OpenMed/multicare-articles huggingface dataset:
Bilateral Femoral Neck Fracture in a Postpartum Woman: Beware of the Risk Factors
Authors: Ismail Sahan, Julie De Deken, Konstantinos Anagnostakos
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Bilateral femoral neck fractures pose a rare injury. Literature data describe this entity in association with epileptic seizures, renal osteodystrophy, electric shock, pregnancy-associated transient osteoporosis, and hypocalcemic seizure. In the present work, we report on a rare case of a 28-year-old woman who suffered from such an injury 3 days postpartum. The patient had two predisposing factors (epilepsy history, transient osteoporosis) that were neglected as possible risk factors by the treating physicians. Awareness of the factors might have prevented the emergence of this injury.
Bone scintigraphy elucidates different metabolic stages of melorheostosis
Authors: Sina Izadyar, Ali Gholamrezanezhad
Journal: Pan Afr Med J (2012)
Keywords: 99mtechnetium-mdp, bone scintigraphy, iran, melorheostosis
MeSH terms: Bone and Bones / diagnostic imaging, Melorheostosis / diagnostic imaging, Metabolic Diseases / diagnostic imaging, Case Reports, Adult, Disease Progression, Female, Forearm / diagnostic imaging, Humans, Melorheostosis / complications, Metabolic Diseases / classification, Metacarpal Bones / diagnostic imaging, Radiography, Radionuclide Angiography, Radionuclide Imaging

Melorheostosis is a rare benign non-hereditary sclerosing dysplasia involving the bone, often in a sclerotomal distribution. we report the case of a 27 years old lady with painful swelling of the left hand and forearm lasting for almost 15 years. The patient experienced aggravation of symptoms and limitation of motion during the past two months. Radiographic assessment revealed hyperostosis involving the left 3(rd) and 4(th) metacarpal bones and corresponding digits as well as the left ulna and distal humerus, with no soft tissue ossification. Angiographic and blood pool images of bone scintigraphy showed increased activity of mid-metacarpal region, corresponding to the sclerotom C-8. Delayed static views showed increased radiotracer uptake of the left 4(th) metacarpal bone and the corresponding digit as well as the left ulna and humerus, but no abnormal osteoblastic activity of the 3(rd) left metacarpal and digit. Histopathologic assessment confirmed the diagnosis of Melorheostosis. The case confirms that even in the same sclerotomal distribution, the multiple foci of involvement can present in different metabolic stages. In fact, the disease does not progress uniformly and different lesions can be seen in dissimilar stages of activity. Hence, metabolic imaging can be important to unmask which of the radiographically detected bony lesions are metabolically active and have the potential to be the source of current patient's symptoms and which of them are old, metabolically inactive and silent lesions, which are not clinically relevant to the patient's complaints.
Salivary Alpha-Amylase Activity Levels in Catatonic Schizophrenia Decrease after Electroconvulsive Therapy
Authors: Misako Kanayama, Tsuyoshi Miyaoka, Tomoko Araki, Maiko Hayashida, Sadayuki Hashioka, Jun Horiguchi
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Background:
Dysfunction of the autonomic nervous system (ANS) in schizophrenia has been detected by electrophysiological methods, but the underlying mechanisms remain unknown. Several studies have suggested that measuring salivary alpha-amylase activity levels is useful for evaluating the ANS activity and that sAA levels increase in schizophrenia and correlate with Brief Psychiatric Rating Scale (BPRS) scores. However, no study has examined the relationship between sAA activity levels and symptoms of schizophrenia with catatonic state.
Methods:
We present the case of a 59-year-old female with persistent catatonic schizophrenia treated by electroconvulsive therapy. We evaluated the ANS activity by measuring sAA activity levels before and after ECT, and we evaluated her symptoms using the BPRS and Bush-Francis Catatonia Rating Scale (BFCRS).
Results:
ECT was highly effective and BPRS and BFCRS scores substantially decreased. sAA activity levels decreased from 125 kU/l to 33 kU/l.
Conclusions:
sAA activity levels could be a potential biomarker of schizophrenia with catatonic state.
Convergent Evaluation of Working Memory and Arithmetic Ability in a Child with Autism Spectrum Disorder without Intellectual Impairment
Authors: Sandra Pellizzoni, Maria C Passolunghi
Journal: Front Psychol (2017)
Keywords: arithmetics, atypical development, autism, math ability, working memory
MeSH terms: Case Reports

