OpenMed/multicare-articles huggingface dataset:
Successful treatment of fulminant myocarditis with intra-aortic balloon pump counterpulsation combined with immunoglobulin and glucocorticoid in a young male adult
Authors: Huanhuan Li, Lun Li
Journal: Front Cardiovasc Med (2022)
Keywords: cardiogenic shock, case report, fulminant myocarditis, glucocorticoid, immunoglobulin, intra-aortic balloon counterpulsation pump, multiple organ failure
MeSH terms: Case Reports

Background:
Fulminant myocarditis (FM) is a serious non-specific inflammatory disease of the myocardium. FM tends to occur in adolescents and the course of the disease progresses rapidly. It is prone to cardiogenic shock (CGS) and multiple organ failure (MOF) with high mortality. We report a case of FM with CGS and MOF in a young male who was successfully treated with intra-aortic balloon pump counterpulsation (IABP) combined with intravenous immunoglobulin (IVIG) and glucocorticoid (GC).
Case summary:
A 21-year-old previously healthy man presented with fever, headache, and chest tightness. He came to the hospital for emergency treatment. The laboratory data showed that the levels of serum cardiac troponin I (cTnI), N-terminal B-type natriuretic peptide (NT-proBNP), myocardial zymogram, and neutrophils increased. Echocardiography showed pericardial effusion and decreased left ventricular systolic function. ECG showed diffuse ST-segment elevation. He was clinically diagnosed with FM and admitted to the intensive care unit for treatment. Within 48 h of admission, the clinical course of the patient deteriorated rapidly, with CGS accompanied by MOF, high atrioventricular block (AVB), and ventricular tachycardia (VT). After using mechanical circulatory support (MCS) therapy with IABP, IVIG, GC, continuous renal replacement therapy (CRRT), and mechanical ventilation complicated with a temporary cardiac pacemaker, he recovered normal cardiac function. He made a full recovery and was discharged home on day 21.
Discussion:
For patients with FM, early diagnosis, close monitoring, timely use of MCS devices, and active comprehensive treatment are very important. MCS devices such as IABP can become lifesaving tools for the treatment of FM.
Metastasis of Uterine Leiomyosarcoma to the Breast: Medical and Histopathological Criteria
Authors: Eugenia Colón
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

It is uncommon for extramammary tumors to metastasize to the breast, and very few cases describing metastasis of primary uterine leiomyosarcoma to the breast have been reported. We present the case of a 51-year-old woman diagnosed with metastasis of uterine leiomyosarcoma to the breast diagnosed 10 years ago after hysterectomy. Ultrasonography, mammography, and cytology were used to establish a preliminary diagnosis that was confirmed upon examination of the excised tumor that show a rare soft tissue tumor composed of atypical spindle cells and increased proliferation rate. We discuss the importance of distinguishing between various primary mesenchymal tumors of the breast because of phenotypic overlap and some guidance of the histological criteria for metastasis of leiomyosarcoma, as well as differential diagnosis and surgical treatment.
Chryseobacterium indologenes infection in a newborn: a case report
Authors: Gema Calderón, Esther García, Pilar Rojas, Elisa García, Marisa Rosso, Antonio Losada
Journal: J Med Case Rep (2011)

Introduction:
Chryseobacterium indologenes is an uncommon human pathogen. Most infections have been detected in hospitalized patients with severe underlying diseases who had indwelling devices implanted. Infection caused by C. indologenes in a newborn has not been previously reported.
Case presentation:
We present a case of ventilator-associated pneumonia caused by C. indologenes in a full-term Caucasian newborn baby boy with congenital heart disease who was successfully treated with piperacillin-tazobactam.
Conclusion:
C. indologenes should be considered as a potential pathogen in newborns in the presence of invasive equipment or treatment with long-term broad-spectrum antibiotics. Appropriate choice of effective antimicrobial agents for treatment is difficult because of the unpredictability and breadth of antimicrobial resistance of these organisms, which often involves resistance to many of the antibiotics chosen empirically for serious Gram-negative infections.
Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary Strategy
Authors: Silvia Maria Lattanzio, Francesca Imbesi
Journal: Front Med (Lausanne) (2018)
Keywords: chronic pain, dietary strategy, exclusion diet, fibromyalgia symptom remission, fibromyalgia syndrome, fructose withdrawal, serotonin, tryptophan
MeSH terms: Case Reports

