OpenMed/multicare-articles huggingface dataset:
Cerebral Arterial Air Embolism after Diagnostic Flexible Fiberoptic Bronchoscopy: A Case Report and Review of the Literature
Authors: Keita Maemura, Hidenori Kage, Hideaki Isago, Hideyuki Takeshima, Kosuke Makita, Yosuke Amano, Daiya Takai, Nobuya Ohishi, Takahide Nagase
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Cerebral arterial air embolism (CAAE) is an extremely rare complication of diagnostic flexible fiberoptic bronchoscopy, reported to occur once about every 103978 examinations. In all the eight cases of CAAE reported previously, the patients had undergone transbronchial lung biopsy (TBLB) or transbronchial needle aspiration (TBNA) prior to the onset of CAAE. Herein, we describe the case of a 77-year-old patient with double primary lung cancer who developed CAAE after bronchial curette cytology, which is considered to be less invasive than TBLB or TBNA. The patient was treated with supplemental oxygen, but paresis of the left upper arm and left spatial neglect remained. This is the first report of CAAE occurring after bronchial curettage during diagnostic flexible fiberoptic bronchoscopy.
Jerky dystonic shoulder following infarction of the posterior thalamus
Authors: Ruth H Walker
Journal: J Clin Mov Disord (2015)
Keywords: dystonia, thalamus
MeSH terms: Case Reports

The syndrome of the jerky dystonic hand is recognized as a consequence of infarction of the posterior thalamus. A patient with multiple risk factors for stroke developed jerky dystonia of more proximal involvement, affecting the shoulder and speech, several months after a stroke affecting the posterior thalamic region. The cause for the proximal, rather than distal, upper limb involvement, is unclear, and is not apparent from the distribution of the lesion on neuroimaging. Injections of botulinum toxin significantly improved the symptoms.
A patient with Pfeifer-Weber-Christian disease--successful therapy with cyclosporin A: case report
Authors: Georg Pongratz, Boris Ehrenstein, Wolfgang Hartung, Jürgen Schölmerich, Martin Fleck
Journal: BMC Musculoskelet Disord (2010)
MeSH terms: Cyclosporine / therapeutic use, Immunosuppression Therapy / methods, Immunosuppressive Agents / therapeutic use, Panniculitis, Nodular Nonsuppurative / drug therapy, Case Reports, Arm / pathology, Arthritis, Rheumatoid / complications, Biopsy, Humans, Male, Middle Aged, Panniculitis, Nodular Nonsuppurative / immunology, Panniculitis, Nodular Nonsuppurative / physiopathology, Steroids / therapeutic use, Subcutaneous Tissue / metabolism, Subcutaneous Tissue / pathology, Subcutaneous Tissue / physiopathology, Treatment Outcome, Immunosuppressive Agents, Steroids, Cyclosporine

Background:
Pfeifer-Weber-Christian disease (PWCD) is a rare inflammatory disorder of the subcutaneous fatty tissue. The diagnosis and therapy of this rare type of panniculitis is still controversial and will be discussed in this article.
Case presentation:
We here report the rare case of a 64-year old male patient, with PWCD. The patient suffered from rheumatoid arthritis for several years, but then developed relapsing fever and recently occurring painful subcutaneous nodules predominantly at the inner part of his left upper limb with no signs of synovitis. Finally, a biopsy from one of the nodules revealed lobular panniculitis with mixed cell infiltrate, which was conformable only with PWCD, after excluding several differential diagnoses. In our patient PWCD developed despite immunosuppressive therapy with steroids and different disease modifying drugs, which the patient received to treat his underlying rheumatoid arthritis. However, when DMARD therapy was switched to Ciclosporin A the patient's symptoms resolved.
Conclusion:
Our observation supports the hypothesis that T cells are involved in the pathogenesis of PWCD. Thus, T cell modifying drugs should be primarily used to treat patients with this rare disorder.
Concurrent COVID-19 and Acute HIV: A Case Report and Diagnostic Review
Authors: Kelly A Johnson, Sally Graglia, Elizabeth D Lynch, Joanna De Mesa, Erin Antunez, Sandra Torres, Susa Coffey, Stephanie E Cohen
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

