OpenMed/multicare-articles huggingface dataset:
Lawsonella clevelandensis, a case series of vascular graft infections caused by a rare pathogen
Authors: Shirin I Nour, Ryan B Khodadadi, Audrey N Schuetz, Robin Patel, Omar M Abu Saleh
Journal: IDCases (2023)
Keywords: lawsonella clevelandensis, rare pathogen, vascular graft infection
MeSH terms: Case Reports

Lawsonella clevelandensis is a fastidious Gram-positive, partially acid-fast, anaerobic, catalase positive bacterium that has been reported to be a rare cause of abdominal, breast, spinal, and liver abscesses. Here, three L. clevelandensis vascular graft infections (VGIs) and cardiac infections are reported.
Successful Treatment of Occlusive Left Main Coronary Artery Dissection by Impella-Supported Stenting
Authors: James J Glazier, Amir Kaki, Theodore L Schreiber
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

We report successful treatment of a patient, who, during diagnostic angiography, developed an ostial left main coronary artery dissection with stump occlusion of the vessel. First, mechanical circulatory support with an Impella CP device was established. Then, patency of the left coronary system was achieved by placement of stents in the left anterior descending, left circumflex, and left main coronary arteries. On completion of the procedure, left ventricular systolic function, as assessed by echocardiography, was normal. At 24-month clinical follow-up, the patient remains angina-free and well. This is the first reported case of the use of an Impella device to support treatment of iatrogenic left main coronary artery dissection.
Case report: NAFLD and maple syrup urine disease: Is there an interplay between branched-chain amino acids and fructose consumption?
Authors: Helena Moreira-Silva, Sandra Ferreira, Manuela Almeida, Isabel Gonçalves, Maria Augusta Cipriano, J R Vizcaíno, Ermelinda Santos-Silva, Esmeralda Gomes-Martins
Journal: Front Pediatr (2022)
Keywords: nafld (non-alcoholic fatty liver disease), fructose, graft liver steatosis, liver transplant, maple syrup urine disease (msud), recurrent nafld
MeSH terms: Case Reports

Background:
The worldwide increase in pediatric overweight and obesity, in parallel with the global increase in the consumption of sucrose and fructose, is associated with non-alcoholic fatty liver disease (NAFLD). Elevated branched-chain amino acids (BCAAs) are a metabolic feature related to obesity and an early risk factor for insulin resistance and NAFLD. However, few studies have assessed metabolic risk factors and nutritional status in maple syrup urine disease (MSUD) patients under restricted BCAA and high carbohydrate diets.
Methods and results:
Herein, we present a pilot report of a 17-year-old boy with classic MSUD with poor diet compliance and high fructose consumption, mainly during early adolescence. At that time, he was overweight and developed features of metabolic syndrome, including persistently elevated liver enzymes and hepatic steatosis. He underwent liver transplantation at the age of 13 years to prevent the risk of progressive cognitive impairment. Two months later, NAFLD relapsed in the graft, despite a better BCAA balance and weight loss. Nevertheless, 6 months after dietary restriction of fructose consumption, NAFLD had sustainably improved.
Conclusion:
Childhood overweight and fructose overconsumption are wellestablished driving forces in the development of pediatric NAFLD. However, their role in the early onset and progression of NAFLD in the allograft remains to be established. Furthermore, it is not known whether the dysmetabolic state associated with elevated BCAAs may be contributory. Further studies are required with a cohort of MSUD subjects to validate our findings and to ascertain the possible interaction between a BCAA imbalance and dietary intake in the development of NAFLD.
Solitary granular cell tumor of cecum: a case report
Authors: Kaoutar Znati, Taoufiq Harmouch, Amal Benlemlih, Hinde Elfatemi, Laila Chbani, Afaf Amarti
Journal: ISRN Gastroenterol (2011)
MeSH terms: Case Reports