A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol. Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months. Depression, widespread chronic pain, chronic fatigue, non-restorative sleep, morning stiffness, and the majority of the comorbidities remitted. Energy and vitality were recovered by the patient as prior to the onset of the disease, reverting the occupational and social disabilities. The patient episodically challenged herself breaking the dietary protocol leading to its negative test and to the evaluation of its benefit. These breaks correlated with the recurrence of the symptoms, supporting the correctness of the biochemical hypothesis underlying the diet design toward remission of symptoms, but not as a final cure. We propose this as a low risk and accessible therapeutic protocol for the symptomatic remission in FMS with virtually no costs other than those related to vitamin and mineral salt supplements in case of deficiencies. A pilot study is required to further ground this metabolic approach, and to finally evaluate its inclusion in the guidelines for clinical management of FMS.
Case report: Creutzfeldt-Jakob disease: a case that initiated with the onset of obsessive-compulsive state
Authors: Baizhu Li, Shan Wang, Shiyu Han, Ning Hu, Xiuli Shang
Journal: Front Neurol (2023)
Keywords: cjd, creutzfeldt-jakob disease, case report, compulsive state, early diagnosis, obsessive-compulsive disorder
MeSH terms: Case Reports

Background:
Obsessive-compulsive disorder (OCD) is a common reason for patients to seek symptomatic treatment in psychiatric departments, which makes it challenging to consider underlying organic nervous system diseases. However, Creutzfeldt-Jakob disease (CJD) can present with atypical symptoms, sometimes even as initial symptoms, leading to misdiagnosis or missed diagnosis. Lumbar puncture and brain DWI are important diagnostic methods for CJD, and the detection of 1,433 protein can be performed to confirm the diagnosis.
Case presentation:
We present the case of a 63-year-old woman who was initially diagnosed with obsessive-compulsive disorder in 2022. Despite seven months of symptomatic treatment, her symptoms did not improve. She also developed symptoms of altered consciousness, such as upper limb tremors and mutism. Based on brain DWI and positive results from the detection of 1,433 protein, she was ultimately diagnosed with CJD.
Conclusion:
Creutzfeldt-Jakob disease (CJD) can manifest initially as obsessive-compulsive disorder (OCD) with atypical symptoms, making it prone to misdiagnosis. Therefore, it is crucial to conduct further investigations, including lumbar puncture and imaging, to exclude organic nervous system diseases before initiating symptomatic treatment for psychiatric disorders. This approach can facilitate early diagnosis of CJD and other potential organic neurological diseases.
Salbutamol-responsive limb-girdle congenital myasthenic syndrome due to a novel missense mutation and heteroallelic deletion in MUSK
Authors: Constanze Gallenmüller, Wolfgang Müller-Felber, Marina Dusl, Rolf Stucka, Velina Guergueltcheva, Astrid Blaschek, Maja von der Hagen, Angela Huebner, Juliane S Müller, Hanns Lochmüller, Angela Abicht
Journal: Neuromuscul Disord (2014)
Keywords: ache, achr, ck, cmap, cms, congenital myasthenic syndromes, musk-related cms, neuromuscular transmission, salbutamol treatment, acetylcholine esterase, acetylcholine receptor, compound muscle action potential, congenital myasthenic syndrome, creatine kinase
MeSH terms: Albuterol / therapeutic use, Mutation, Missense, Myasthenic Syndromes, Congenital / drug therapy, Myasthenic Syndromes, Congenital / genetics, Receptor Protein-Tyrosine Kinases / genetics, Receptors, Cholinergic / genetics, Case Reports, Research Support, Non-U.S. Gov't, Alleles, Humans, Male, Myasthenic Syndromes, Congenital / diagnosis, Sequence Deletion, Siblings, Receptors, Cholinergic, MUSK protein, human, Receptor Protein-Tyrosine Kinases, Albuterol