A 26-year-old male presented to the emergency department feeling unwell in February of 2021 with symptoms including diaphoresis, loose stools, and loss of taste sensation. Workup not only confirmed a diagnosis of COVID-19 but also revealed discordant HIV test results, with a reactive fourth-generation antigen/antibody test but a negative HIV-1/2 differentiation immunoassay. Subsequent HIV viral load testing obtained two days later ultimately established a diagnosis of acute HIV (AHI). Screening for HIV and other sexually transmitted infections decreased during the COVID-19 pandemic. It is critical that providers (1) continue recommended screening for HIV as an essential service; (2) consider acute HIV in the differential when evaluating patients with acute viral syndromes; (3) recognize that AHI can occur concurrently with other infections, including COVID-19; and (4) understand the differential diagnosis for discordant HIV test results and know when HIV viral load testing is needed to resolve such discordant results.
Successful Endoscopic Resection of Primary Rectal Mucosa-Associated Lymphoid Tissue Lymphoma by Endoscopic Submucosal Dissection: A Case Report
Authors: Jian Han, Zhe Zhu, Chao Zhang, Hua-Ping Xie
Journal: Front Med (Lausanne) (2021)
Keywords: colonoscopy, endoscopic mucosal resection, endoscopic submucosal dissection, mucosa-associated lymphoid tissue lymphoma, rectum
MeSH terms: Case Reports

Mucosa-associated lymphoid tissue (MALT) lymphoma arises in extra-nodal sites from the malignant transformation of B lymphocytes that are mainly triggered by infection or autoimmune process. MALT lymphoma is frequently detected in the gastrointestinal tract. As the causal relationship between Helicobacter pylori (H. pylori) infection and gastric MALT lymphoma, it was well-established that early-stage gastric MALT lymphoma could be cured by H. pylori eradication, and about 50-95% of cases achieved complete response with anti-H. pylori treatment. Compared to the stomach which is the most involved site due to the high prevalence of H. pylori infection, the colorectum is rarely affected. Primary rectal MALT lymphoma is a rare malignancy, and there are no specific therapeutic strategies so far. Here we report a case of rectal MALT lymphoma successfully resected by endoscopic submucosal dissection (ESD). ESD serves as a novel strategy to cure small localized rectal MALT lymphomas to avoid unnecessary surgery or chemo-radiotherapy.
Cone Beam Computed Tomography (CBCT) findings of fungal sinusitis in post COVID-19 patient: A case report
Authors: Farida Abesi, Mona Alimohamadi
Journal: Caspian J Intern Med (2022)
Keywords: cone beam computed tomography (cbct), corona virus, sinusitis
MeSH terms: Case Reports

Background:
Fungal infections of the paranasal sinus are increasingly recognized in both normal and immunocompromised individuals. It is necessary to distinguish invasive diseases from the non- invasive as the result and prognosis of sinus treatment different in each one. CBCT imaging could help us in this regard. In this case, we describe a fungal sinusitis according to Cone Beam Computed Tomography (CBCT) findings.
Case presentation:
We present a case of a 48-year-old woman with diabetes mellitus referred to our Maxillofacial Radiology Center in Babol, Iran. The patient has been discharged from the hospital recently after recovering from COVID-19 Considering the background systemic disease (diabetes) and clinical and radiological findings (extension of bone destruction), fungal sinusitis (invasive form) was listed top in the differential diagnosis list , as it is the most common condition in post-COVID-19 patients.
Conclusion:
CBCT images are very useful for diagnosing normal anatomy variations and sinus lesions especially bone lesions .In this case, its early diagnosis led to rapid recovery of the patient.
Esophageal Crohn's disease treated "topically" with swallowed aerosolized budesonide
Authors: Petros Zezos, Georgios Kouklakis, Anastasia Oikonomou, Michail Pitiakoudis, Constantinos Simopoulos
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Proximal Crohn's disease, involving the esophagus, the stomach, the duodenum, and the proximal jejunum, is uncommon. Treatment for proximal Crohn's disease is based on data derived from case series than from controlled trials. We present a case of Crohn's colitis with concomitant proximal esophagogastroduodenal involvement treated with conventional treatment plus swallowed aerosolized budesonide as a novel adjuvant topical treatment for the esophageal disease, and we review the treatment options for proximal Crohn's disease.
A case report: New-onset refractory status epilepticus in a patient with FASTKD2-related mitochondrial disease
Authors: Alexandra Astner-Rohracher, Matthias Mauritz, Markus Leitinger, Fabio Rossini, Gudrun Kalss, Caroline Neuray, Elisabeth Retter, Saskia B Wortmann, Melanie T Achleitner, Johannes A Mayr, Eugen Trinka
Journal: Front Neurol (2023)
Keywords: fastkd2 mutation, drug-resistant epilepsy, genetic epilepsies, mitochondrial disease, new-onset refractory status epilepticus (norse)
MeSH terms: Case Reports