Granular cell tumor (GCT) was first described by Abrikossof in 1926. This tumor is a benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin. GCT is not common and most often affects the tongue, skin, and soft tissue, although it may occur anywhere in the body. Gastrointestinal tract involvement, and especially that of the colon, is very rare. This usually benign tumor appears as a submucosal nodule, measuring less than 2 cm in diameter and is often found incidentally during colorectal examinations. We describe the case of a 27-year-old man with a GCT in the cecum that was detected after a screening colonoscopy. Endoscopic examination revealed a yellowish submucosal tumor, 0.7 cm in diameter. An endoscopic mucosal polypectomy was done for histological confirmation and treatment.
Sclerosing Angiomatoid Nodular Transformation: Laparoscopic Splenectomy as Therapeutic and Diagnostic Approach at the Same Time
Authors: Calogero Cipolla, Ada Maria Florena, Gabriella Ferrara, Riccardo Di Gregorio, Elettra Unti, Antonino G Giannone, Luigi A Lazzaro, Giuseppa Graceffa, Gianni Pantuso
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiopathogenesis and with definite features of imaging, histopathology, and immunohistochemistry. It was first described by Martel et al. in 2004, and to date, only 151 cases have been reported.
Case description:
We report a case of SANT of the spleen detected in a 66-year-old Caucasian, without comorbidities, presented to our department with epigastric pain. We, also, presented a review of the literature.
Conclusions:
SANT is a benign incidentally vascular condition in the majority of cases. The wide age and gender distribution in our review is in accordance with that in previous studies in English literature. In our opinion, splenectomy is the choice treatment because it is at the same time diagnostic and therapeutic in a definitive way.
Early Disseminated Lyme Carditis Inducing High-Degree Atrioventricular Block
Authors: Connor C Kerndt, John A Bills, Zaid J Shareef, Alexander M Balinski, Daniel F Summers, Jose M Tan
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Lyme disease is the most common tick-borne illness in the United States due to Borrelia burgdorferi infection. This case demonstrates a 20-year-old male patient presenting with complaints of annular skin rash, malaise, fever, and lightheadedness after significant outdoor exposure. Physical exam revealed multiple large targetoid lesions on the back and extremities. The rash had raised borders and centralized clearing consistent with erythema migrans chronicum. Electrocardiogram (ECG) revealed a high-degree atrioventricular (AV) block. The patient was started on intravenous ceftriaxone due to clinical suspicion for Lyme carditis. ELISA and Western blot tests were reactive for Lyme IgM and IgG, confirming the diagnosis. The AV block resolved by hospital day four and the patient was discharged with outpatient follow-up. Early identification of disease allowed for effective treatment with no adverse outcomes or sequelae.
Pulsatile varicose veins: an uncommon presentation of a common condition
Authors: Thilina Gunawardena, Manujaya Godakandage, Balasubramaniyam Saseekaran, Rezni Cassim, Mandika Wijeyaratne
Journal: J Vasc Bras (2021)
Keywords: parkes weber syndrome, pulsatile varicose veins, secondary varicose veins, tri-cuspid regurgitation
MeSH terms: Case Reports

Varicose veins of the lower limbs are common. However, pulsatile varicose veins are unusual. They could be an indicator of a sinister underlying pathology, such as severe cardiac dysfunction. It is easy to miss these rare cases during clinical workup, which can result in futile treatment with potentially dangerous consequences. In this report, we describe 2 cases of pulsatile varicose veins that highlight different etiologies and management strategies for this condition.
Case Report: Management of Cholestasis Associated With Congenital Syphilis
Authors: Kotaro Ogawa, Koya Kawase, Tokio Sugiura, Toshihiro Yasui, Seiya Yamagata, Tamao Watanabe, Yoshikazu Kawabe
Journal: Front Pediatr (2020)
Keywords: treponema pallidum, cholestasis, congenital syphilis, liver fibrosis, syphilis
MeSH terms: Case Reports

Cholestasis is a rare but life-threatening complication of congenital syphilis. However, standard management methods for this disease have not been established. Here, we report a case of congenital syphilis presenting with progressively worsening cholestasis, and we review the clinical features and management practices. In these cases, differentiation from other diseases presenting with cholestasis during the neonatal period, such as biliary atresia, is critical. In this regard, operative cholangiogram and histopathological analysis of the liver are required. Moreover, comprehensive genetic analysis can be useful. Although there is no specific treatment for cholestasis associated with congenital syphilis, appropriate nutritional management and supplementation with fat-soluble vitamins, especially vitamin K, should be provided. The severity of liver fibrosis may affect the prognosis of cholestasis associated with congenital syphilis. Therefore, attention should be paid to liver fibrosis in these patients.
Clinical and molecular characterization of a patient with interstitial 6q21q22.1 deletion
Authors: Elisa Tassano, Marisol Mirabelli-Badenier, Edvige Veneselli, Aldamaria Puliti, Margherita Lerone, Carlotta Maria Vaccari, Giovanni Morana, Simona Porta, Giorgio Gimelli, Cristina Cuoco
Journal: Mol Cytogenet (2015)
Keywords: 6q21q221, array-cgh, interstitial deletion, karyotype/phenotype correlation, poland syndrome
MeSH terms: Case Reports