Congenital myasthenic syndromes (CMS) are clinically and genetically heterogeneous disorders characterized by a neuromuscular transmission defect. In recent years, causative mutations have been identified in atleast 15 genes encoding proteins of the neuromuscular junction. Mutations in MUSK are known as a very rare genetic cause of CMS and have been described in only three families, world-wide. Consequently, the knowledge about efficient drug therapy is very limited. We identified a novel missense mutation (p.Asp38Glu) heteroallelic to a genomic deletion affecting exons 2-3 of MUSK as cause of a limb-girdle CMS in two brothers of Turkish origin. Clinical symptoms included fatigable limb weakness from early childhood on. Upon diagnosis of a MUSK-related CMS at the age of 16 and 13years, respectively, treatment with salbutamol was initiated leading to an impressive improvement of clinical symptoms, while treatment with esterase inhibitors did not show any benefit. Our findings highlight the importance of a molecular diagnosis in CMS and demonstrate considerable similarities between patients with MUSK and DOK7-related CMS in terms of clinical phenotype and treatment options.
Dexmedetomidine as a procedural sedative for percutaneous tracheotomy: case report and systematic literature review
Authors: Jerrold L Perrott, Michelle T Co, Steven C Reynolds, Derek J R Gunning
Journal: Case Rep Crit Care (2012)

Purpose. To describe the successful use of dexmedetomidine as the primary procedural sedative for a percutaneous tracheotomy procedure and to systematically present the supporting literature. Materials and Methods. A Case report of our experience and systematic literature search. PubMed, Embase, and Google Scholar were searched without restriction using the key words dexmedetomidine, percutaneous tracheotomy, and tracheotomy procedure. All relevant published references were retrieved irrespective of their methodological quality. Results. In total, only 3 relevant references were found. These include one small placebo controlled randomized trial and 2 case reports. The randomized, placebo controlled trial enrolled patients already sedated on midazolam and included 64 total patients. The 2 other case reports both described the use of dexmedetomidine as the primary procedural sedative. All of the cases reported the successful completion of the percutaneous tracheotomy without any major complication, but none reported the subjective patient experience. Conclusion. Based on the available published literature and our experience, we suggest that dexmedetomidine be considered for use as the primary procedural sedative for percutaneous tracheotomy procedure. Dexmedetomidine's ability to provide adequate sedation and amnesia, without blunting the respiratory drive and protective reflexes of the patient, may make it an optimal agent in specific cases.
Early Metastasis of Clear Cell Renal Cell Carcinoma to the Esophagus: A Case Report
Authors: Heliberto Paez Quintero, Daniel Clavijo Cabezas, Nathalie Hernandez Hidalgo, Gregorio Londoño, Rafael Parra-Medina
Journal: Cureus (2023)
Keywords: anatomical places, case report, clear cell kidney cancer, esophagus, metastatic
MeSH terms: Case Reports

Metastatic involvement of clear cell renal cancer in the esophagus has been described in the literature as an uncommon condition. These usually present as late relapse causing clinical manifestations such as dysphagia and melena. We present the case of a 57-year-old man with a history of renal cell carcinoma who presented an early metastasis to the esophagus. In addition, we made a comparison of the reason for examination, time of relapse, and metastasis in other anatomical places of all the cases reported in the literature of esophageal involvement due to clear cell metastasis.
Cutaneous metastasis of renal cell carcinoma: Fine needle aspiration provides rapid diagnosis
Authors: Rusella Mirza, Steven Ellsworth, Judy King, Guillermo Sangster, Mingxia Shi
Journal: Clin Case Rep (2018)
Keywords: cutaneous, fine needle aspiration, metastasis, renal cell carcinoma
MeSH terms: Case Reports