Studies focusing on a joint evaluation of both Working Memory (WM) and Math Ability (MA) in autism are far from abundant in literature, possibly due to inadequate methodological approaches and reported inconsistencies between results obtained in each separate field of research, resulting in contradictory conclusions. The specific aim of this case report is therefore evaluating and integrating results on these two cognitive abilities in a child with autism spectrum disorder without intellectual impairment. Our data on an autistic 10-year-old child (M.N.) show that the levels of functional (active vs. passive), rather than structural (phonological vs. visual), data manipulation are quite relevant in the way the child scored differently in the various tasks. Furthermore, M.N. generally displayed average to good ability levels in math calculation, except for oral multiplication, and division activities. By way of conclusion, data are discussed in terms of strengths and weaknesses in relation to special learning trajectories in education and the relevant achievements.
Extraskeletal mesenchymal chondrosarcoma arising in adductor magnus with metastatic foci
Authors: Kyle Hunter, Alan Alexander, Stephen Passerini, Allen Rovner, Ankur Garg
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Mesenchymal chondrosarcoma is a rare and aggressive chondrogenic neoplasm arising from the bone or the soft tissue. Mesenchymal chondrosarcomas develop outside the osseous structures in about one-third of cases, and the majority of these occur in the meninges and the brain parenchyma. Intramuscular extraskeletal mesenchymal chondrosarcoma (EMC) is exceedingly rare, with very few cases reported in the literature. Although mesenchymal chondrosarcoma has a high potential for metastasis, there have been no reports of pulmonary metastasis from an EMC of intramuscular origin. Here, we describe a patient who came to our facility with a history of progressively worsening left lower extremity pain and swelling, and was found to have pathology-proven EMC originating in the left adductor magnus, with complete workup demonstrating multiple bilateral pulmonary metastases in addition to a possible metastatic focus in the right adrenal gland discovered during the interval surveillance period.
Locally transmitted malaria in Tawau, Sabah, Malaysia
Authors: Vivek J Jayaraj, Dhesi Baharaja, Navindran Gopalakrishnan, Yomain Kaco
Journal: Malariaworld J (2017)
MeSH terms: Case Reports

Background:
Tawau was the epicentre of malaria infections in the 1970-1990's, when industrialisation swept across the state of Sabah, Malaysia. Since then, effective public health intervention, mainly the Malaria Elimination Programme, introduced in 1998, has seen the disease shrivel down into its final elimination phase. Here we retrospectively analyse the case of a 63 year old male with multiple comorbidities who had no exposure to localities with high risk of infection- thus raising the question regarding the means of transmission.
Materials and methods:
Multiple interviews and an entomological survey were conducted to elucidate the possible mechanism of infection in this patient.
Results:
Findings point to locally-transmitted malaria, likely introduced by a patient from an endemic region in Tawau. Transmission via this route is rare, and has never before been reported in our setting.
Conclusions:
This rare case highlights the need for constant vigilance in malaria control and elimination, especially when the target of country-wide elimination is close.
Infectious Disease Control and Management in Ethiopia: A Case Study of Cholera
Authors: Se Eun Park, Yeonji Jeon, Sunjoo Kang, Abel Gedefaw, Dejene Hailu, Biruk Yeshitela, Moti Edosa, Mesfin Wossen Getaneh, Mekonnen Teferi
Journal: Front Public Health (2022)
Keywords: ethiopia, ocv, case detection, case management, cholera, health system, national cholera control plan, outbreak response
MeSH terms: Cholera / epidemiology, Cholera / prevention & control, Communicable Diseases / epidemiology, Research Support, Non-U.S. Gov't, Communicable Disease Control, Diarrhea / epidemiology, Disease Outbreaks / prevention & control, Ethiopia / epidemiology, Humans

