OpenMed/multicare-articles huggingface dataset:
Late Ps. aeruginosa Inguinal Mesh Infection 12 Years after the Initial Operation: Report of the Case and Short Review of the Literature
Authors: Dimitrios Filippou
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Inguinal hernia mesh repair is one of the most frequent operations performed worldwide. The Lichtenstein technique and its various modifications are the most popular operations for groin hernia repair. The rate of surgical site infection (SSI) following inguinal hernia repair ranges between 0 and 14% in various series. Most of these infections developed early postoperatively. The incidence of late mesh infection following open inguinal hernia repair still remains unclear and highly variable. Late deep mesh infections are relatively rare specially after more than 10 years. The most common pathogens reported in the literature are E. coli and St. aureus. The infection is treated by conservative means initially but in case of failure then the mesh should be removed surgically. A unique case of a patient with very late (chronic) mesh infection is presented. The infection was due to Pseudomonas aeruginosa, which occurred 14 years after the initial operation and presented as subcutaneous fistula.
Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, Nonmotile Bacillus megaterium in Disguise of Bacillus anthracis
Authors: Shih Keng Loong, Boon Teong Teoh, Jefree Johari, Chee Sieng Khor, Juraina Abd-Jamil, Siti Sarah Nor'e, Nur Izyan Samsudin, Noor Syahida Azizan, Che Norainon Yaacob, Asma Anati CheMatSeri, Nur Hidayana Mahfodz, Sazaly AbuBakar
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Bacillus anthracis is a bacterial pathogen of major concern. The spores of this bacteria can survive harsh environmental conditions for extended periods and are well recognized as a potential bioterror weapon with significant implications. Accurate and timely identification of this Bacillus species in the diagnostic laboratory is essential for disease and public health management. Biosafety Level 3 measures and ciprofloxacin treatment were instituted when B. anthracis was suspected from a patient with gangrenous foot. 16S rDNA sequencing was performed to accurately identify the suspected bacterium, due to the superiority of this method to accurately identify clinically isolated bacteria. B. megaterium was identified as the causative agent and the organism was subsequently treated as a Biosafety Level 2 pathogen.
Sporadic Burkitt's lymphoma of the axilla: CT and MR imaging findings
Authors: Yukihiro Hama
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Burkitt's lymphoma (BL) is a high-grade B-cell non-Hodgkin's lymphoma, which can be divided into endemic, sporadic and human immunodeficiency-associated subtypes. The sporadic BL typically presents as an intra-abdominal tumour but that of cutaneous or subcutaneous origin is very uncommon. We present a case of sporadic BL arising from the axillary soft tissue and discuss the CT and MRI findings.
Radiologically Guided Renal Artery Embolization with an Amplatzer Vascular Plug as a Rescue Therapy for Refractory Nephrotic Syndrome in AL-Amyloidosis
Authors: I Spozio Züst, H R Räz, F Burkhalter
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Nephrotic syndrome is common in immunoglobulin light-chain (AL) amyloidosis and successful therapy may pose a challenge. We report the case of a 63-year-old patient with severe nephrotic syndrome due to primary renal AL-amyloidosis with well-preserved renal function at first presentation. Therapy with high dose steroids, loop diuretics, and ACE-inhibitors did not affect his proteinuria and he was seriously disabled because of symptomatic orthostatic hypotension and anasarca. With the patient's informed consent, medical nephrectomy was tried with nonsteroidal-anti-inflammatory drugs (NSAIDs), cyclosporine, and aminoglycosides, with significant deterioration of his renal function, but without relevant effect on his proteinuria. Despite adequate anticoagulation life threatening thrombotic and bleeding complications occurred. Total renal ablation was finally achieved using an Amplatzer vascular plug Typ IV (AVP 4) with a self-expanding Nitinol mesh design, which was placed in both main renal arteries in the same intervention. The patient became completely anuric, protein loss stopped, and serum albumin slowly rose to normal levels. The patient's clinical condition dramatically improved and he regained his full mobility at the price of a lifelong renal replacement therapy. To our knowledge, this is the first reported usage of such a vascular occluder in the setting of refractory nephrotic syndrome with normal kidney function at the time of first presentation.
Jejunal Diverticular Perforation Causing Small Bowel Obstruction in a Type 4 Hiatal Hernia: A Rare Case Report of a Nonagenarian Patient and Review of Relevant Literature
Authors: Saptarshi Biswas, Shekhar Gogna, Prem Patel
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Type IV paraesophageal hernia (PEH) is very rare and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a case of a 90-year-old male patient who presented at our emergency department complaining of epigastric pain that he had experienced over the past few hours and getting progressively worse. On the day after admission, his pain became severe. Chest radiography revealed an intrathoracic intestinal gas bubble; emergency exploratory laparotomy identified a type IV PEH with herniation of only the jejunum with perforated diverticula on mesenteric side through a hiatal defect into mediastinum. There are a few published cases of small bowel herniation into the thoracic cavity in the literature. Our patient represents a rare case of an individual diagnosed with type IV PEH with herniation of jejunum with perforated diverticula.
Overdrive pacing in the acute management of osimertinib-induced ventricular arrhythmias: A case report and literature review
Authors: Yanyu Zhang, Xingtong Wang, Yilin Pan, Beibei Du, Kumaraswamy Nanthakumar, Ping Yang
Journal: Front Cardiovasc Med (2022)
Keywords: qtc interval prolongation, osimertinib, temporary pacemaker, torsade de pointes (tdps), ventricular tachycardia
MeSH terms: Case Reports