The diagnosis of cutaneous metastasis of renal cell carcinoma is challenging in a young person in absence of a prior history of cancer. In such situation, fine needle aspiration alone as a minimally invasive procedure can provide rapid, accurate and cost effective diagnosis, even in case of unknown primary.
MRA Mapping and Selective Embolization of a Large Uterine Cavity Pseudoaneurysm at 20 Weeks of Gestation
Authors: Jean V Storey, Timothy B Dinh, Deirdre M McCullough, Steven H Craig, Christian L Carlson
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Antepartum uterine cavity pseudoaneurysm rupture can cause massive hemorrhage with high maternal and fetal mortality risk. Invasive placentation can predispose to vascular malformations. We present a novel use of macrocyclic intravenous contrast-enhanced magnetic resonance angiography for preprocedure planning followed by selective low radiation embolization of a uterine cavity pseudoaneurysm in the setting of invasive placentation at 20 weeks of gestation. To our knowledge, this is the first reported case of uterine cavity pseudoaneurysm successfully mapped with MRA and treated with embolization at 20 weeks of gestation.
Accidental Intraoperative Mandibular Fracture in a Third Molar Surgery: When Surgical Skills Are Mandatory in the Face of Empiricism
Authors: John Nadson Andrade Pinho, Lucas Alves da Mota Santana, Leandro Napier de Souza, Paulo Nand Kumar, Paulo Almeida Júnior, Liane Maciel de Almeida Souza
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Iatrogenic mandible fractures are rare complications from third molar removal surgeries. While most documented cases stress risk factors inherent to the patient and tooth presentation in fractures' etiology, appreciation of the risk factors underlying the practitioner's skills is scarce. Here, we describe an intraoperative fracture in a healthy 26-year-old female resulting from an incompatible surgical technique during the right mandibular third molar removal. The patient showed facial swelling, pain, malocclusion, and significant mobility of the fractured segment. The surgical management involved an intraoral open reduction with the installation of titanium plates for the fixation of the bone segments. Thus, we highlight that acknowledging the extent of the operator's surgical skills should be part of comprehensive treatment planning, serving as a valuable measure to prevent iatrogenic mandible fractures besides avoiding a traumatic experience for the patient.
Kinetics of Rituximab Excretion into Urine and Peritoneal Fluid in Two Patients with Nephrotic Syndrome
Authors: Klaus Stahl, Michelle Duong, Anke Schwarz, A D Wagner, Hermann Haller, Mario Schiffer, Roland Jacobs
Journal: Case Rep Nephrol (2017)
MeSH terms: Case Reports

Clinical observations suggest that treatment of Rituximab might be less effective in patients with nephrotic range proteinuria when compared to nonnephrotic patients. It is conceivable that the reason for this is that significant amounts of Rituximab might be lost in the urine in a nephrotic patient and that these patients require a repeated or higher dosage. However, this has not been systematically studied. In this case report we describe two different patients with nephrotic range proteinuria receiving Rituximab. The first patient received Rituximab for therapy resistant cryoglobulinemic membranoproliferative glomerulonephritis and the other for second line treatment of Felty's syndrome. We employed flow cytometry to determine the amount of Rituximab excretion in both urine and peritoneal fluid specimens in these patients following administration of Rituximab. We found that a significant amount of Rituximab is lost from the circulation by excretion into the urine. Furthermore we saw a close correlation of the excretion of Rituximab to the excretion of IgG molecules suggesting selectivity of proteinuria as the determining factor of Rituximab excretion. Further larger scale clinical studies could have the potential to evaluate an optimal cut-off value of IgG urinary loss before a possible administration of Rituximab therefore contributing to a more individualized treatment approach in patients with nonselective and nephrotic range proteinuria.
Case Report of First Angiography-Based On-Line FFR Assessment during Coronary Catheterization
Authors: Ran Kornowski, Hana Vaknin-Assa
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from hyperemic pressure measurements and requires a pressure-monitoring guide wire and hyperemic stimulus. Although it has become the standard of reference for decision-making regarding coronary revascularization, the procedure remains underutilized due to its invasive nature. FFRangio is a novel technology that uses the patient's hemodynamic data and routine angiograms to generate a complete three-dimensional coronary tree, with color-coded display of the FFR values at each point along the vessels. After being proven to be as accurate as invasive FFR measurements in an off-line study, this case report presents the first on-line application of the system in the catheterization lab. Here too, a high concordance between FFRangio and invasive FFR was observed. In light of the demonstrated capabilities of the FFRangio system, it should emerge as an important tool for clinical decision-making regarding revascularization in patients with coronary artery disease.
Pancreatic metastasis from prostate cancer
Authors: Julian Jacob, Cyrus Chargari, Olivier Bauduceau, Maryse Fayolle, Bernard Ceccaldi, Frédéric Prat, Sylvestre Le Moulec, Lionel Vedrine
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The pancreas is an unusual location for metastases from other primary cancers. Rarely, pancreatic metastases from kidney or colorectal cancers have been reported. However, a variety of other cancers may also spread to the pancreas. We report an exceptional case of pancreatic metastasis from prostate cancer. Differences in management between primary and secondary pancreatic tumors make recognition of metastases to the pancreas an objective of first importance. Knowledge of unusual locations for metastatic spread will reduce diagnostic delay and lead to a timely delivery of an appropriate treatment.
Unexpected combination of acute croup and myocarditis: case report
Authors: George Briassoulis, Athina Tsorva, Emmanuel Agapitos, John Papadatos
Journal: BMC Clin Pathol (2005)