Objectives:
New-onset refractory status epilepticus (NORSE) is associated with high morbidity and mortality. Despite extensive work-up, the underlying etiology remains unknown in 50% of affected individuals. Mitochondrial disorders represent rare causes of NORSE. Biallelic variants in FASTKD2 were reported as a cause of infantile encephalomyopathy with refractory epilepsy.
Case description:
In the study, we report a previously healthy 14-year-old with a new, homozygous FASTKD2 variant presenting with NORSE. Following a seizure-free period of 7 years, he experienced another super-refractory SE and subsequently developed drug-resistant focal epilepsy, mild myopathy, optic atrophy, and discrete psychomotor slowing. Structural MRI at the time of NORSE showed right temporo-parieto-occipital FLAIR hyperintensity and diffusion restriction, with extensive right hemispheric atrophy at the age of 22 years. Whole-exome sequencing revealed a novel homozygous loss of function variant [c.(1072C>T);(1072C>T)] [p.(Arg358Ter);(Arg358Ter)] in FASTKD2 (NM_001136193), resulting in a premature termination codon in the protein-coding region and loss of function of FASTKD2. Oxidative phosphorylation (OXPHOS) in muscle and skin fibroblasts was unremarkable.
Conclusion:
This is the first case of a normally developed adolescent with a new homozygous loss of function variant in FASTKD2, manifesting with NORSE. The phenotypical spectrum of FASTKD2-related mitochondrial disease is heterogeneous, ranging from recurrent status epilepticus and refractory focal epilepsy in an adolescent with normal cognitive development to severe forms of infantile mitochondrial encephalopathy. Although mitochondrial diseases are rare causes of NORSE, clinical features such as young age at onset and multi-system involvement should trigger genetic testing. Early diagnosis is essential for counseling and treatment considerations.
Successful Treatment of Bullous Pemphigoid Lesions by Berberine Stamp Therapy: A Case Report and Literature Review
Authors: Linyan Cheng, Yi Wang, Hanzhi Lu, Wanjun Guo, Ge Yan, Jianyong Zhu, Dongjie Guo, Fulun Li
Journal: Front Med (Lausanne) (2022)
Keywords: autoimmune dermatoses, berberine, bullous pemphigoid, case report, stamp therapy, treatment
MeSH terms: Case Reports

Bullous pemphigoid (BP) is a life-threatening autoimmune disease of the skin that is mainly characterized by a large range of tension blisters and intense itching of the skin. The 1-year mortality rate of BP was 23.5%. Superinfection caused by skin lesion ulceration is one of the important causes of disease death. Therefore, it is challenging to control infection and improve skin wound healing. Here, we report the case of an elderly woman who presented with BP and involved the oral mucosa. The patient was successfully treated with hormones combined with topical berberine, and 95% of the patients' lesions healed completely after 1 month. In addition, we inductively analyzed the current treatments for BP to provide a reference for BP clinical treatment.
Tear of peroneus longus in long distance runners due to enlarged peroneal tubercle
Authors: Ezequiel Palmanovich, Lior Laver, Yaron S Brin, Iftach Hetsroni, Meir Nyska
Journal: BMC Sports Sci Med Rehabil (2014)
MeSH terms: Case Reports

