor size gradually decreased to approximately 1.0 cm within six months. Six months after TAE, elective laparoscopic surgery was performed, and the diagnosis was confirmed by histopathology. We observed a decrease in the size of the ruptured pheochromocytoma after TAE. To reduce the risk of laparoscopic adrenal surgery, it may be useful to monitor the size of a ruptured pheochromocytoma after TAE before deciding the surgery time.
A Complete Constellation of Nervous System Lesions of NF2: Imaging Evaluation
Authors: Kiran Gangadhar, Sandeep Kumar, Lovekesh Bhatia, Arjit Agarwal
Journal: Case Rep Radiol (2012)
MeSH terms: Case Reports

The radiological findings fulfilling the criteria of neurofibromatosis type 2 (NF2) were reviewed. NF2 is a rare disease with few cutaneous but frequent, typical radiological findings in the central nervous system. The presenting symptom is most commonly hearing loss due to acoustic schwannomas, although symptoms emanating from other intracranial or tumors are not uncommon. The discovery of multiple spinal neurofibromas or multiple meningiomas without cutaneous lesions should initiate a search for acoustic schwannomas even when the patient has normal hearing as in our case patient who actually presented for weakness of all four limbs.
Hemolytic uremic syndrome in the setting of COVID-19 successfully treated with complement inhibition therapy: An instructive case report of a previously healthy toddler and review of literature
Authors: Matija Matošević, Ivanka Kos, Maša Davidović, Maja Ban, Hana Matković, Ivan Jakopčić, Ivana Vuković Brinar, Ágnes Szilágyi, Dorottya Csuka, György Sinkovits, Zoltán Prohászka, Kristina Vrljičak, Lovro Lamot
Journal: Front Pediatr (2023)
Keywords: covid-19, hus, tma, complement blockade, hemolytic uremic syndrome, ravulizumab, thrombotic microangiopathy
MeSH terms: Case Reports

Introduction:
As the global pandemic continues, new complications of COVID-19 in pediatric population have turned up, one of them being hemolytic uremic syndrome (HUS), a complement-mediated thrombotic microangiopathy (CM-TMA) characterized by triad of thrombocytopenia, microangiopathic hemolytic anemia and acute kidney injury (AKI). With both multisystem inflammatory syndrome in children (MIS-C) and HUS sharing complement dysregulation as one of the key factors, the aim of this case report is to highlight differences between these two conditions and also emphasize the importance of complement blockade as a treatment modality.
Case report:
We describe a 21-month-old toddler who initially presented with fever and confirmed COVID-19. His condition quickly deteriorated and he developed oliguria, accompanied with diarrhea, vomiting and oral intake intolerance. HUS was suspected, supported with compelling laboratory findings, including decreased platelets count and C3 levels, elevated LDH, urea, serum creatinine and sC5b-9 and presence of schistocytes in peripheral blood, negative fecal Shiga toxin and normal ADAMTS13 metalloprotease activity. The patient was given C5 complement blocker Ravulizumab and started to display rapid improvement.
Conclusion:
Although reports of HUS in the setting of COVID-19 continue to pour in, the questions of exact mechanism and similarities to MIS-C remain. Our case for the first time accentuates the use of complement blockade as a valuable treatment option in this scenario. We sincerely believe that reporting on HUS as a complication of COVID-19 in children will give rise to improved diagnosis and treatment, as well as better understanding of both of these intricating diseases.
Isolated cerebral aspergillus abscess as a complication of pulmonary alveolar proteinosis in a child
Authors: Rachna Khera, Venkateswara Rao, Mohan Krishna Pasam, Ravindranath Tagore, Sudha S Murthy, Challa Sundaram
Journal: Chin Neurosurg J (2019)
Keywords: aspergillus fumigatus, cerebral abscess, opportunistic infection, pulmonary alveolar proteinosis
MeSH terms: Case Reports

Background:
Pulmonary alveolar proteinosis (PAP) poses a risk of opportunistic infections with a variety of organisms with Nocardia being the most common pathogen followed by mycobacteria and fungi.
Case presentation:
A 7-year-old female child, presented with headache and multiple episodes of vomiting. There was no fever or altered sensorium. On examination, there were no focal deficits or cranial nerve palsies. An MRI brain showed a small T2 hyperintense lesion in the left superior parietal lobe suggestive of an abscess. She was diagnosed as PAP based on CT chest and bronchioloalveolar lavage 7 months earlier and treated with corticosteroids. A left parieto-occipital craniotomy was done with drainage of abscess and abscess wall excision. Histopathology revealed a suppurative lesion with slender septate acute angle branching hyphae which were positive on fungal stains. Culture done on the pus was positive for Aspergillus fumigatus. The patient was treated with voriconazole and stable at 1 year follow-up.
Conclusion:
Opportunistic infections are common in patients diagnosed with PAP. High index of clinical suspicion and early diagnosis are important for favorable outcome.