OpenMed/multicare-articles huggingface dataset:
Positive Outcomes of Physiotherapy Intervention in a Wedge Compression Fracture of the L1 Vertebra: A Case Report
Authors: Richa S Gandhi, Shruti S Bhoge, Tejaswini Fating, Rutuja G Sawalkar
Journal: Cureus (2024)
Keywords: exercise, injuries, physiotherapy, posterior decompression spinal fusion, road traffic accidents, vertebral, vertebral compression fracture, wedge compression fracture
MeSH terms: Case Reports

The thoracolumbar spine is prone to vertebral compression fractures (VCFs). An injury mechanism known as flexion compression is responsible for thoracolumbar spine compression fractures. Usually, this mechanism affects the longitudinal ligament at the front and the front part of the vertebral body as the first components. Pain is the first and foremost symptom; here we present a case report of a 34-year-old male, who came to the hospital with complaints of back pain, and difficulty in breathing followed by a road traffic accident (RTA). MRI and X-ray investigations were done. The patient was diagnosed with a fracture of the anterolateral aspect of the right fourth and fifth ribs and posterolateral aspect of the sixth rib, acute anterior wedge compression fracture of the L1 vertebra, and bilateral minimal pneumothorax and haemothorax. The patient was managed surgically with post-decompression and spinal fusion at the D12-L2 level. The outcomes used were the Oswestry Low-Back Disability Questionnaire, the numerical pain rating scale, and Manual Muscle Testing (MMT). This case report specifies the physiotherapeutic rehabilitation protocol, mainly focusing on techniques like breathing exercises, and upper limb and lower limb strengthening along with trunk and pelvic floor muscles strengthening.
Abdominal Tremor in Idiopathic Parkinson's Disease: A Case Report
Authors: Raumin S Neuville, Anna E Morenkova
Journal: Tremor Other Hyperkinet Mov (N Y) (2024)
Keywords: abdominal tremor, levodopa-responsive, parkinson’s disease (pd), tremor
MeSH terms: Parkinson Disease / complications, Parkinson Disease / drug therapy, Case Reports, Abdomen / diagnostic imaging, Adult, Hand, Humans, Levodopa / therapeutic use, Male, Tremor / drug therapy, Tremor / etiology, Levodopa

Background:
Tremor in Parkinson's disease (PD) is commonly seen in the upper extremities and can involve the lower extremities and mouth. We present a case of a patient with idiopathic PD who presented with abdominal tremor.
Case report:
A 40-year-old man with a 2-year history of subjective weakness and stiffness in the right arm and leg, followed by emergence of a right hand tremor, subsequently developed abdominal tremor. Patient experienced marked improvement of both abdominal and hand tremor and mobility of the right limbs with levodopa.
Discussion:
Our case report serves as the second only published report of abdominal tremor in an idiopathic PD patient.
Highlights:
Tremor in Parkinson's disease (PD) commonly affects the upper and lower extremities and mouth. We describe a 40-year-old man with PD who developed abdominal tremor which was brought under control with levodopa. This case is one of only two published reports of abdominal tremor in PD.
Reduction of Proteinuria in a Patient With Primary Aldosteronism by Angiotensin II Receptor Blocker Administration
Authors: Junjiro Rikitake, Kenji Ashida, Mami Miura, Masatoshi Nomura
Journal: JCEM Case Rep (2022)
Keywords: aldosterone, angiotensin ii, mineralocorticoid receptor antagonists, proteinuria, renin-angiotensin aldosterone system
MeSH terms: Case Reports

The renin-angiotensin-aldosterone system (RAAS) is a major target for treating hypertension and preventing various complications. Mineralocorticoid receptor (MR) antagonists are recommended as specific drugs to ameliorate hyperactive MR signaling, especially for patients with idiopathic hyperaldosteronism. However, the clinical implications of an increased RAAS activity and angiotensin II level induced by MR antagonist administration remain unclear. A 72-year-old Japanese man was referred to our university hospital for refractory hypertension management. He has also had type 2 diabetes mellitus and nephropathy for 8 years. MR antagonists, initiated based on the diagnosis of primary aldosteronism, effectively improved his hypertension. However, proteinuria of 2.5 g/g creatinine, concomitant with an increase in both active renin concentration and plasma aldosterone concentration, occurred. Additional administration of an angiotensin II receptor blocker successfully reduced the plasma aldosterone concentration and proteinuria (<0.3 g/g creatinine). Preserved renal function was confirmed for 1 year thereafter. In conclusion, this case suggests that the angiotensin II receptor is a potential target to treat proteinuria concomitant with primary aldosteronism. RAAS reactivation should be considered when an MR antagonist is initiated for patients with primary aldosteronism, especially idiopathic hyperaldosteronism.
The dangers of "Chasing the dragon": a fatal case of heroin-induced leukoencephalopathy
Authors: Iliass Bourekba, Ismail Halfi, Najwa Ech Cherif Kettani, Meryem Fikri, Mohamed Jidane, Firdaous Touarsa
Journal: BJR Case Rep (2023)
Keywords: heroin-induced leukoencephalopathy, spongiform encephalopathy, toxic encephalopathy
MeSH terms: Case Reports