Background:
Tear of the Peroneus longus in association with a prominent peroneal tubercle is rare.
Case presentation:
Recently we treated two long distance runners who developed lateral ankle pain. Maximum tenderness was located over the lateral surface of the heel in the area of the peroneal tendons. Imaging disclosed a tear of the peroneus longus at the area of the peroneal tubercle.
Conclusion:
Following resection of the peroneal tubercle and repair of the peroneus longus, both patients regained full activity with no pain. This report describes the clinical presentation and surgical management of this rare injury.
Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency
Authors: Harufumi Maki, Motohiro Nishiyama, Motoaki Shirakawa
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV), splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected. Electrocardiography revealed ST depression in leads II, III, and aVF. Transthoracic echocardiography revealed hypokinesis of the apex and interventricular septum and a hypoechoic mass in the LV (26 × 20 mm). She was diagnosed with acute arterial obstruction caused by the LV thrombus, which might have resulted from previous myocardial infarction. Protein C activation turned out to be low (41%) 5 days after admission. The anticoagulant therapy was switched from heparin to rivaroxaban 16 days after admission. The LV thrombus disappeared 24 days after initial treatment, and she has had no thrombotic episodes for 2.8 years under rivaroxaban therapy. Thrombophilia should be investigated for cases of simultaneous left ventricular and deep venous thrombi. Rivaroxaban can be effective in prevention of further thrombotic events.
Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia
Authors: Silke Coemans, Esli Struys, Kyrana Tsapkini, Philippe Paquier, Dorien Vandenborre, Stefanie Keulen
Journal: Front Hum Neurosci (2023)
Keywords: aphasia, bilingual aphasia, bilingualism, cerebellum, executive functions (efs), neurolinguistics, transcranial direct current simulation
MeSH terms: Case Reports

Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham.
Reconstruction of Acute Patellar Tendon Rupture after Patellectomy
Authors: Kenjiro Fujimura, Koji Sakuraba, Satoshi Kamura, Kiyoshi Miyazaki, Nobuo Kobara, Kazumasa Terada, Hisaaki Miyahara
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Acute rupture of the knee extensor mechanism after patellectomy is extremely rare. We present the case of a patient with acute patellar tendon rupture who had undergone patellectomy 53 years before. Twelve days after the injury, the ruptured patellar tendon was repaired with end-to-end suture. Postoperatively, we splinted the knee for 6 weeks but permitted the patient to walk without limiting weight bearing at 1 week postoperatively. At one-year follow-up, the patient is able to move his knee almost full range of motion and the Lysholm knee score is 81. The patient is satisfied with the outcome. This is the first report to treat acute rupture of the patellar tendon in a patient who had undergone patellectomy. Although careful rehabilitation is required, end-to-end suture might be an adequate surgical procedure for acute rupture of the knee extensor mechanism after patellectomy.
Six Gynecological Cancer Patients Infected With SARS-CoV-2 After Surgery or Radio-/Chemo-Therapy Treatment: Case Series
Authors: Chen Liu, Yuhan Huang, Tianyu Qin, Ensong Guo, Peng Wu, Chaoyang Sun, Gang Chen
Journal: Front Oncol (2020)
Keywords: covid-19, sars-cov-2, gynecological cancer, suggestions, treatment

Objective:
Recently, the number of gynecological cancer patients infected with SARS-CoV-2 has been increasing. This article was committed to studying the influence of gynecological tumor treatment history compared to the Coronavirus Disease 2019 (COVID-19), which was of great significance for the treatment of gynecological cancer patients during the outbreak of COVID-19.
Methods:
We retrospectively analyzed the diagnosis and treatment of six gynecological cancer patients infected with SARS-CoV-2 in Tongji Hospital in Wuhan from January 30 to March 25, 2020. To better explain the treatment of gynecological cancer patients during the epidemic of COVID-19, we summarized the case characteristics, auxiliary examination, treatment plan, and outcome of these six patients.
Results:
We observed a high rate of nosocomial SARS-CoV-2 infection among these six gynecological cancer patients, who were in a low immune state. Also, due to the influence of cancer treatment history, COVID-19-related atypical symptoms became the first symptom of COVID-19 in some cases, which increased the difficulty of diagnosis. Furthermore, in terms of treatment for these cases, immune boosters and reagents that raised white blood cells were applied, except for in symptomatic antiviral treatment. At present, all patients in this study were discharged from the hospital with a good prognosis.
Conclusion:
After cancer-related treatment, the gynecological cancer patients became more susceptible to COVID-19. Besides, the history of cancer treatment made the diagnosis of COVID-19 difficult, which also affected the treatment of COVID-19. Therefore, we put forward the corresponding therapy suggestions for gynecological cancer patients during the outbreak of COVID-19.
Ischemic Stroke in a Young Patient with Nephrotic Syndrome and Antiphospholipid Syndrome
Authors: K K Neoh, A S N Tang, I Looi, B M Anita
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