QT interval prolongation and ventricular arrhythmias (VAs) induced by osimertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor, are life-threatening complications. However, no consensus has been achieved regarding their management. Overdrive pacing has been shown to be effective in shortening the QT interval and terminating torsade de pointes (TdP). Here, we report a case of osimertinib-induced QT prolongation accompanied by frequent VAs and TdP. Osimertinib was immediately discontinued after it was identified as the etiology for QT prolongation and VAs. A temporary pacemaker and overdrive pacing were used after other anti-arrhythmia treatments had failed and successfully shortened the QTc interval and terminated VAs. Repeated Holter monitoring at 1 week showed no remaining VAs or TdP, and the pacemaker was removed. Routine electrocardiography (ECG) surveillance was conducted afterward, and three- and 6-month follow-ups showed good recovery and normal ECG results. Vigilance is required for rare vital arrhythmias in patients taking osimertinib, and ECG surveillance should be conducted.
Small cell carcinoma of the uterine cervix in a pregnant patient diagnosed with liquid based cytology and cell block immunocytochemistry
Authors: Mawuli F Attipoe, Charles D Sturgis
Journal: Case Rep Pathol (2014)

Definitive cytomorphologic diagnosis of small cell carcinoma of the uterine cervix is possible but can be challenging in routine cervicovaginal cancer screening specimens. Several small series of reported cases of cervical small cell carcinoma have shown this uncommon malignancy to represent fewer than 2% of all invasive cervical cancers. This tumor type is associated with poor prognosis and rapid disease progression and can develop to an advanced stage in the interval between screening visits. Only rare case reports of small cell carcinoma arising in gravid cervices are known. In the current case a 29-year-old, gravida 6, para 2, pregnant (10-week gestation) female presented with postcoital bleeding. A definitive diagnosis of small cell carcinoma of the cervix was made possible by liquid based Pap testing with ancillary cell block preparation allowing for immunocytochemical characterization of the lesional cell population.
Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
Authors: Trevor J Shelton, Alton W Skaggs, Gavin C Pereira
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection (PJI), including recovery of his left-sided draining sinus tract. Now 8 years after discontinuing AST, the patient has no pain, good function, and no major or minor criteria of joint infection according to the Musculoskeletal Infection Society (MSIS) workgroup. The authors have not identified literature describing a similar resolution of draining sinus tracts from around a prosthetic joint after discontinuing AST. Despite the resolution of this patient's sinus tract, the authors do not advocate for discontinuing AST in patients with a draining sinus tract. However, in spite of the fact that the MSIS consensus statement suggests that a draining sinus is a sure sign of PJI and that the assumption is that the infection will not go away until explant, this case was different.
A Case of an Insufficiency Fracture of the Medial Proximal Tibia Secondary to Osteomalacia Associated with Long-Term Saccharated Ferric Oxide Administration
Authors: Daichi Ishimaru, Hiroshi Sumi
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

This article presents a case of insufficiency fracture of medial proximal tibia caused by long-term administration of saccharated ferric oxide (SFO) in a 77-year-old female. In this case, 2-year administration of SFO for iron deficit anemia induced hypophosphatemic osteomalacia and finally resulted in an insufficiency fracture of medial proximal tibia. Hypophosphatemia and pain due to the insufficiency fracture were recovered promptly by withdrawing SFO administration and rest. This case represented varus deformity of the knee associated with osteoarthritis, which may also cause the insufficiency fracture of medial proximal tibia in addition to osteomalacia due to long-term administration of SFO. Long-term SFO administration should be avoided because of a definitive risk of osteomalacia and fragile fracture.
Treatment of Severe Steroid-Refractory Acute-Graft-vs.-Host Disease With Mesenchymal Stem Cells-Single Center Experience
Authors: Maja Česen Mazič, Lenart Girandon, Miomir Kneževič, Simona L Avčin, Janez Jazbec
Journal: Front Bioeng Biotechnol (2018)
Keywords: gvhd, immunosuppressive therapy, pediatrics, regeneration, remission induction, stem cell

The most effective treatment of steroid refractory acute graft vs. host disease (aGvHD) is not yet established and mesenchymal stem cells (MSC) appear to be a promising therapy for the condition. We report single center case series of three patients, who underwent allogeneic hematopoietic cell transplantation and later developed steroid refractory graft-vs.-host disease, treated with MSC infusions. Two patients achieved complete remission and one patient partial remission of skin and/or gastrointestinal aGvHD. We demonstrated application of MSC for treatment of severe steroid refractory aGvHD is feasible in clinical practice. Detailed description of patient's features and MSC production protocol is crucial for future comparison on efficacy and safety of cell-based therapies. However, for any substantial conclusions regarding efficacy of MSC higher patient numbers will be required.
Herpes Zoster Radiculomyelitis With Aquaporin-4 Antibodies: A Case Report and Literature Review
Authors: Hiroto Eguchi, Haruka Takeshige, Sho Nakajima, Masayoshi Kanou, Asuka Nakajima, Atsuto Fuse, Jiro Fukae, Hideto Miwa, Yasushi Shimo
Journal: Front Neurol (2020)
Keywords: aquqporin-4 immunoglobulin g, case report, herpes zoster, myelitis, neuromyelitis optica spectrum disorder
MeSH terms: Case Reports

Background: The relationship between varicella-zoster virus (VZV)-associated myelitis and aquaporin-4 immunoglobulin-G (AQP4-IgG) remains unknown. Case Report: We report a case of acute radiculomyelitis with longitudinal extensive hyperintensity signals traversing the brainstem until the upper thoracic cord in a 55-year-old healthy woman following herpes zoster infection in the left C4-T3 dermatome. VZV-specific IgG in the cerebrospinal fluid (CSF) and AQP4-IgG positivity on enzyme-linked immunosorbent assay (ELISA) were undetectable. Thus, she was diagnosed with immune-competent VZV radiculomyelitis. Forty-two months later, she experienced a relapse, and AQP4-IgG positivity was detected on ELISA. A cell-based assay (CBA) showed AQP4-IgG positivity not only at the time of recurrence but also retrospectively at 1 month after the initial symptoms. We concluded that AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD) was concurrent with VZV myelitis. After the second attack, she was treated with azathioprine and has had no relapse since then. Conclusion: We reported a case of VZV radiculomyelitis with confirmed concurrent AQP4-IgG positivity. NMOSD induced by herpes zoster has been recently identified, but distinguishing it from VZV myelitis can be difficult and whether these two diseases aggravate each other is unknown. Awareness of the potentially varied presentation of VZV myelitis can enable earlier recognition and proper treatment.
Case report: Personalized transcatheter approach to mid-aortic syndrome by in vitro simulation on a 3-dimensional printed model
Authors: Luca Giugno, Giovanni Maria Formato, Massimo Chessa, Emiliano Votta, Mario Carminati, Francesco Sturla
Journal: Front Cardiovasc Med (2023)
Keywords: 3d printing, in vitro simulation, interventional cardiology, mid-aortic syndrome, stenting
MeSH terms: Case Reports

An 8-year-old girl, diagnosed with mid-aortic syndrome (MAS) at the age of 2 months and under antihypertensive therapy, presented with severe systemic hypertension (>200/120 mmHg). Computed tomography (CT) examination revealed aortic aneurysm between severe stenoses at pre- and infra-renal segments, and occlusion of principal splanchnic arteries with peripheral collateral revascularization. Based on CT imaging, preoperative three-dimensional (3D) anatomy was reconstructed to assess aortic dimensions and a dedicated in vitro planning platform was designed to investigate the feasibility of a stenting procedure under fluoroscopic guidance. The in vitro system was designed to incorporate a translucent flexible 3D-printed patient-specific model filled with saline. A covered 8-zig 45-mm-long Cheatham-Platinum (CP) stent and a bare 8-zig, 34-mm-long CP stent were implanted with partial overlap to treat the stenoses (global peak-to-peak pressure gradient > 60 mmHg), excluding the aneurysm and avoiding risk of renal arteries occlusion. Percutaneous procedure was successfully performed with no residual pressure gradient and exactly replicating the strategy tested in vitro. Also, as investigated on the 3D-printed model, additional angioplasty was feasible across the frames of the stent to improve bilateral renal flow. Postoperative systemic pressure significantly reduced (130/70 mmHg) as well as dosage of antihypertensive therapy. This is the first report demonstrating the use of a 3D-printed model to effectively plan percutaneous intervention in a complex pediatric MAS case: taking full advantage of the combined use of a patient-specific 3D model and a dedicated in vitro platform, feasibility of the stenting procedure was successfully tested during pre-procedural assessment. Hence, use of patient-specific 3D-printed models and in vitro dedicated platforms is encouraged to assist pre-procedural planning and personalize treatment, thus enhancing intervention success.
Spontaneous rupture of the imperforate hymen in an adolescent girl with hematocolpometra
Authors: Zehra Kurdoglu, Mertihan Kurdoglu, Zehra Kucukaydin
Journal: ISRN Obstet Gynecol (2011)
MeSH terms: Case Reports

Background. Imperforate hymen is usually treated with hymenotomy, and the management after its spontaneous rupture is not very well known. Case. In this paper, we present spontaneous rupture of the imperforate hymen in a 13-year-old adolescent girl with hematocolpometra just before a planned hymenotomy operation. The patient was managed conservatively with a satisfactory outcome. Conclusion. Hymenotomy may not be needed in cases with spontaneous rupture of the imperforate hymen if adequate opening for menstrual discharge is warranted.
Disseminated tuberculosis presenting with finger swelling in a patient with tuberculous osteomyelitis: a case report
Authors: Shradha Agarwal, Daniel Caplivski, Edward J Bottone
Journal: Ann Clin Microbiol Antimicrob (2005)
MeSH terms: Finger Phalanges, Metacarpal Bones, Osteomyelitis / diagnosis, Tuberculosis, Osteoarticular / diagnosis, Case Reports, Humans, Male, Middle Aged, Osteomyelitis / drug therapy, Tuberculosis, Osteoarticular / drug therapy

Background:
Extrapulmonary manifestations of tuberculosis have become increasingly important in the era of HIV/AIDS.
Case presentation:
We describe a case of tuberculosis (TB) dactylitis in a patient with AIDS who originated from the Ivory Coast. The diagnosis was established by direct visualization of acid-fast bacilli on joint fluid and bone biopsy of the proximal phalanx. Imaging of the chest revealed multiple bilateral nodules. Confirmation of the diagnosis was made by isolation of Mycobacterium tuberculosis from sputum and bone cultures.
Conclusion:
Tuberculosis should be considered in patients with unusual soft tissue or skeletal lesions, especially when an immunosuppressive condition is present. Ziehl-Neelsen staining and culture of tissue obtained via surgical biopsy offer the most direct approach to diagnosis.
Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests
Authors: Meghan Glibbery, Adam Fleming, Rahul Chanchlani, Olufemi Abiodun Ajani, Norma Marchetti, Alexa Marr, M Constantine Samaan
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Growth hormone deficiency (GHD) in children has significant impacts on growth and metabolism. Two-agent GH stimulation tests are commonly used to diagnose GHD, and these tests are generally considered safe. We report the case of a 5-year 5-month-old boy with a history of anaplastic ependymoma who underwent GH stimulation testing for growth deceleration using clonidine and arginine. He developed bilateral calf myalgia and gross hematuria within 24 hours of the tests. Myalgia and hematuria resolved spontaneously. Importantly, the literature review and database searches for hematuria identified 6 cases with clonidine and 20 cases with arginine. This case highlights an unusual combination of adverse reactions to clonidine and arginine in children undergoing GH stimulation testing to assess for GHD. Pediatric endocrinologists need to be aware of the potential for these side effects to allow appropriate management, and further studies are needed to clarify the mechanisms and frequency of these side effects. We recommend that patients and families need to be counselled about hematuria as an association of GH testing with these medications.
Why is population information crucial for taxonomy? A case study involving a hybrid swarm and related varieties
Authors: Tobias Marczewski, Yong-Peng Ma, Xue-Mei Zhang, Wei-Bang Sun, A Jane Marczewski
Journal: AoB Plants (2016)
Keywords: china, rhododendron, hybridization, morphological characters, population variance, taxonomy

Hybridization has become a focal topic in evolutionary biology, and many taxonomists are aware that the process occurs more frequently than previously assumed. Nonetheless many species and varieties are still described without explicitly considering the possibility of hybridization, especially in countries that have relatively short scientific histories, but which often possess the highest species diversities. Furthermore, new taxa are often described based only on herbarium specimens, not taking into account information from wild populations, significantly decreasing the potential to detect morphologies arising from hybridization at this crucial descriptive stage. We used morphological data from a hybrid swarm involving two Rhododendron species to showcase possible character combinations in intermediates. Certain characters used to distinguish taxa were more variable within the same individual than between species, emphasizing the importance of population information for an adequate choice of characters. Most described varieties of the two species fell within the spectrum of hybrid morphology, suggesting that these taxa would be unlikely to have merited formal description if contemporary standards had been employed. In all investigated cases the hybrid nature of described varieties seems to have been detectable with adequate morphological data alone, if populations had been assessed. A post hoc assessment of taxa is often complicated, especially if certain types of information are not provided. To avoid accumulation of such invalid taxa, careful scrutiny should be employed for new descriptions. Hybrids (not hybrid species) described as taxa obscure valuable information about natural processes and impact negatively on further research that depends on taxonomic data.
Successful Liver Transplantation Case Report from a Deceased Donor with Sickle Cell Anemia
Authors: Lucas Souto Nacif, Estrella Bianca de Mello, Rafael Soares Pinheiro, Fabiana Roberto Lima, Rodrigo Bronze de Martino, Wellington Andraus, Luiz Carneiro D'Albuquerque
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

There is a worldwide problem of waiting time and mortality rate associated with remaining on the waiting list for a liver transplant. However, some situations have been encouraging in terms of determining appropriate recipients and expanding the donor criteria. We herein report a case of useful liver donor with sickle cell anemia for liver transplantation. Here we described a case of liver transplantation from a donor with sickle cell anemia to a recipient with hepatocellular carcinoma who was deemed to be at risk of tumor growth and at risk of being dropped from the waiting list. The literature reveals the importance of using safe donors, and we describe the benefits of using a safe, deceased liver donor with sickle cell anemia who was an adequate option for liver transplantation.