Heroin-induced leukoencephalopathy (HLE) is a rare toxic encephalopathy associated primarily with heroin inhalation, commonly referred to as "chasing the dragon." This study presents a clinical case of a 27-year-old polydrug user diagnosed with HLE during hospitalization for rapidly progressive flaccid tetraplegia and aphasia. The clinical manifestations encompassed cerebellar and bulbar dysfunction, coupled with motor impairment and altered consciousness. Based on the clinical data and MRI results, HLE was identified as the most likely cause. This article aims to provide insights into the clinical and radiological aspects of HLE, emphasizing the diagnostic significance of radiological findings. The gold standard examination for diagnosis is MRI, crucial due to the difficulties in obtaining histological confirmation for this rare condition.
Atypical presentation of γ/δ mycosis fungoides with an unusual phenotype and SOCS1 mutation
Authors: Pia Rude Nielsen, Lone Schejbel, Pär Lars Josefsson, Lone Skov, Signe Ledou Nielsen
Journal: Open Life Sci (2024)
Keywords: cutaneous t-cell lymphoma, gamma/delta phenotype, immunophenotypic, mycosis fungoides
MeSH terms: Case Reports

Mycosis fungoides is the most frequent subtype of primary cutaneous T-cell lymphomas. The diagnosis is based on a thorough clinic-pathologic correlation, which can, especially in early-stage disease, be challenging due to similarities with several benign skin disorders such as psoriasis and atopic dermatitis. Here, we present a case of an 81-year-old man with a 20-year-long medical history of skin problems treated as psoriasis with limited effect. Since December 2021, the patient experienced worsening of his skin symptoms with rapidly growing tumors and widespread patches and plaques. Positron emission tomography/computed tomography evaluation revealed markedly metabolic activity related to the skin tumors and increased FDG uptake in several retroperitoneal lymph nodes. Histological assessment of skin biopsies demonstrated a highly proliferative T-cell lymphoma with a γ/δ+ and CD8+ cytotoxic phenotype. The morphology of the tumor cells appeared blastic with an abnormal immunephenotype CD3+, CD2-, CD5dim, CD4-, CD8+, CD56-, and CD30-. Next-generation sequencing detected a likely pathogenic SOCS1 mutation with an allele frequency of 72% as well as a STAT3 variant of unknown significance. This case highlights the diagnostic complexity of an indolent skin lymphoma evolving into an aggressive cytotoxic lymphoma.
Rare giant retroperitoneal melanotic schwannoma: a case report and literature review
Authors: Pan Chen, Junfeng Cheng, Lin Zhang
Journal: Front Oncol (2024)
Keywords: malignant melanotic nerve sheath tumor(mmnst), melanotic schwannoma(ms), rare giant tumor, retroperitoneal schwannoma, surgical resection
MeSH terms: Case Reports

Background:
Melanotic schwannoma (MS), a rare variant of peripheral nerve sheath tumor, is especially infrequent when originating from the peritoneum. Its definitive diagnosis relies on postoperative histopathological examination and immunohistochemical analysis, while preoperative diagnosis is difficult.
Case presentation:
In the present study, we reported a rare case of giant MS in the retroperitoneum, which was previously misdiagnosed before surgery. However, intraoperative exploration revealed it was retroperitoneal tumor. The tumor had invaded the abdominal aorta and bilateral common illiac artery walls. A surgical resection was subsequently executed, and postoperative histopathological examination confirmed it as a MS.
Conclusion:
The incidence of peritoneal MS is extremely rare, and surgical resection remains the preferred treatment modality. Given the absence of established guidelines for postoperative adjuvant therapy, long-term follow-up becomes imperative to accumulate valuable clinical expertise.
Rare Case Studies of Bilateral and Symmetric Sacroiliac Disease
Authors: Stephen Soloway, Alyxandra M Soloway, Tyler G Chin, Timothy Lieske
Journal: Case Rep Rheumatol (2024)
MeSH terms: Case Reports