Cholera remains a significant public health problem among the vulnerable populations living in many resource-limited settings with poor access to safe and clean water and hygiene practice. Around 2.86 million cholera cases and 95,000 deaths are estimated to occur in endemic countries. In Ethiopia, cholera has been one of the major epidemic diseases since 1634 when the first cholera outbreak was recorded in-country. Several cholera epidemics occurred with recent outbreaks in 2019-2021. Cholera has been often reported as acute watery diarrhea due to limited diagnostic capacity in remote areas in Ethiopia and sensitivities around cholera outbreaks. The government of Ethiopia has been executing several phases of multi-year health sector development plan in the past decades and has recently developed a national cholera control plan. Here, we aim to present the existing cholera control guidelines and health system in Ethiopia, including case detection and reporting, outbreak declaration, case management, and transmission control. Challenges and way forward on further research and public health interventions are also discussed to address the knowledge and health service gaps related to cholera control in Ethiopia.
Diagnostic delay of pulmonary nontuberculous mycobacterial infection in China
Authors: Hui Jing, Wanming Tan, Yunfeng Deng, Dachuan Gao, Liang Li, Zhiming Lu, Edward A Graviss, Xin Ma
Journal: Multidiscip Respir Med (2014)
Keywords: china, infection, nontuberculous mycobacterium
MeSH terms: Case Reports

Background:
Nontuberculous mycobacteria (NTM) infection is an emerging, but neglected public health concern in China.
Findings:
To investigate diagnostic delay of NTM diseases in China, we analyzed 91 patients with pulmonary NTM infection in ShandongProvince. The median diagnostic delay time of the analyzed patients was 84 days, which was significantly associated with rural inhabitance (135 days vs. 73 days of urban inhabitance, p < 0.01) and lower level of first visiting hospitals/clinics (70 and 82 days of tertiary and secondary hospitals/clinics respectively vs. 120 days of primary hospitals/clinics, p < 0.05). M. farcinogenes was isolated from a 79-year-old male patient, which is the first report of pulmonary infection in humans.
Conclusions:
Our results indicate a significant diagnostic delay of NTM diseases in China, especially for rural patients with limited access to higher-level healthcare services.
Prenatal diagnosis of a variant of the azygos venous system
Authors: Clelia Lo Verso, Valentina Cigna, Gianfranca Damiani, Laura Lo Verso, Rossella Conti, Vincenzo Duca
Journal: Springerplus (2016)
Keywords: accessory hemiazygos vein, azygos vein, hemiazygos vein, prenatal diagnosis, variants

Background:
The azygos venous system consists of the azygos vein on the right side and the hemiazygos and accessory hemiazygos on the left side. The azygos vein runs through the abdominal cavity along the right side of the vertebral bodies, in a cranial direction, passes through the diaphragm and reaches the mediastinum, where it forms the arch of the azygos which flows into the superior vena cava. Along its course, the azygos vein communicates with the intercostal veins on the right, the hemiazygos vein that collects blood from the left lower intercostal veins, and accessory hemiazygos vein that drains into the left upper intercostal veins. The last two, at the level of the seventh thoracic vertebra, unite and end in the azygos vein. The accessory hemiazygos vein is normally included in the length between T4 and T8. The embryological origin of the accessory hemiazygos vein is the result of an expansion in the direction of the cranial hemiazygos vein, which comes from the left upper sovracardinale vein (Dudiak et al. in Semin Roentgenol 24(1):47-55, 1989; Radiographics 11(2):233-246, 1991; Webb et al. in Am J Roentgenol 139(1):157-161, 1982).
Findings:
This case report describes a rare variant of azygos vein system identified in prenatal diagnosis and confirmed by postnatal ultrasonography.
Conclusions:
The observation of the patient has excluded hemodynamic alterations associated with vascular anomaly.
Small Intestinal Obstruction with Intussusception due to Acute Myeloid Leukemia: A Case Report
Authors: Sangeeta Kini, Anjali Amarapurkar, Meenaskshi Balasubramanian
Journal: Case Rep Gastrointest Med (2012)

Myeloid sarcoma is known to precede the development of acute myeloid leukemia (AML) and can be the only clinical manifestation. Gastrointestinal involvement by AML is rare with the commonest site being small intestine. Patients present with vague abdominal pain and/or obstruction. Prognosis is usually poor as most of them rapidly progress to AML. We report a case of 25-year-old man with complaints of abdominal pain and vomiting of one-year duration. OGD scopy revealed infiltration of lesser curvature of stomach. Subsequently patient came back within a week with signs and symptoms of acute intestinal obstruction for which an ileal resection was done. Although the histology of stomach biopsy and ileal segments showing similar features were thought to be non-Hodgkin's lymphoma, immunohistochemistry confirmed the diagnosis of myeloid sarcoma. Bone marrow investigations confirmed involvement by AML. Patient succumbed to the disease due to extensive involvement of AML. This case highlights the primary gastrointestinal manifestation of AML which can often prove to be a diagnostic difficulty clinically and histologically. Prompt diagnosis is essential to hasten the management.
Neurodegenerative disorders with hair abnormalities: an emergency room consultation for dermatologists
Authors: Arun C Inamadar, Aparna Palit
Journal: Int J Trichology (2009)
Keywords: elejalde disease, menkes kinky hair syndrome, hair abnormalities
MeSH terms: Case Reports