We report a case of a 21-year-old man with underlying nephrotic syndrome (NS) secondary to minimal change disease, who developed an ischemic stroke with left hemiparesis. He received intravenous thrombolysis followed by a mechanical thrombectomy. After mechanical thrombectomy, he developed acute kidney injury which subsequently required haemodialysis. Further workup revealed that he had concomitant antiphospholipid syndrome (APS) and NS. He was started on vitamin K antagonist anticoagulant. This case report illustrates the importance of workup in identifying causes of ischemic stroke in a young patient.
Successful Immunomodulatory Treatment of COVID-19 in a Patient With Severe ACTH-Dependent Cushing's Syndrome: A Case Report and Review of Literature
Authors: Bojana Popovic, Aleksandra Radovanovic Spurnic, Jelena Velickovic, Aleksandra Plavsic, Milica Jecmenica-Lukic, Tijana Glisic, Dusan Ilic, Danka Jeremic, Jelena Vratonjic, Vladimir Samardzic, Zoran Gluvic, Tatjana Adzic-Vukicevic
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: covid-19, cushing’s syndrome, ivig, hypercortisolism, immunomodulation, immunosuppression
MeSH terms: COVID-19 Drug Treatment, COVID-19 / complications, Cushing Syndrome / complications, Cushing Syndrome / diagnosis, Cushing Syndrome / drug therapy, Case Reports, Review, Adrenocorticotropic Hormone, Aged, Female, Humans, Immunoglobulins, Intravenous / therapeutic use, Pandemics, Immunoglobulins, Intravenous, Adrenocorticotropic Hormone

Introduction:
Patients with Cushing's syndrome (CS) represent a highly sensitive group during corona virus disease 2019 (COVID-19) pandemic. The effect of multiple comorbidities and immune system supression make the clinical picture complicated and treatment challenging.
Case report:
A 70-year-old female was admitted to a covid hospital with a severe form of COVID-19 pneumonia that required oxygen supplementation. Prior to her admission to the hospital she was diagnosed with adrenocorticotropic hormone (ACTH)-dependent CS, and the treatment of hypercortisolism had not been started yet. Since the patient's condition was quickly deteriorating, and with presumend immmune system supression due to CS, we decided on treatement with intraveonus immunoglobulins (IVIg) that enabled quick onset of immunomodulatory effect. All comorbidities were treated with standard of care. The patient's condition quickly stabilized with no direct side effects of a given treatment.
Conclusion:
Treatment of COVID-19 in patients with CS faces many challenges due to the complexity of comorbidity effects, immunosupression and potential interactions of available medications both for treatment of COVID-19 and CS. So far, there are no guidelines for treatment of COVID-19 in patients with active CS. It is our opinion that immunomodulating therapies like IVIg might be an effective and safe treatment modality in this particularly fragile group of patients.
Case report: Surgical valvular pulmonary reconstruction for a previous unreported rheumatic right-sided valve disease with severe pulmonary regurgitation
Authors: Zijing Zhou, Weijie Tang, Xiaokang Tu, Feng Li, Zhonghua Huang, Wancun Jin, Qin Wu, Feng Liu, Chengming Fan
Journal: Front Cardiovasc Med (2023)
Keywords: cardiac surgery, echocardiography, pulmonary valve, reconstruction, rheumatic heart disease
MeSH terms: Case Reports

Rheumatic heart disease (RHD) is a widespread illness in developing countries. RHD causes 99% of mitral stenoses in adults and 25% of aortic regurgitation. However, it only causes 10% of stenoses of the tricuspid valve, and is almost always associated with left-side valvular lesions. Isolated right-side valves are rarely affected, but may result in severe rheumatic pulmonary regurgitation. Herein, we present a case of rheumatic right-sided valve disease with severe pulmonary valve contracture and regurgitation in a symptomatic patient, successfully managed by surgical valvular reconstruction with a tailored bileaflet bovine pericardial patch. The options for surgical approach are also discussed. To our knowledge, the presented rheumatic right-sided valve disease with severe pulmonary regurgitation is the first to be reported in the literature.