Background:
Lower vaccination coverage among foreign-born children is of concern because they live in households and communities characterized by more intense exposure to infectious diseases. Because of their higher prevalence rates, there is an increasing occurrence of infectious diseases imported into developed countries. This case report emphasizes the emerging necessity for new clinicians and pathologists of having competence with old infectious disease pathology.
Case presentation:
A three and a half year old girl, who presented with croup history of 5 days and has been in severe respiratory distress, was admitted to the Pediatric Intensive Care Unit in shock and acute respiratory failure. The patient was immediately intubated, and a grayish nonadherent membrane extending through the glottis down into the larynx was apparent during the procedure. Echocardiographic findings, which were consistent with acute myocarditis, confirmed poor left ventricular contractility despite escalating high doses of inotropes. Autopsy showed numerous strains of toxigenic corynobacterium diphtheriae, which also grew on the Loeffler cultures of membranes received during the intubation.
Conclusion:
It is critical that new generations of clinicians and bio-pathologists not only be trained in the subspecialty of infectious disease pathology, but that they also be willing participants in the diagnosis and investigation of infectious diseases.
Case report: Complete pathologic response with first-line immunotherapy combination in a young adult with massive liver dissemination of mismatch repair-deficient metastatic colorectal cancer: Immunological and molecular profiling
Authors: Francesca Bergamo, Silvia Dalla Santa, Fotios Loupakis, Krisida Cerma, Anna Tosi, Caterina De Grandis, Anna Dalla Pietà, Enrico Gringeri, Valentina Angerilli, Gaetano Ramondo, Alessandro Rago, Fabiola Cecchi, Stephen Benz, Umberto Cillo, Angelo Paolo Dei Tos, Vittorina Zagonel, Matteo Fassan, Antonio Rosato, Sara Lonardi
Journal: Front Oncol (2022)
Keywords: msi-h, colorectal cancer, complete pathological response, ipilimumab, nivolumab
MeSH terms: Case Reports

The current level of evidence for immunotherapy in previously untreated microsatellite unstable metastatic colorectal cancer is based on recent pieces of evidence of few studies that demonstrated durable response and clinical benefit, in terms of objective response rate, disease control rate, and progression-free survival in this subgroup of patients. On the basis of combinatorial immunotherapy with nivolumab plus ipilimumab, we report the exceptional case of a complete pathological response in a 21-year-old woman presenting a clinically aggressive stage IV colorectal cancer with massive nodal and liver involvement. Extensive molecular analyses based on whole genome next-generation DNA sequencing, RNA sequencing, fluorescent multiplex immunohistochemistry, and flow cytometry provided a detailed description of tumoral and immunological characteristics of this noteworthy clinical case.