Background:
Interstitial 6q deletions, involving the 6q15q25 chromosomal region, are rare events characterized by variable phenotypes and no clear karyotype/phenotype correlation has been determined yet.
Results:
We present a child with a 6q21q22.1 deletion, characterized by array-CGH, associated with developmental delay, intellectual disability, microcephaly, facial dysmorphisms, skeletal, muscle, and brain anomalies.
Discussion:
In our patient, the 6q21q22.1 deleted region contains ten genes (TRAF3IP2, FYN, WISP3, TUBE1, LAMA4, MARCKS, HDAC2, HS3ST5, FRK, COL10A1) and two desert gene regions. We discuss here if these genes had some role in determining the phenotype of our patient in order to establish a possible karyotype/phenotype correlation.
Uterine adenocarcinoma with pulmonary, liver and mesentery metastasis in a holstein cow
Authors: George Stilwell, Maria C Peleteiro
Journal: Vet Med Int (2010)
MeSH terms: Case Reports

The clinical and pathology features of a cow with uterine adenocarcinoma and multiple metastasis are described. Weight loss, inappetence, mild respiratory signs, and reduced milk yield were evident on clinical examination. Grossly deformed uterus, enlarged iliac lymph nodes, and rosary arranged nodules in the mesentery were felt by rectal palpation. Right side laparotomy revealed numerous small masses covering the omentum, and mesentery. Euthanasia was performed. Necropsy and histopathology exam revealed a uterine adenocarcinoma with multiple pulmonary, liver and mesentery metastasis. Uterine adenocarcinoma with metastasis should be included in the differential diagnosis of cows showing weight loss and mild respiratory distress and palpation of numerous firm nodules in the mesentery should be suggestive of neoplasias' metastasis.
Pseudoaneurysm of the Pancreaticoduodenal Artery Associated with Duodenal Diverticulitis
Authors: Scarlett B Hao, Dale B Johnson, Hugo J R Bonatti
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Background:
Duodenal diverticula tend to be asymptomatic; however, patients may develop duodenal diverticulitis.
Case presentation:
A 66-year-old Caucasian man presented to our emergency room with a two-day history of right-sided abdominal pain, chills, tachycardia, nausea, and emesis. His WBC, lactic acid, and bilirubin were elevated. CT-scan revealed an inflammatory process involving the gallbladder, the duodenum and ascending colon, a mesenteric soft tissue mass, and a diverticulum of the second portion of the duodenum. He was admitted, antibiotics were started, and he improved clinically over the next 36 hours. Repeat triple contrast CT-scan showed a two cm pseudoaneurysm (PA) of the pancreaticoduodenal artery causing a mesenteric hematoma. The inflammatory changes had significantly improved, and WBC and CRP were normalizing. Repeat CT-scan three days later demonstrated an interval increase in size of the PA. Angiography through celiac access and gastroduodenal artery demonstrated predominant inflow to the PA from the inferior pancreaticoduodenal artery. The superior mesenteric artery was accessed showing a replaced right hepatic artery hindering access to the branch feeding the PA. The patient was transferred to a specialized facility where ultimately occlusion of the PA inflow was obtained. The patient recovered without any complication from this rare condition.
Conclusion:
This seems to be the first reported case of duodenal diverticulitis causing a PA of the pancreaticoduodenal artery. Antibiotic therapy together with percutaneous embolization of the bleeding source resulted in a good outcome.
AL-Amyloidosis Presenting with Negative Congo Red Staining in the Setting of High Clinical Suspicion: A Case Report
Authors: Kristina Bowen, Nina Shah, Matthew Lewin
Journal: Case Rep Nephrol (2012)

A histologic diagnosis of amyloidosis requires acquiring tissue containing amyloid fibrils from an affected organ or alternate site. The biopsy site and staining techniques may influence testing accuracy. We present a case in which systemic amyloidosis was suspected; however, biopsies of the bone marrow, an osteosclerotic bone lesion, arterial and venous vessels, and the fat pad were all negative for the diagnostic Congo red stain. An eventual renal biopsy demonstrated AL-amyloidosis, kappa light chain associated with extensive vascular interstitial, and glomerular, involvement. Choice of biopsy site, as well as staining and analysis of the tissue, can influence sensitivity and specificity of amyloid testing. Fat-pad biopsies are less invasive and offer reasonable sensitivity. Bone marrow samples are only diagnostic up to 63% of the time. A renal biopsy offers improved sensitivity and is generally safe in experienced hands, but is a more invasive procedure with increased number of relative contraindications and complications. The choice of the biopsy site should be based on considering the expected yield, accessibility of the site, and the risks associated with the procedure.
Persistent mycotic superficial femoral artery pseudoaneurysm after endovascular treatment: a case report
Authors: Ruth Fuente, Francisco J Medina, Natalia Moradillo, Ignacio Agúndez, Mónica Herrero, Victoria Santaolalla
Journal: J Vasc Bras (2021)
Keywords: escherichia coli, arterial ligation, endovascular treatment, mycotic pseudoaneurysm, stent thrombosis, superficial femoral artery
MeSH terms: Case Reports

Mycotic pseudoaneurysms of the superficial femoral artery (SFA) are rare and are usually secondary to colonization of an atherosclerotic plaque during an episode of bacteremia. We describe the case of a 68 year-old diabetic male who presented to the Emergency Department with pyrexia and a painful expanding mass in the left thigh. He had a history of diarrhea and had been treated 16 days earlier for an SFA pseudoaneurysm that had been excluded with a covered stent with no adjunctive antibiotic therapy. Angio CT showed an abscess surrounding femoral vessels and stent thrombosis. Under general anesthesia, we performed extensive debridement, removal of the endovascular material, SFA ligation, and empirical antibiotic therapy. Blood and tissue cultures were positive for Escherichia coli. At the 3-months follow up visit, the patient reported he had no claudication. In selected patients, mycotic pseudoaneurysms can be treated by SFA ligation.
Post-Traumatic Pseudoaneurysm of the Superficial Temporal Artery in a Pediatric Patient
Authors: Martine Leeman, Astrid Leus, Caroline Ernst
Journal: J Belg Soc Radiol (2023)
Keywords: pseudoaneurysm, child, head injury, superficial temporal artery, yin-yang sign
MeSH terms: Case Reports

Teaching Point: A pseudoaneurysm of the superficial temporal artery is a rare complication of head injury in a child.
Using taTME to maintain restorative options in locally advanced rectal cancer: A technical note
Authors: José Tomás Larach, Peadar S Waters, Jacob J McCormick, Alexander G Heriot, Philip J Smart, Satish K Warrier
Journal: Int J Surg Case Rep (2020)
Keywords: en-bloc vaginal wall resection, extended resection, r0 resection, rectal cancer, transanal total mesorectal excision, tatme
MeSH terms: Case Reports

Background:
The safe adoption of transanal total mesorectal excision (taTME) has occurred in Australasia as previously reported by the current authors. Planes beyond TME can be utilised in more advanced cases to achieve negative margins during transanal dissection.
Methods:
In this article we describe how taTME is used to perform an en-bloc partial vaginectomy and aid restore intestinal and vaginal continuity in a young female with a locally advanced rectal cancer and posterior vaginal wall involvement in the pre-treatment magnetic resonance imaging.
Results:
The transanal technique allowed the surgeons to remove a disc of vagina, ensure organ preservation and control the main R1 risk point. An R0 resection was achieved.
Conclusion:
This technical note highlights that in experienced hands, taTME may be safely implemented to maintain restorative options in locally advanced rectal cancer requiring resection beyond the total mesorectal excision plane.
Concomitant primary hyperparathyroidism and systemic lupus erythematosus: coincidence or not? A new case report
Authors: Habiba Bennesser Alaoui, Siham Hamaz, Houda Bachir, Ahmed Amine Eloumri, Mohammed Berrimi, Abdellatif Bouayad, Khalid Serraj
Journal: Pan Afr Med J (2020)
Keywords: hypercalcemia, case report, primary hyperparathyroidism, systemic lupus erythematosus
MeSH terms: Hypercalcemia / diagnosis, Hyperparathyroidism, Primary / diagnosis, Lupus Erythematosus, Systemic / complications, Pulmonary Embolism / diagnosis, Case Reports, Adult, Antiphospholipid Syndrome / diagnosis, Female, Humans, Hypercalcemia / etiology, Hyperparathyroidism, Primary / complications, Lupus Nephritis / diagnosis, Osteoporosis / etiology, Pulmonary Embolism / etiology

Primary hyperparathyroidism (PHP) is the most common cause of hypercalcemia. Patients with systemic lupus erythematosus (SLE) can develop hypercalcemia but it is exceptionally due to PHP. There are only few cases of concurrent SLE and primary hyperparathyroidism (PHP) described in the literature. We report a case of a 31-year-old patient having SLE with lupus nephritis class III and anti-phospholipid syndrome, complicated by pulmonary embolism associated to primary hyperparathyroidism causing severe hypercalcemia and osteoporosis. Even if there is no evidence for potential pathogenic association between PHP and SLE, the recognition of this association is very important because of therapeutic and prognostic impact. Early detection of PHP leads to avoid severe complications and significant morbidity.
Laryngocele: a cause of upper airway obstruction
Authors: Jose Antonio de Paula Felix, Felippe Felix, Luiz Fernando Pires de Mello
Journal: Braz J Otorhinolaryngol (2008)
MeSH terms: Airway Obstruction / etiology, Laryngeal Diseases / complications, Case Reports, Review, Airway Obstruction / surgery, Dilatation, Pathologic / complications, Dilatation, Pathologic / surgery, Female, Humans, Laryngeal Diseases / diagnosis, Laryngeal Diseases / surgery, Larynx / pathology, Middle Aged, Tracheotomy

Laryngoceles are abnormal dilatations of the laryngeal saccule, which rises between the ventricular folds, the base of the epiglottis and the inner surface of the thyroid cartilage. Clinical symptoms are rare, and the find of asymptomatic laryngoceles in pathology studies are frequent. Sometimes it is presented as cervical swelling causing airway obstruction in need of emergency intervention. In this study, we report a case of upper airway obstruction due to laryngocele treated by emergency tracheotomy and we review of the literature. Laryngocele complications include infection (pyocele formation), pathogens aspirations with subsequent bronchitis and pneumonia and upper airway obstruction, as in the case reported. Despite being benign tumors, laryngoceles cause relevant airway obstruction. Correct diagnosis and proper treatment can preclude emergencies as it happened to our patient hereby reported.
Mesenteric Cyst: A Case Report
Authors: Hanan E Alqurashi, Abdulrahman A Alaryni, Rani A Alsairafi, Ahlam M Alharbi, Abdullah A Alaqla
Journal: Cureus (2023)
Keywords: cysts, excision surgery, general surgery, mesenteric cyst, mesentery
MeSH terms: Case Reports

Mesenteric cysts are rare benign abdominal lesions that possess the risk of malignant transformation in 3% of reported cases. Most cysts are asymptomatic and diagnosed incidentally or during the management of their complications. In the majority of cases, they arise from the mesentery of the small bowel, followed by the mesocolon. We present a case report of a 20-year-old female with an abdominal mesenteric cyst.
Case Report: Primary graft failure due to a reversed lenticule in Descemet Stripping Automated Endothelial Keratoplasty
Authors: Anahita Kate, Sayan Basu
Journal: F1000Res (2022)
Keywords: descemet stripping automated endothelial keratoplasty, endothelial keratoplasty, graft adhesion, inverted lenticule, primary graft failure
MeSH terms: Corneal Diseases / etiology, Corneal Diseases / surgery, Descemet Stripping Endothelial Keratoplasty / adverse effects, Descemet Stripping Endothelial Keratoplasty / methods, Case Reports, Research Support, Non-U.S. Gov't, Aged, Endothelium, Corneal / transplantation, Humans, Keratoplasty, Penetrating / adverse effects, Male, Visual Acuity

Introduction and importance: This report details the clinical features and management in a case of Descemet stripping automated endothelial keratoplasty (DSAEK) which had primary graft failure (PGF) due to an inverted yet attached lenticule. Presentation of case: A 66-year-old gentleman had poor visual recovery in the right eye after undergoing cataract surgery 12 years prior to presentation. The visual acuity was counting fingers and examination revealed endothelial decompensation. The patient underwent a DSAEK and postoperatively had a well attached lenticule. However, the cornea was edematous three weeks after the surgery and optical coherence tomography (OCT) revealed a reversed lenticule. The patient underwent a repeat DSAEK and had an uneventful postoperative course. The visual acuity was 20/40 after 7 months with a clear cornea and a well attached graft. Discussion: PGF is a rare complication following DSAEK which occurs due to poor endothelial function of the donor graft. Insertion of a reversed lenticule may get overlooked as a cause of PGF unless the graft edge profile is examined on an OCT scan. The graft in the current case was well attached despite its inverted position suggesting that graft adherence is perhaps not a function of the corneal endothelial pumps in isolation and may be driven by factors such as the intraocular pressure. Conclusion: A reversed DSAEK lenticule may have normal adherence to the host stroma and must be considered in cases with PGF. OCT of the graft edge is required for diagnosis before performing a repeat keratoplasty.