Introduction:
Inflammatory sacroiliitis is common in rheumatology practice. Spondyloarthritis is often underdiagnosed due to the lack of proper evaluation of the sacroiliac joints (SIJs), clinically and radiographically. If SIJ is inflamed or arthritic, the arthritic said patient typically has spondyloarthritis, in the absence of infections or crystal arthritis. Sacroiliitis, in particular, when diagnosed between 12 and 45 years of age, is indicative of spondyloarthritis. People are often misdiagnosed and mislabeled as fibromyalgia because their serologies are negative. Our goal is to point out the importance of proper evaluation, diagnosis, and importance of inflammatory SIJ disease and conditions that involve SIJ inflammation.
Cases:
We present three rare conditions presenting with bilateral and symmetric SIJ disease, none of which is ankylosing spondylitis, Crohn's colitis, ulcerative colitis, psoriatic arthritis, and reactive arthritis (Reiter syndrome); there are reports of concurrent SIJ disease in rheumatoid arthritis and SLE.
Conclusion:
The authors believe that SIJ disease is overlooked, is underdiagnosed, and can lead to incorrect treatment. We suggest a greater focus on SIJ imaging in the diagnosis and treatment of unexplained illnesses associated with low back pain, morning stiffness, or unexplained buttock pain. Providers should review their own SIJ films. The meaning of SIJ widening, cortical irregularity, spurs, and the significance of the anterior inferior SI joints, bone marrow edema, and fusion (namely, the natural history of sacroiliac pathophysiology).
Case Report: An extremely rare penile shrapnel injury
Authors: Renbing Pan, Jingwen Liu, Lijun Wan, Jianyong Zhu
Journal: Front Pediatr (2024)
Keywords: dysuria, erectile function, neurovascular bundle, penis, shrapnel injury
MeSH terms: Case Reports

Penile shrapnel injuries are an exceedingly rare occurrence and a medical emergency. Herein, we present a case of penile shrapnel wounds in an adolescent male and discuss the management and complications associated with penetrating injuries to penile. We reported that an 18-year-old Chinese armed police soldier underwent debridement, shrapnel removal and suturing under spinal anesthesia. Six days postoperatively, he was discharged from the hospital smoothly. The patient reported normal erectile function and urination following discharge. With a follow-up of three months, the patient exhibited no symptoms of dysuria or erectile dysfunction. It is explicitly stated that prompt surgery intervention described in this report resulted in optimal prognosis. Penile shrapnel injury is a rare phenomenon typically associated with emergency drill and military training involving explosive shells. With regard to penetrating penile injury, timely surgical exploration is essential because it avoids penile plaque formation, penile fibrosis and angulation, and accelerates the return to erectile and urination function.
Case report: dengue fever associated acute macular neuroretinopathy
Authors: How-Chen Wang, Chia-Ching Lin, Chia-Hsin Chang, Jih-Jin Tsai
Journal: Front Med (Lausanne) (2024)
Keywords: denv-1, acute macular neuroretinopathy (amn), case report, dengue fever, maculopathy, ocular manifestations
MeSH terms: Case Reports

Dengue fever (DF), which is caused by the dengue virus (DENV) and transmitted through Aedes mosquitoes, is well recognized for its systemic manifestations, with its ocular involvement gaining recent attention. We present a case of a 41-year-old Taiwanese female who developed acute macular neuroretinopathy (AMN) following a DF diagnosis related to DENV-1, emphasizing the need for awareness of this complication. The patient, with a history of completely resolved optic neuritis (ON) and comorbidities, experienced blurred vision on day 10 after the onset of DF. The ophthalmic examination revealed macular edema, ellipsoid zone (EZ) infiltration, and choriocapillaris involvement. Despite pulse therapy with corticosteroids, visual disturbances persisted, highlighting the challenge of managing ocular complications. Ocular manifestations in DF include hemorrhages, inflammation, and vascular complications. DF-associated AMN, a rare presentation, poses challenges in diagnosis and treatment response evaluation. While most patients recover spontaneously, some face persistent visual impairment, especially with AMN. Our case emphasizes the importance of recognizing ocular complications in DF, necessitating a multidisciplinary approach for optimal management and further research to delineate treatment strategies and outcomes.
Sigmoid Colon Perforation, Pelvic Collection, and Hydronephrosis Caused by an Ingested Chicken Wishbone
Authors: Ali Yasen Y Mohamedahmed, Hassan Jouni, Jyotsna Kakarla, Mohamed Ebraheem, James Eccersley
Journal: Cureus (2024)
Keywords: chicken bone, foreign body, hydronephrosis, large bowel perforation, sigmoid colon
MeSH terms: Case Reports

