OpenMed/multicare-articles huggingface dataset:
Progressive hypertrophic genital herpes in an HIV-infected woman despite immune recovery on antiretroviral therapy
Authors: Mark H Yudin, Rupert Kaul
Journal: Infect Dis Obstet Gynecol (2008)
MeSH terms: AIDS-Related Opportunistic Infections / pathology, HIV Infections / complications, HIV Infections / drug therapy, Herpes Genitalis / pathology, Herpesvirus 2, Human / pathogenicity, Vulvar Diseases / pathology, Case Reports, Research Support, Non-U.S. Gov't, AIDS-Related Opportunistic Infections / drug therapy, AIDS-Related Opportunistic Infections / virology, Administration, Topical, Adult, Aminoquinolines / administration & dosage, Aminoquinolines / therapeutic use, Antineoplastic Agents / administration & dosage, Antineoplastic Agents / therapeutic use, Antiretroviral Therapy, Highly Active, Antiviral Agents / administration & dosage, Antiviral Agents / pharmacology, Drug Resistance, Viral, Female, Foscarnet / administration & dosage, Foscarnet / pharmacology, HIV Infections / immunology, HIV Infections / virology, HIV-1, Herpes Genitalis / drug therapy, Herpes Genitalis / virology, Humans, Hypertrophy, Imiquimod, Treatment Outcome, Vulvar Diseases / drug therapy, Vulvar Diseases / virology, Aminoquinolines, Antineoplastic Agents, Antiviral Agents, Foscarnet, Imiquimod

Most HIV-infected individuals are coinfected by Herpes simplex virus type 2 (HSV-2). HSV-2 reactivates more frequently in HIV-coinfected individuals with advanced immunosuppression, and may have very unusual clinical presentations, including hypertrophic genital lesions. We report the case of a progressive, hypertrophic HSV-2 lesion in an HIV-coinfected woman, despite near-complete immune restoration on antiretroviral therapy for up to three years. In this case, there was prompt response to topical imiquimod. The immunopathogenesis and clinical presentation of HSV-2 disease in HIV-coinfected individuals are reviewed, with a focus on potential mechanisms for persistent disease despite apparent immune reconstitution. HIV-infected individuals and their care providers should be aware that HSV-2 may cause atypical disease even in the context of near-comlpete immune reconstitution on HAART.
Rendezvous procedure to establish ureteral continuity from a delayed ureteral leak following pelvic surgery. A case report
Authors: George Chang, Arshad A Khan, Saher Sabri, Paul H Sugarbaker
Journal: Int J Surg Case Rep (2020)
Keywords: appendiceal mucinous neoplasms, partial sacrectomy, percutaneous nephrostomy, pseudomyxoma peritonei, ureteral necrosis, ureteral stent, ureteral trauma
MeSH terms: Case Reports

Background:
Iatrogenic damage to the ureter as a result of an abdominal or pelvic surgical procedure is unusual. However, it does occur and the surgeon must be prepared to deal knowledgeably with the injury. Leaks that are recognized within the operating theater are managed, for the most part, at the same surgical procedure oftentimes with urologic consultation. A delayed leak presents unique problems in that direct access to the site of the leak is not possible except by a reoperative procedure. Delayed leaks present a clinical situation involving the urologist, interventional radiologist, as well as the surgeon.
Methods:
A patient who developed delayed urine leakage following a partial sacrectomy to remove recurrent mucinous appendiceal malignancy was studied. The leakage was controlled using a nephroureteral stent. Placement of the nephroureteral stent was made possible by the rendezvous procedure.
Results:
The sequence of procedures to reestablish ureteral continuity following a delayed leak are important in the successful placement of a nephroureteral stent. After establishing the site of the injury a percutaneous nephrostomy must be placed. Then, through the nephrostomy, a guidewire is placed in the ureter to be recovered and advanced into the bladder using a ureteroscope and grasping forceps. A nephroureteral stent is placed over the guidewire to bridge the gap and stent the ureteral defect.
Conclusions:
The rendezvous procedure can be successful a large percentage of the time with a delayed ureteral leakage. Successful recovery of a guidewire in the ureter by ureteroscopy requires a combined interventional radiology and urologic procedure.
Phenytoin intoxication with no symptoms correlated with serum drug level: a case study
Authors: Mucahit Avcil, Ali Duman, Kenan Ahmet Turkdogan, Mucahit Kapci, Ayhan Akoz, Selcuk Eren Canakci, Yunus Emre Ozluer
Journal: Pan Afr Med J (2015)
Keywords: phenytoin intoxication, emergency service, serum level
MeSH terms: Anticonvulsants / poisoning, Phenytoin / poisoning, Suicide, Attempted, Case Reports, ATP Binding Cassette Transporter, Subfamily B, Member 1 / genetics, Adult, Anticonvulsants / administration & dosage, Anticonvulsants / pharmacokinetics, Drug Overdose, Female, Humans, Mutation, Phenytoin / administration & dosage, Phenytoin / pharmacokinetics, ATP Binding Cassette Transporter, Subfamily B, Member 1, Anticonvulsants, Phenytoin