Menke's syndrome and Elejalde disease are the two neurodegenerative disorders of dermatological interest. These patients present with characteristic hair changes which may be of diagnostic value in resource-poor setup where facilities for specific genetic analysis are not available. Simple light microscopic examination of hair may be a helpful diagnostic tool to pick up such cases.
A well-hidden esophageal foreign body in an 11-year-old boy treated for gastroesophageal reflux disease: a case report
Authors: Dimitrios Godosis, Maria Fotoulaki, Chrysostomos Kepertis, Ioannis Spyridakis
Journal: Pan Afr Med J (2022)
Keywords: foreign body, case report, children, esophageal obstruction, ingestion
MeSH terms: Airway Obstruction / complications, Foreign Bodies / complications, Gastroesophageal Reflux / diagnosis, Gastroesophageal Reflux / etiology, Case Reports, Child, Humans, Male

Symptoms of gastroesophageal reflux disease (GERD) in children with developmental disorders could be often confusing. Especially when considering accidental foreign body ingestion, with no acute signs or symptoms of choking. We hereby present a case of an 11-year-old male with a well-hidden esophageal foreign body who was already treated for GERD and finally diagnosed with a hidden foreign esophageal object, ingested 12 months ago. Ingestion of objects of any kind, especially in certain groups of children, must always raise high suspicion for the clinical pediatric specialties, regardless of the presence or absence of classic symptoms.
Herpes Simplex Virus Type 2 Myelitis: Case Report and Review of the Literature
Authors: Raffaele Nardone, Viviana Versace, Francesco Brigo, Frediano Tezzon, Giulio Zuccoli, Slaven Pikija, Larissa Hauer, Johann Sellner
Journal: Front Neurol (2017)
Keywords: herpes simplex virus type 2, infectious myelitis, longitudinally extensive transverse myelitis, myeloradiculitis, outcome, treatment
MeSH terms: Case Reports

Non-traumatic myelopathies can result from a wide spectrum of conditions including inflammatory, ischemic, and metabolic disorders. Here, we describe the case of a 60-year old immunocompetent woman who developed acute back pain followed by rapidly ascending flaccid tetraparesis, a C6 sensory level, and sphincter dysfunction within 8 h. Acyclovir and steroids were started on day 2 and herpes simplex virus type 2 (HSV-2) was confirmed by polymerase chain reaction in cerebrospinal fluid. Magnetic resonance imaging revealed a bilateral anterior horn tractopathy expanding from C2 to T2 and cervicothoracic cord swelling. Screening for paraneoplastic antibodies and cancer was negative. Neurophysiology aided in the work-up by corroborating root involvement. Recovery was poor despite early initiation of antiviral treatment, adjuvant anti-inflammatory therapy, and neurorehabilitation efforts. The clinical course, bilateral affection of the anterior horns, and early focal atrophy on follow-up magnetic resonance imaging take a necrotizing myelitis potentially caused by intraneuronal spread of the virus into consideration. Further, we summarize the literature on classical and rare presentations of HSV-2 myeloradiculitis in non-immunocompromised patients and raise awareness for the limited treatment options for a condition with frequent devastating outcome.
Renal cell carcinoma of different pathological types in bilateral native kidneys of a kidney transplant recipient: A case report and literature review
Authors: Cheng Yi, Xiangyun You, Ang Sha, Zhen Zhang, Junfeng Yu, Xiaolin Guo, Henglong Hu
Journal: Front Oncol (2023)
Keywords: bilateral renal tumors, clear cell, kidney transplantation, native kidney, nephrectomy, papillary, renal cell carcinoma
MeSH terms: Case Reports