This case report presents an unusual and challenging case of an 82-year-old female patient who presented with constipation and abdominal pain and was diagnosed with bowel perforation and hydronephrosis caused by an ingested chicken wishbone. This patient was treated with emergency laparotomy and bowel sigmoid resection. She made a good recovery and was discharged home. The patient's clinical presentation, diagnostic challenges, and successful management are discussed.
Duped by dumping syndrome: non-endemic Vibrio cholerae bacteremia in an immunocompetent host with gastric bypass surgery, a case report
Authors: Fabiola Reyes, Nicole Pecora, Zoe Freeman Weiss
Journal: Access Microbiol (2023)
Keywords: novc, bacteremia, case report, gastric bypass, infectious diarrhea, non-epidemicvibrio cholerae
MeSH terms: Case Reports

Extra-intestinal infection with non-O1/non-O139 strains of Vibrio cholerae (NOVC) is rare, though bacteremia and hepatobiliary manifestations have been reported. Reduced stomach acid, or hypochlorhydria, can increase risk of V. cholerae infection. We describe a 42-year-old woman with hypochlorhydria due to untreated Helicobacter pylori infection, gastric-bypass surgery, and chronic proton pump inhibitors (PPI) exposure, who developed acute diarrhoea following raw oyster consumption. Her symptoms were attributed to rapid gastric emptying (dumping syndrome) after a negative limited stool work-up. She had persistent diarrhoea, weight loss, and after 5 months was admitted with acute cholecystitis and NOVC bacteremia, requiring cholecystectomy. This is the first reported case of NOVC bacteremia and cholecystitis in a patient with gastric bypass. This case highlights the potential for NOVC biliary carriage, the role of hypochlorhydria as a risk factor for Vibrio infection, and the importance of excluding infectious diarrhoea in patients with new onset of symptoms compatible with dumping syndrome and a relevant travel history.
Case report: Epilepsy during the use of recombinant human growth hormone: a report on two cases and a literature review
Authors: Yuan Zhou, Ruofan Jia, Zhuangjian Xu, Yaping Ma
Journal: Front Pharmacol (2024)
Keywords: boy, epilepsy, gonadotrophin-releasing hormone analog, recombinant human growth hormone, short stature
MeSH terms: Case Reports

Background:
Epilepsy during recombinant human growth hormone (rhGH) therapy is rare in children. The potential association between rhGH treatment and epilepsy remains unclear.
Methods:
We retrospectively analyzed the clinical data of two Chinese boys who experienced epilepsy during the use of rhGH and reviewed the relevant literature.
Results:
Case 1, an 8-year and 2-month-old boy, was diagnosed with short stature, malnutrition, and congenital hypothyroidism. He was on levothyroxine sodium tablets for a long time. Recurrent febrile convulsions were present at 6-7 years. Electroencephalogram and magnetic resonance imaging (MRI) showed no abnormality, and no treatment was given. He was diagnosed with complex febrile convulsions. The boy started rhGH treatment (approximately 0.15 IU/kg/day, sc, qd) at 8 years and 4 months. Epilepsy occurred three times during the 6 months of rhGH treatment. Electroencephalography confirmed a definitive diagnosis of epilepsy. Then, he discontinued rhGH treatment at 8 years and 11 months and started taking levetiracetam (0.25 g, po, bid) for antiepileptic therapy. Epilepsy was well-controlled 4 months later. He continued rhGH treatment at 10 years and 3 months and has been on rhGH treatment until now, with no recurrence of epilepsy. He has been taking levetiracetam to date. Case 2, a 9-year and 1-month-old boy, was diagnosed with central precocious puberty, predicted short final height, and overweight. He started treatment with triptorelin (3.75 mg, im, q4w) and rhGH (approximately 0.15 IU/kg/day, sc, qd) at 9 years and 3 months. He tended to fall repeatedly when he was approximately 10 years old. Electroencephalography showed a few medium- to high-amplitude sharp waves and sporadic sharp slow waves in the left middle temporal region, sometimes involving the left posterior temporal region. He was diagnosed with epilepsy. Triptorelin discontinuance provided no symptom relief, which worsened further. Subsequently, he withdrew from rhGH treatment, and the symptoms occurred occasionally within a week and stopped after 15 days. The electroencephalogram returned to normal. No further seizures occurred during follow-up to date.
Conclusion:
During the use of rhGH in short-stature children with complex febrile convulsions or underlying lesions related to neurological impairment or those being treated with antiepileptic drugs, epilepsy may be induced.
Extracorporeal membrane oxygenation treatment for severe asthma had unexpected adverse effects: a case report
Authors: Yun Wang, Weimin Zhang, Xingxing Chen, Xuping Cheng, Xuandong Jiang
Journal: Front Med (Lausanne) (2023)
Keywords: asthma, extracorporeal membrane oxygenation, hemorrhage, hypokalemia, respiratory acidosis
MeSH terms: Case Reports

Asthma, a chronic respiratory ailment, affects millions worldwide. Extracorporeal membrane oxygenation (ECMO) has gained traction as a life-saving intervention for patients with severe asthma who are unresponsive to conventional treatments. However, complications associated with ECMO, including electrolyte imbalances and hemorrhage, can have significant clinical implications. This case report highlights a 49 years-old male patient with severe asthma who developed pronounced hypokalemia and hemorrhage following venovenous ECMO (VVECMO) therapy. Despite potassium supplementation, serum potassium levels continued declining before normalizing after 24 h. The patient subsequently experienced gastrointestinal bleeding, cerebral hemorrhage, and extensive cerebral infarction, ultimately resulting in a deep coma. Hypokalemia during ECMO therapy can result from a rapid reduction of carbon dioxide, β-receptor agonist use, corticosteroid use, and diuretic administration. Hemorrhage is another common ECMO complication, often linked to heparin anticoagulation therapy. Clinicians should be aware of potential complications and adopt appropriate prevention and management strategies when using ECMO in patients with severe asthma.
Resolution of occult anastomotic stricture with anal dilator: challenges with the conventional diagnostic criteria in low anterior rectal resection patient-a case report
Authors: Gaoyang Cao, Xinjie Zhang, Songtao Wu, Wei Zhou
Journal: Front Oncol (2024)
Keywords: anal dilatation, anastomotic stricture, diagnostic criteria, occult, rectal cancer surgery
MeSH terms: Case Reports

Background:
Anastomotic stricture (AS) is a common complication following rectal cancer surgery with anastomosis, but its diagnosis and management pose significant challenges due to the lack of standardized diagnostic criteria. We present a case highlighting the complexities encountered in diagnosing and managing occult AS post-rectal cancer surgery.
Case presentation:
A 51-year-old male patient presented with symptoms suggestive of AS following robot-assisted laparoscopic low anterior resection for rectal adenocarcinoma. Despite conventional evaluations, including colonoscopy, digital rectal examination, and radiography, AS was not identified. Following prolonged and ineffective treatment for suspected conditions such as low anterior resection syndrome (LARS), the patient underwent anal dilatation, resulting in significant symptom improvement.
Conclusions:
This case underscores the challenges associated with diagnosing and managing occult AS following rectal cancer surgery. The absence of standardized diagnostic criteria and reliance on conventional modalities may lead to underdiagnosis and inadequate treatment. A comprehensive diagnostic approach considering intestinal diameter, elasticity, and symptoms related to difficult defecation may enhance diagnostic accuracy. Further research is needed to refine the diagnostic and therapeutic strategies for occult AS.
Epikeratophakia for Keratoconus: A Case Report with 30 Years of Follow-Up
Authors: Takashi Miyai, Tetsuya Toyono, Hitoha Ishii, Kohdai Kitamoto, Yukako Taketani, Takashi Ono, Makoto Aihara, Kazunori Miyata
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Background:
Epikeratophakia is a refractive surgical procedure used to correct aphakic eyes, hyperopia, and keratoconus and is often performed in children. In this report, we present the long-term effects of epikeratophakia on the progression of keratoconus in a patient who underwent surgery. Case Presentation. The patient was a 17-year-old boy with keratoconus who had difficulty wearing hard contact lenses. As a solution, he underwent right eye epikeratophakia with a plano-powered lenticule. We followed up the patient for 30 years. Although the progression of keratoconus ceased in the operated eye, it continued in the nonoperated left eye and resulted in acute hydrops 9 years and 10 months after surgery. Subsequently, 20 years after the operation, anterior-segment optical coherence tomography was performed, which revealed that the progression of keratoconus had been interrupted in the right eye but had continued in the left eye, as evidenced by the parameters of the average and maximum keratometry and thinnest corneal thickness.
Conclusions:
Herein, we reported the longest follow-up to date of a case of keratoconus, in which one eye was treated with epikeratophakia. The progression of keratoconus was halted in the treated eye but continued in the nonoperated contralateral eye.