In high-dose intake of phenytoin, which is used frequently to treat epilepsy, nystagmus, diplopia, nausea-vomiting, lethargy, confusion, seizure, and coma can be observed. In recent studies on phenytoin intoxication, in which seizure and coma were observed in drug levels greater than 50 ug/mL. The serum phenytoin level of a patient, who consumed approximately 100 pcs of 100 mg phenytoin tablets in an effort to commit suicide, and who had no pathological finding in her neurologic examination, was 124 ug/mL. High drug level and the absence of toxic effect (or the absence of toxic effect correlated with the drug level) indicates that cytochrome P450 is functioning, but there can be a mutation in the MDR1 gene. In our case study, we report on phenytoin intoxication in a patient having a high level of phenytoin but no symptoms correlated with serum drug level, as supported by the findings in the literature.
Fulminant Vasculitis Complicated by ST-Elevation Myocardial Infarction and Stroke
Authors: Vy A Pham, Christopher P Kovach, Karl Gordon Patti, Evan S Manning, Stephen J Slade, Rebecca Pollard, Elena Weinstein, Jennifer Simpson, James E Carter Jr
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Acute coronary syndrome is a rare complication of vasculitis. We present a case of fulminant medium-vessel vasculitis, most likely PAN, complicated by STEMI and stroke, that was successfully treated with percutaneous revascularization, high-quality stroke care, and immunosuppression. This case highlights the importance of prompt diagnosis and treatment of vasculitis and the recognition of coronary and cerebral ischemia as potentially serious complications.
Accelerated Tooth Movement with Orthodontic Mini-Screws
Authors: S Aksakalli, A Balaban, K Nazaroglu, E Saglam
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

This case report outlines the possibility of accelerated tooth movement with the combination of microosteoperforation and mini-screws. A 14-year-old male patient presented Class II malocclusion with maxillary incisor protrusion. Upper first premolars were extracted, and after leveling, accelerated canine distalization started. For pre- and postdistalization times, amount of distalization, periodontal health, and root resorption were assessed. Within the limitations of this case report, micro-osteoperforations with mini-screw have a potential for shortening the treatment time.
Probable Autoimmune Depression in a Patient With Multiple Sclerosis and Antineuronal Antibodies
Authors: Dominique Endres, Sebastian Rauer, Nils Venhoff, Patrick Süß, Rick Dersch, Kimon Runge, Bernd L Fiebich, Kathrin Nickel, Miriam Matysik, Simon Maier, Katharina Domschke, Karl Egger, Harald Prüss, Ludger Tebartz van Elst
Journal: Front Psychiatry (2020)
Keywords: autoantibody, autoimmune encephalitis, connective tissue disease, depression, multiple sclerosis
MeSH terms: Case Reports

Background:
In a subgroup of patients with mood disorders, clear-cut organic disorders are responsible for depressive symptoms (e.g., autoimmune diseases such as multiple sclerosis or systemic lupus erythematosus). In these cases, an organic affective disorder can be diagnosed.
Case presentation:
The authors present the case of a 59-year-old male patient who developed a severe depressive episode over approximately 6 months and was, therefore, admitted to the hospital. In retrospect, he reported that, at age 39, he suffered from self-limiting sensory disturbances and muscle weakness in both legs. The current magnetic resonance imaging of his brain showed several conspicuous FLAIR-hyperintense supratentorial white matter lesions compatible with chronic inflammatory brain disease. Imaging of the spinal axis revealed no clear spinal lesions. Cerebrospinal fluid (CSF) analyses showed CSF-specific oligoclonal bands. Therefore, multiple sclerosis was diagnosed. Further CSF analyses, using tissue-based assays with indirect immunofluorescence on unfixed murine brain tissue, revealed a (peri-)nuclear signal and a strong neuritic signal of many neurons, especially on granule cells in the cerebellum, hippocampus, and olfactory bulb, as well as in the corpus callosum. Additionally, antinuclear antibody (ANA) titers of 1:12,800 and a lymphopenia were detected in blood tests. Further system clarification showed no suspicion of rheumatic or oncological disease. Anti-inflammatory treatment led to rapid and sustained improvement.
Conclusion:
The present patient suffered from a probable "autoimmune depression" in the context of newly diagnosed multiple sclerosis with typical MRI and CSF pathologies, alongside mild concomitant latent systemic autoimmune process (with high-titer ANAs and lymphopenia) and unknown antineuronal antibodies. The case report illustrates that a depressive syndrome suggestive of primary idiopathic depressive disorder may be associated with an autoimmune brain involvement. The detection of such organic affective disorders is of high clinical relevance for affected patients, as it enables alternative and more causal treatment approaches.
Open Reduction and Internal Fixation of a Proximal Femoral Shaft Fracture in a Patient with Bilateral Congenital Hip Disease
Authors: Stefania Kanata, Antonios Anastasiadis
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We present a rare case of a femoral shaft fracture in a 74-year-old woman with a preexisting untreated bilateral congenital hip dislocation and with concomitant leg length discrepancy. Because of the marked deformity of the upper femur, a derivative of the congenital hip disease, an open reduction and internal fixation was performed, with the use of an anatomic femur plate originally designed for the treatment of periprosthetic fractures. The patient was treated successfully and returned to her previous status of activity. The management of a femoral fracture in the presence of ipsilateral hip disease is a challenging issue. The surgical treatment choice in such cases has to be individualized, taking into consideration several anatomic and medical parameters.
Benznidazole treatment of chagasic encephalitis in pregnant woman with AIDS
Authors: Margarita Bisio, Jaime Altcheh, Jorge Lattner, Guillermo Moscatelli, Valeria Fink, Juan M Burgos, Facundo García Bournissen, Alejandro G Schijman, Héctor Freilij
Journal: Emerg Infect Dis (2013)
Keywords: aids, chagas disease reactivation, hiv, trypanosoma cruzi, benznidazole, parasites, pregnancy, protozoa
MeSH terms: Acquired Immunodeficiency Syndrome / drug therapy, Chagas Disease / drug therapy, Encephalitis / drug therapy, Nitroimidazoles / therapeutic use, Pregnancy Complications, Infectious, Trypanocidal Agents / therapeutic use, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antiretroviral Therapy, Highly Active, Coinfection, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome, Treatment Outcome, Trypanosoma cruzi / genetics, Nitroimidazoles, Trypanocidal Agents, benzonidazole

We report a case of chagasic meningoencephalitis reactivation in a pregnant woman co-infected with Trypanosoma cruzi and HIV that was successfully managed with benznidazole and highly active antiretroviral therapy. Early diagnosis enabled rapid specific treatment that improved the health of the patient and her baby.
Reconstruction of Natural Smile and Splinting with Natural Tooth Pontic Fiber-Reinforced Composite Bridge
Authors: Maryam S Tavangar, Fatemeh Aghaei, Massoumeh Nowrouzi
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Teeth replacement is challenging in old patients with severe periodontal disease, limiting prosthetics treatment options. Here, we report a fiber-reinforced composite (FRC) resin bridge using natural tooth pontic in a patient with severe periodontitis. A 60-year-old lady complaining of teeth mobility was diagnosed with severe periodontitis, recession, bone loss, and crowding in the anterior maxillary teeth. Due to a hopeless periodontal prognosis, lateral incisors were extracted and sectioned using a cylindrical diamond bur. The pulp chamber was debrided and filled with self-adhesive flowable composite resin. After three weeks, the pontics were fixed in proximal contact areas, and the FRC bridge was fabricated directly using the resin fiber strip followed by occlusion adjustment, finishing, and polishing. Esthetic, occlusion, and periodontal status were re-evaluated after six months. Here, FRC using natural pontic could successfully reconstruct a natural smile, splint the adjacent teeth, eliminate crowding, and provide stable occlusion. Therefore, this method may be considered for similar cases.
Case report: Drug reaction with eosinophilia and systemic symptoms (DRESS)-induced hemophagocytic disorder
Authors: Eliza I Pope, Hosanna Au, Deborah M Levy, Ruud H J Verstegen
Journal: Front Pharmacol (2022)
Keywords: dress (drug reaction with eosinophilia and systemic symptoms), antibiotics, case report, drug reaction, hemophagocytic lymphohistiocytosis, hemophagocytosis, macrophage activation syndrome, pediatrics
MeSH terms: Case Reports

Hemophagocytic disorders are severe and life-threatening conditions that can be genetic in origin [i.e., primary hemophagocytic lymphohistiocytosis (HLH)] or result from infections (i.e., secondary hemophagocytic lymphohistiocytosis), rheumatologic disease [i.e., macrophage activation syndrome (MAS)], and less frequently immunodeficiency or metabolic disease. Although rare, drug-induced hemophagocytosis needs to be considered in the work-up as it requires specific management strategies. Most drug-induced hemophagocytic disorders are related to Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). We present the case of a 7-year-old girl who initially presented with fever, maculopapular rash, and unilateral lymphadenopathy, who went on to develop hemophagocytosis secondary to DRESS caused by prolonged combination treatment with amoxicillin/clavulanic acid and trimethoprim/sulfamethoxazole. This case illustrates the importance of considering adverse drug reactions in the evaluations of patients with a hemophagocytic process.
Acute rhabdomyolysis associated with coadministration of levofloxacin and simvastatin in a patient with normal renal function
Authors: Maria Paparoupa, Sebastian Pietrzak, Adrian Gillissen
Journal: Case Rep Med (2014)

We report a rare case of severe acute rhabdomyolysis in association with coadministration of levofloxacin and simvastatin in a patient with normal renal function. A 70-year-old Caucasian male was treated due to community acquired pneumonia with levofloxacin in a dosage of 500 mg once and then twice a day. On the 8th day of hospitalization the patient presented with acute severe rhabdomyolysis requiring an intensive care support. After discontinuation of levofloxacin and concomitant medication with simvastatin 80 mg/day, clinical and laboratory effects were totally reversible. Up to now, levofloxacin has been reported to induce rhabdomyolysis mainly in patients with impaired renal function, as the medication has a predominant renal elimination. In our case renal function remained normal during the severe clinical course. According to a recent case report rhabdomyolysis was observed due to interaction of simvastatin and ciprofloxacin. To our best knowledge this is the first case of interaction between simvastatin and levofloxacin to be reported. This case emphasizes the need of close monitoring of creatine kinase in patients under more than one potentially myotoxic medication especially when patients develop muscle weakness.
Survival Following Extreme Hypernatraemia Associated with Severe Dehydration and Undiagnosed Diabetes Mellitus
Authors: Hao Xiao, Rahul Barmanray, Sarah Qian, Dilantha De Alwis, Gerard Fennessy
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

We report a case of a previously well 58-year-old man, who presented with delirium and low GCS, and was found to have extreme hypernatraemia (Na+ = 191 mmol/L) and hyperglycaemia (glucose = 31 mmol/L). This resulted in a corrected serum sodium of 202 mmol/L. He was treated with fluid and electrolyte replacement in the intensive care unit, and had returned to essentially normal function by hospital discharge. The aetiology was believed to be due to severe dehydration and a new diagnosis of diabetes mellitus. Extreme hypernatraemia (serum sodium level greater than 190 mmol/L) is rare and associated with a high mortality. The mainstay of treatment is careful fluid and electrolyte management. Most recommendations advise to reduce the serum sodium by 0.5 mmol/L/hour, due to concerns over cerebral oedema; however, there are reports that slower correction is associated with higher mortality. In this case, the initial corrected sodium of 202 mmol/L was steadily corrected to 160 mmol/L over 91 hours, at a rate of 0.46 mmol/L/hour. This demonstrates the safety of the recommended approach.
Elective transfemoral amputation and simultaneous implantation of a transcutaneous osseointegrated prosthesis stem as salvage treatment after knee joint arthrodesis with poor function: A case report
Authors: Katharina Krause, Katherina Richter, Thomas Beyer, Horst Heinrich Aschoff, Dagmar-Christiane Fischer, Thomas Mittlmeier
Journal: Front Surg (2022)
Keywords: acl reconstruction, gait analysis, knee joint arthrodesis, surgical complication, transcutaneous osseointegrated prosthesis system, transfemoral amputation
MeSH terms: Case Reports

Background:
Surgical reconstruction of anterior cruciate ligament ruptures is a well-established procedure, and although it is for the vast majority of patients without severe complications, total knee joint arthroplasty, arthrodesis of the knee, and finally transfemoral amputation have to be considered in the worst-case scenario.
The case:
We report a case of a patient with a 13-year history of recurrent failure after anterior cruciate ligament reconstruction. She claimed she had severely impaired mobility secondary to a knee joint arthrodesis via an Ilizarov circular frame 2 years ago and chronic immobilizing pain, making a permanent medication with opioids necessary. She was aware of the therapeutic options and asked for transfemoral amputation and concomitant supply with a transcutaneous osseointegrated prosthesis system (TOPS).
Procedures:
After careful evaluation and clinical work-up, the indication for transfemoral amputation and concomitant implantation of the prosthetic stem into the femoral cavity was secured. Six weeks after the creation of the stoma for coupling of the artificial limb and onset of physiotherapy, balance and gait training were scheduled. Full weight-bearing and walking without crutches were allowed 12 weeks after the index procedure. This sequence of events was paralleled by a series of pre-defined examinations, that is, questionnaires and mobility scores addressing the situation of transfemoral amputees, as well as standardized clinical gait analysis. The latter was performed before surgery and 6, 9, and 18 months after the index procedure.
Outcome:
At the time of the index procedure, opioids could be tapered to zero, and the patient quickly regained her walking abilities during the rehabilitation period. Clinical gait analysis confirmed the restoration of bilateral symmetry by mutual approximation of kinematics and kinetics to a standard gait pattern.
Conclusion:
The outcome of our patient strengthens the therapeutic potential of a unilateral transfemoral amputation in combination with TOPS. Nevertheless, long-term follow-up is necessary to detect future complications of this approach.
A new patient with a terminal de novo 2p25.3 deletion of 1.9 Mb associated with early-onset of obesity, intellectual disabilities and hyperkinetic disorder
Authors: Maria Clara Bonaglia, Roberto Giorda, Sergio Zanini
Journal: Mol Cytogenet (2014)
Keywords: deletion 2p253, hypekinetic disorder, language delay, myt1l, obesity
MeSH terms: Case Reports

Terminal and interstitial deletions of 2p25.3 (size < Mb), detected by array-CGH analysis, have been reported in about 18 patients sharing common clinical features represented by early-onset obesity/ overweightness associated with intellectual disabilities (ID) and behavioural troubles. This observations led to hypothesize that 2p subtelomeric deletion should be associated with syndromic obesity and MYT1L became the main candidate gene for ID and obesity since it is deleted or disrupted in all hitherto published cases. Here we described a 2p25.3 de novo terminal deletion of 1.9 Mb, of paternal origin, detected by array-CGH analysis in a girl of 4.4 years with a distinctive phenotype consisting of early-onset of obesity associated with moderate ID, and hyperkinetic disorder. The deletion disrupted MYT1L and encompassed five other OMIM genes, ACP1, TMEM18, SNTG2, TPO, and PXDN. Here, we discuss the combined functional effects of additional haploinsufficient genes, that may concur with heterozygous deletion of MYT1L, in the aetiology for syndromic obesity associated with 2p25.5 subtelomeric deletion.
Severe Anaphylaxis to Volplex, a Colloid Solution during Cesarean Section: A Case Report and Review
Authors: K Karri, R Raghavan, J Shahid
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

Anaphylaxis is a life-threatening event that can occur anytime during pregnancy. It has been reported following administration of various substances with adverse maternal and neonatal consequences. It should be considered in the differential diagnosis of intrapartum collapse. We encountered a case of severe anaphylactic reaction following a routine cesarean section. It is very important that all members of the perinatal team are aware of early recognition and management of anaphylactic reaction. We think that it is important to highlight this as a further case report of severe anaphylactic reaction to a colloid solution and discuss the pathophysiology and management.
Coexistence of invasive ductal breast carcinoma and fibroadenoma
Authors: Fatma Saadallah, Imen Bouraoui, Lamia Naija, Saida Sakhri, Ines Zemni, Jamel Ben Hassouna, Tarak Ben Dhieb, Hatem Bouzaiene, Khaled Rahal
Journal: Pan Afr Med J (2019)
Keywords: breast cancer, benign breast disease, fibroadenoma, risk factor
MeSH terms: Breast Neoplasms / diagnosis, Carcinoma, Ductal, Breast / diagnosis, Fibroadenoma / diagnosis, Case Reports, Breast Neoplasms / pathology, Breast Neoplasms / surgery, Carcinoma, Ductal, Breast / pathology, Carcinoma, Ductal, Breast / surgery, Female, Fibroadenoma / pathology, Fibroadenoma / surgery, Humans, Mammography / methods, Middle Aged

Fibroadenomas are the most common breast disease that occurs usually in young. The coexistence of an invasive ductal carcinoma and a fibroadenoma in the ipsilateral breast is extremely rare. We present the case of a 52 years woman, presented to us for an upper-outer breast lump. Breast imaging concluded to tow contiguous lesions, one of them was suspicious. She had a conservative surgery. Histology concluded to a fibroadenoma and an invasive ductal carcinoma.