Patients after kidney transplantation have a much higher risk of developing malignant tumors than the general population. And the native kidney is an organ relatively susceptible to malignant tumors after renal transplantation. However, the simultaneous development of bilateral renal tumors is very rare; especially the bilateral native kidneys harbor different pathological types of renal cell carcinoma (RCC). We report a case of a patient who developed malignant tumors in both native kidneys nearly 19 years after renal transplantation. This patient underwent bilateral laparoscopic radical nephrectomy, and postoperative pathological examination showed clear cell RCC on the left native kidney and papillary RCC on the right one. And the early detection and surgical treatment resulted in a good prognosis. The literature related to the diagnosis and treatment of bilateral RCC after renal transplantation is also reviewed.
Persistent Idiopathic Facial Pain Associated with Somatoform Disorder in an 11-Year-Old Boy
Authors: Yoshihiko Sakurai, Asami Fujii, Fumie Kato
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Persistent idiopathic facial pain (PIFP) is a poorly understood chronic disorder that rarely occurs in children. An 11-year-old boy initially presented with right cheek pain and a streptococcal infection 6 weeks previously. Facial cellulitis was suspected, which was resolved by antibiotic treatment. The right cheek pain recurred within 4 weeks of this initial visit. Because the antibiotic treatment did not relieve the pain, the patient visited our outpatient clinic. Physical examination revealed facial tenderness in an area that corresponded with the region supplied by the second branch of the trigeminal nerve (maxillary nerve), suggesting trigeminal neuralgia (TN). However, brain magnetic resonance imaging revealed no vascular compression. Furthermore, the continuous nagging and dull nature of the pain experienced by the patient differed from the sudden and severe nature of pain associated with TN. Subsequently, PIFP was diagnosed. The patient was unable to attend school because of prolonged lassitude, nausea, headache, and anorexia. Psychological counseling revealed psychological stress related to his out-of-school life. Upon learning stress management through psychotherapy, his general malaise gradually improved, and he was able to attend school with more facial expressions. This case indicates the psychogenic aspect of PIFP as well as the value of psychological counseling.
Hilar/mediastinal and cutaneous drug-induced sarcoidosis-like reaction associated with immune checkpoint inhibitors in metastatic colorectal cancer: a case report
Authors: Tamotsu Sagawa, Yasushi Sato, Hiroyuki Nagashima, Kohichi Takada, Mamoru Takahashi, Masahiro Hirakawa, Kyoko Hamaguchi, Fumito Tamura, Koshi Fujikawa, Koichi Okamoto, Yutaka Kawano, Masahiro Sogabe, Hiroshi Miyamoto, Tetsuji Takayama
Journal: Front Immunol (2023)
Keywords: colorectal cancer, immune checkpoint inhibitor, microsatellite instability, sarcoidosis, side effects
MeSH terms: Colonic Neoplasms / chemically induced, Rectal Neoplasms, Sarcoidosis / chemically induced, Sarcoidosis / diagnosis, Case Reports, Female, Granuloma / chemically induced, Humans, Immune Checkpoint Inhibitors / adverse effects, Lymphatic Metastasis, Neoplasm Recurrence, Local, Nivolumab / adverse effects, Nivolumab, Immune Checkpoint Inhibitors

Background:
Immune checkpoint inhibitors (ICIs) are the standard treatment for metastatic colorectal cancer (mCRC) with high microsatellite instability (MSI-H). Among immune-related adverse events (irAEs), drug-induced sarcoidosis-like reactions (DISR) are often difficult to differentiate from cancer progression.
Main body:
This is a case of a woman in her mid-60s, with mCRC (RAS wild/BRAF mutant/MSI-H) and abdominal lymph node metastasis, treated with four courses of ipilimumab + nivolumab every 3 weeks, followed by nivolumab every 2 weeks as third-line treatment. After treatment, the original lymph node metastases shrank, but hilar/mediastinal lymph nodes appeared. Endoscopic ultrasound-guided fine-needle aspiration of these lymph nodes revealed multiple epithelioid granulomas without necrosis, indicating a sarcoidosis-like reaction. Fluorodeoxyglucose-positron emission tomography scan showed abnormal subcutaneous accumulation in bilateral forearms and bilateral knee joints. Biopsy of the cutaneous lesions was also performed, which revealed epithelioid granulomas. As the patient had no symptoms in other organs, no specific therapeutic intervention was administered. After the discontinuation of immunotherapy, the sarcoidosis-like reaction regressed without cancer relapse.
Conclusions:
Clinicians should be aware of the possibility of DISR as an irAE during the ICI treatment of mCRC. In suspected cases of DISR following ICI therapy, it is important to differentiate between cancer progression and DISR through histological diagnosis for the subsequent strategy, as radiological and serological findings are not definitive.
Anesthesic management for escobar syndrome: case report
Authors: Ayse Hande Arpaci, Fusun Bozkirli, Onur Konuk
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration.