OpenMed/multicare-articles huggingface dataset:
Use of a dual lumen cannula for venovenous extra corporeal membrane oxygenation in a patient with acute respiratory distress syndrome and a previously inserted inferior vena cava filter: a case report
Authors: Fernando Palizas Jr, Christian Casabella García, Mariano Norese
Journal: Rev Bras Ter Intensiva (2016)
MeSH terms: Extracorporeal Membrane Oxygenation / methods, Respiratory Distress Syndrome / therapy, Vena Cava Filters, Case Reports, Aged, Cannula, Extracorporeal Membrane Oxygenation / instrumentation, Humans, Male, Pulmonary Embolism / prevention & control

Extracorporeal membrane oxygenation is used in refractory hypoxemia in many clinical settings. Thoracic trauma patients usually develop acute respiratory distress syndrome. Due to high risk of bleeding, thrombotic complications present in this context are particularly difficult to manage and usually require insertion of an inferior vena cava filter to prevent embolism from the distal veins to the pulmonary circulation. Here, we present a case of a thoracic trauma patient with severe acute respiratory distress syndrome requiring venovenous extracorporeal membrane oxygenation via a right internal jugular double lumen cannula due to a previously inserted inferior vena cava filter caused by distal bilateral calf muscle vein deep vein thrombosis.
Successful Brace Treatment of Pectus Carinatum in Osteogenesis Imperfecta Using the Dynamic Compression System
Authors: Beth A Orrick, Amy L Pierce, Charles L Snyder, Uri S Alon
Journal: European J Pediatr Surg Rep (2019)
Keywords: dynamic compression system, osteogenesis imperfecta, pectus carinatum
MeSH terms: Case Reports

Osteogenesis imperfecta (OI) is a genetic disorder of collagen resulting in a "fragile" skeleton with increased fracture risk and other complications, dependent on the specific variant. Pectus deformities of the chest wall, while not common, can be associated with OI. The use of a pectus carinatum brace in a patient with OI poses unknown risks for fractures and adverse treatment outcomes. We successfully applied external compression bracing using the dynamic compression system to one such patient. This case illustrates the ability to treat an OI patient with pectus carinatum using a nonsurgical brace, without complications, resulting in an excellent cosmetic result.
Transjugular Approach to Closure of Patent Foramen Ovale Under the Guidance of Fluoroscopy and Transthoracic Echocardiography: A Case Report
Authors: Lu He, Jian-Ying Xue, Ya-Juan Du, Xue-Gang Xie, Xing-Ye Wang, Yu-Shun Zhang
Journal: Front Cardiovasc Med (2022)
Keywords: atrial septal aneurysm, closure, inferior vena cava thrombosis, patent foramen ovale, transjugular
MeSH terms: Case Reports

Background:
We describe a rare case of patent foramen ovale (PFO) associated stroke in a patient with pulmonary embolism, inferior vena cava thrombosis and undergoing filter implantation who successfully underwent PFO closure using the right internal jugular venous approach.
Case summary:
This is a rare case of a 42-year-old patient who presented with stroke and pulmonary embolism and was diagnosed with a PFO, inferior vena cava thrombosis and underwent filter implantation. The patient suffered from stroke and pulmonary embolism successively; that is, embolic events occurred in both the arterial and venous systems. Transesophageal echocardiography (TEE) showed a PFO with an atrial septal aneurysm (ASA), which we considered a "pathological" PFO. Due to the obstructive nature of the inferior vena cava approach, we successfully performed PFO closure via the right internal jugular venous approach under the guidance of X-ray and transthoracic echocardiography (TTE).
Discussion:
The right jugular venous approach provides a simple technical solution for patients who require PFO closure when femoral venous access is unavailable, which can be performed under X-ray and TTE guidance.
Rebleeding of a Splenic Artery Aneurysm after Coil Embolisation
Authors: Kyra D Kingma, Antonius N van der Linden, Rudi M H Roumen
Journal: Case Rep Surg (2016)

Background. Splenic artery aneurysm (SAA) is an uncommon and difficult diagnosis. SAA is more common in females. Only 20% of SAA is symptomatic and may present as a rupture. A ruptured SAA is associated with a 25% mortality rate. Case Presentation. We present a case of a male patient with a bleeding SAA that rapidly increased in size. Distal coiling was technically impossible and despite proximal coil embolisation the SAA continued to bleed. A laparotomy including splenectomy and partial pancreatectomy was performed with an uneventful patient recovery. Discussion. Endovascular management is currently considered the optimal treatment of SAA. However, careful monitoring and follow-up is needed after embolisation as rapid recanalization of the SAA may possibly occur, especially when distal coiling of the aneurysm is unsuccessful. Conclusion. Endovascular treatment of an SAA is not necessarily effective. Surgeons must be prepared to perform open procedures to further reduce mortality rates.
Benzylthiouracil-induced glomerulonephritis
Authors: Sihem Trimeche Ajmi, Rim Braham, Sarra Toumi, Molka Chadli Chaieb, Amel Maaroufi, Koussay Ach, Larbi Chaieb
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Vasculitis is a rare complication of antithyroid drugs (ATDs). It was first described with Propylthiouracil (PTU). We report a new case of antineutrophil cytoplasmic antibody (ANCA) vasculitis with glomerulonephritis induced by Benzylthiouracile (BTU). A 50-year-old man with Graves disease treated with BTU developed general malaise and haematuria without skin rash or respiratory involvement. Laboratory data revealed acute renal failure with proteinuria and haematuria. An indirect immunofluorescence test for ANCA was positive, showing a perinuclear pattern with specificity antimyeloperoxidase (MPO). A renal biopsy was performed and revealed pauci-immune extracapillary glomerular nephropathy and necrotic vasculitis lesions. Based on these findings we concluded to the diagnosis of rapidly progressive glomerulonephritis associated with ANCA induced by BTU therapy. The drug was therefore discontinued and the patient was treated with steroids and immunosuppressive treatment during 3 months. Renal failure, proteinuria and haematuria significantly improved within 2 months. However, P-ANCA remained positive until 10 months after drug withdrawal. Thyroid function was kept within normal range using iodine solution. We demonstrated clearly that BTU may induce severe forms of vasculitis with glomerulonephritis. Thus, the ANCA must be measured when confronted to systemic manifestation during treatment.
Contralateral diaphragmatic palsy in acute stroke: an interesting observation
Authors: Sudhir Kumar, Rajesh Reddy, Subhashini Prabhakar
Journal: Indian J Crit Care Med (2009)
MeSH terms: Case Reports

Diaphragmatic palsy in hemiparetic stroke is not well recognized. Further, its implications on stroke outcome have not been studied. Here, we report a patient with left-sided diaphragmatic palsy due to an acute right middle cerebral artery territory infarction. The diagnosis was suspected on finding an elevated dome of the diaphragm on the left side in a routine chest radiograph and was confirmed by finding decreased movements of the left hemidiaphragm on fluoroscopic examination. We hypothesize that this condition is probably under-recognized in clinical practice and its clinical importance not well known. The pathophysiological basis of diaphragmatic palsy in acute stroke and its possible clinical implications are discussed.
Case report: Two siblings with neuronal intranuclear inclusion disease exhibiting distinct clinicoradiological findings
Authors: Yutao Liu, Li Zeng, Yanpeng Yuan, Yangyang Wang, Kai Chen, Yan Chen, Jiaying Bai, Feng Xiao, Yuming Xu, Jing Yang, Song Tan
Journal: Front Neurol (2022)
Keywords: notch2nlc gene, mitochondrial encephalopathy, neuronal intranuclear inclusion disease, ribbon sign, siblings
MeSH terms: Case Reports

Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder characterized by the presence of eosinophilic hyaline intranuclear inclusions. Owing to its widely varying clinical manifestations, NIID is frequently misdiagnosed or overlooked. However, a characteristic high-intensity corticomedullary junction signal on diffusion-weighted imaging (DWI) is often indicative of NIID. In this study, we described the case of two sisters with NIID who presented with distinct symptoms and imaging data. The younger sister showed symptoms similar to those of mitochondrial encephalopathy, with a reversible high-intensity signal from the cortex on T2 and DWI. The elder sister showed a characteristic high-signal "ribbon sign" in the corticomedullary junction on DWI. Skin biopsy confirmed that both had neuronal intranuclear inclusion. Two years later, the younger sister also developed the characteristic high-signal "ribbon sign" in the corticomedullary junction on DWI. This case study provides new insights into the complexity of NIID. The findings suggest that patients with this condition, including those belonging to the same family, may exhibit varying clinical and imaging features at different times.
Intracranial Germinoma Misdiagnosed as Hyperthyroidism: A Case Report and Review of the Literature
Authors: Juan Tian, Jialu Wu, Zhe Yan, Hui Huang
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: central diabetes insipidus, hyperthyroidism, hypopituitarism, intracranial germinoma, radiotherapy
MeSH terms: Brain Neoplasms / diagnostic imaging, Germinoma / diagnostic imaging, Hyperthyroidism / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Review, Adrenal Insufficiency / blood, Adrenal Insufficiency / etiology, Brain Neoplasms / complications, Brain Neoplasms / radiotherapy, Diagnostic Errors, Germinoma / complications, Germinoma / radiotherapy, Humans, Hyperprolactinemia / blood, Hyperprolactinemia / etiology, Hyperthyroidism / blood, Hyperthyroidism / etiology, Hypogonadism / blood, Hypogonadism / etiology, Magnetic Resonance Imaging, Male, Thyrotropin / blood, Thyroxine / blood, Triiodothyronine / blood, Young Adult, Triiodothyronine, Thyrotropin, Thyroxine

Intracranial germ cell tumors (GCTs) are relatively rare, which account for 0.5% of all primary intracranial neoplasms. Intracranial germinomas most commonly occur in the pineal and suprasellar region, making up the majority of all intracranial GCTs. For its diversified clinical manifestations, the diagnosis is easily confused with other diseases. Here, we present a case of a 19-year-old boy with intracranial germinoma who was preliminarily misdiagnosed as hyperthyroidism for the symptoms of weight loss and thyroid dysfunction.
A Case Report of a Subdural Hematoma following Spinal Epidural prior to a Total Knee Arthroplasty
Authors: Brian J Carlson, David G Deckey, Henry D Clarke, Joshua S Bingham
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Introduction:
This case report adds to current literature on management of a subdural hematoma following total knee arthroplasty and is particularly important as joint replacement moves into outpatient surgery centers where the orthopedic surgery team becomes the sole patient contact point. Case Presentation. A 66-year-old male presented to the emergency department five days after elective robotic-assisted left total knee arthroplasty performed with spinal epidural with the symptoms of a persistent nonpostural headache. CT of the head revealed a small bifrontal acute subdural hematoma. He was admitted for overnight monitoring as a precaution. No vascular abnormalities or underlying pathology was found on further advanced imaging. He was discharged the following morning after follow-up CT showed no focal changes. Magnetic resonance imaging (MRI) one month later confirmed resolution of the subdural hematoma.
Conclusion:
Orthopedic surgeons should be aware of the signs and symptoms, as well as the risk factors for subdural hematomas following lumbar puncture, as it is a rare, but potentially life-threatening complication of spinal epidural.
Case Report: Pulmonary sarcomatoid carcinoma complicating TP53 mutation treated successfully with Tislelizumab combined with Anlotinib-a case report
Authors: Yu-Feng Li, Xin-Fei Zhao, Yue Tian, Xin-Yao Xiao, Cai-Yun Yan, Hua Shen
Journal: Front Genet (2022)
Keywords: anlotinib, tp53 mutation, tislelizumab, case report, hepatitis c, pulmonary sarcomatoid carcinoma
MeSH terms: Case Reports

Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of lung malignant tumor. Conventional chemotherapy has a suboptimal effectiveness. PSC has the characteristics of rapid disease progression and poor prognosis. We herein report a 56-year-old male patient with substantial smoking history was pathologically diagnosed as PSC, cT4N0M0 IIIA stage. Peripheral blood NGS showed TP53 mutation. The patient had poor tolerance to the first-line chemotherapy regimen "albumin paclitaxel + cisplatin," but the severe anemia was significantly improved after 5 days of anti-angiogenic therapy with Anlotinib. At this time, the patient received anti-PD-1 immunotherapy with Tislelizumab. Half a month later, degree III liver injury occurred repeatedly. After excluding drug-induced liver injury, we found that HCV-RNA 3.10 × 105 IU/ml and suspended all anti-tumor therapy. After the start of anti-HCV treatment with Epclusa, the treatment of Tislelizumab combined with Anlotinib was restarted, and there was no liver injury after that. The patient received monthly maintenance therapy with Tislelizumab combined with Anlotinib to the present. The pulmonary lesions continued to decrease, and only one lung cavity is left. The patient has achieved clinical complete remission (CCR) with PSF over 20 months. Our findings suggest that Tislelizumab combined with Anlotinib may be a preferred strategy in PSC complicating TP53 mutation. Core tip: Immune-check point inhibitors (ICIs) have been reported for the treatment of PSC in a small number of case reports and retrospective analysis, but there are few reports of ICIs combined with anti-angiogenic drugs. This patient was diagnosed as locally advanced PSC complicated with TP53 mutation and hepatitis C. After 14 cycles of Tislelizumab combined with Anlotinib treatment (during the course of treatment, several courses were not treated on time for economic reasons, rather than adverse reactions), the patient has achieved CCR. III degree liver injury occurred during the treatment, and the liver function returned to normal range after anti-hepatitis C treatment, which did not affect the continued treatment of this regimen.
Successful transarterial embolization with cellulose porous beads for occipital haemangioma in an infant with Kasabach-Merritt syndrome
Authors: Zaw Aung Khant, Toshinori Hirai, Osamu Ikeda, Eiji Furukoji, Yoshihito Kadota, Minako Azuma, Norihiro Shinkawa, Keiji Kitatani, Yoichi Mizutani, Kimihiko Endo, Yasuyuki Yamashita
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

We report a 3-month-old boy with Kasabach-Merritt Syndrome (KMS) with an occipital haemangioma who underwent successful transarterial embolization (TAE) with cellulose porous beads (CPBs). As his response to steroids and coil embolization was inadequate, we performed TAE with CPBs, carefully preventing their migration via dangerous anastomoses. The tumour blush decreased, there were no complications, all coagulation tests were immediately normalized and the tumor size decreased gradually. TAE with CPBs is useful for the treatment of KMS.
Spontaneous Iliopsoas Hematoma following Microvascular Free Tissue Transfer
Authors: Jeffrey D Markey, A Sean Alemi, Margaret L Naunheim, Daniel L Faden, Chase M Heaton, Rahul Seth
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Spontaneous hematoma within the iliopsoas muscle (SIH) is a rare complication most commonly seen in coagulopathic patients. Often, patients undergoing microvascular free tissue transfer are anticoagulated for anastomotic patency. Here we describe two cases of postoperative SIH following contralateral anterolateral thigh (ALT) free tissue transfer for reconstruction of oncologic head and neck defects. Both patients described hip pain after mobilization and had a corresponding acute blood loss anemia. Diagnosis of SIH was confirmed by CT and both patients were managed conservatively. Given that anticoagulation is a common practice following head and neck free tissue transfer, surgeons should be aware of this potential complication.
A case report of spindle cell (sarcomatoid) carcinoma of the larynx
Authors: Harry Boamah, Billy Ballard
Journal: Case Rep Med (2012)

Spindle cell carcinoma (SpCC) or sarcomatoid carcinoma is a highly malignant variant of squamous cell carcinoma which comprises 2% to 3% of all laryngeal cancers. It is considered to be a biphasic tumor that is composed of a squamous cell carcinoma (in situ or invasive) and spindle cell carcinoma with sarcomatous appearance. Most spindle cell tumors are polypoid and pedunculated; they are often detected at an early stage, removed by polypectomy during diagnosis, and tend to have a very good prognosis. We present a case of spindle cell carcinoma in a 67-year-old Caucasian male who presented with progressive hoarseness of his voice, dysphagia, odynophagia and a 20-pound weight loss. The patient underwent direct laryngoscopy with excision of the malignant mass and received radiation therapy. His symptoms gradually improved, and he regained good control of his voice.
Case Report: Various Abnormalities in Lipid and Glucose Metabolism Induced by Capecitabine
Authors: Takatoshi Anno, Tomoki Yamatsuji, Koichi Tomoda, Shuhei Nakanishi, Hideaki Kaneto
Journal: Front Oncol (2021)
Keywords: capecitabine, dyslipidemia, hypercholesterolemia, hyperinsulinemia, hypertriglyceridemia, metabolic disorder
MeSH terms: Case Reports

Capecitabine has been used for the treatment of various types of tumors. The rare side effects induced by capecitabine have been reported as hypertriglyceridemia, acute pancreatitis associated with hypertriglyceridemia and hypertriglyceridemia complicated with hyperglycemia. The mechanisms of capecitabine-induced hypertriglyceridemia are unclear. In this report, we present a subject with sigmoid colon cancer and capecitabine-induced dyslipidemia. LDL-cholesterol level was markedly elevated throughout the long period of treatment with capecitabine. In addition, triglyceride level was high and not stable during the treatment period. Her dyslipidemia was ameliorated by the treatment with 5 mg of rosuvastatin, which is one of the HMG-CoA reductase inhibitors.
Ocular Jarisch-Herxheimer Reaction in the Treatment of Ocular Syphilis: A Case Report and Review of the Literature
Authors: Noranida Abd Manan, Azlan Azha Musa, Pooi Wah Lott, Mimiwati Zahari, Iqbal Tajunisah
Journal: Cureus (2023)
Keywords: jarisch-herxheimer, macular atrophy, macular edema, ocular syphilis, syphilis uveitis
MeSH terms: Case Reports

Jarisch-Herxheimer reaction (JHR) is a transient clinical phenomenon in patients with syphilis who receive antibiotic treatment. A 31-year-old man with an underlying HIV infection presented with worsening vision in the right eye two days after being treated with oral doxycycline for presumed left-eye neuroretinitis. Prior history revealed two episodes of penile discharge and ulcers that were not investigated. Examination showed bilateral optic disc swelling with right eye placoid chorioretinitis around the macula. Optical coherence tomography (OCT) demonstrated right macular edema and left macular thinning. Blood investigations confirmed syphilis infection. Subsequently, the patient was scheduled for a contrasted brain CT with oral steroid coverage due to underlying allergies. His vision incidentally improved soon after the short course of steroids. Repeated OCT demonstrated marked improvement of right macular edema, which we believe was secondary to JHR initiated by the earlier doxycycline treatment. Following oral steroid addition, improvement in vision and ocular findings were seen. At six-month post-treatment, there was right macular atrophy as a sequela of the macular edema. Ophthalmologists should be aware of ocular-related JHR complications, particularly in potentiating macular atrophy following macular edema upon initiating antibiotic treatment in syphilitic disease.
Clinical repercussions of Glanders (Burkholderia mallei infection) in a Brazilian child: a case report
Authors: Eusébio Lino Dos Santos Júnior, Juliane de Carvalho Rocha Moura, Bruna Karoline Pinheiro França Protásio, Vanise Aragão Santos Parente, Maria Helena Neves Dorea Veiga
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Burkholderia mallei / isolation & purification, Glanders / diagnosis, Case Reports, Child, Glanders / drug therapy, Humans, Male

Glanders is a relatively unknown zoonotic disease caused by Burkholderia mallei. This bacterium affect solipeds and humans, and can be used as a biological warfare. Glanders is characterized as an occupational disease. We report the case of an 11-year-old boy who was presented to an emergency department with chest pain and dyspnea. He evolved into septic shock, pneumonia, and multiple abscesses. B. mallei was found in the exudate culture. Human infection is rare and difficult to confirm. The knowledge on glanders is important for differential diagnosis from other serious illnesses causing pneumonia and multiple abscesses.
A Case Report on Chikungunya Virus-Associated Encephalomyelitis
Authors: Harsh Khatri, Heli Shah, Dhara Roy, Kaushalendra Mani Tripathi
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Chikungunya is a rerising alphavirus infection that has resulted from enhanced vector competence. Alphaviruses are divided into arthritogenic viruses (old world) and encephalitogenic viruses (new world) including equine encephalitis viruses. Chikungunya is a dengue-like illness characterized by acute febrile polyarthralgia, arthritis, malaise, body ache, rash, headache, and nausea. The illness is self-limiting. The neurological manifestations are uncommon and incorporate meningoencephalitis, myelitis, Guillain-Barre syndrome, cranial nerve palsies, myelopathy, and neuropathy; MRI abnormalities in patients with encephalopathy from India have been reported in the form of multiple punctuate white matter lesions that are more prominent on diffusion-weighted MRI than on T2 or T1. Here, we present an intriguing case of chikungunya encephalomyelitis who presented to our tertiary care hospital with quadriparesis and urinary retention. He was treated with 5 doses of intravenous immunoglobulin along with supportive care with which he showed partial recovery.
Where Did the Pericardial Effusion Go? A Case of Cardiopulmonary Resuscitation Acting as Treatment for Pericardial Tamponade
Authors: Varun Tej Gonuguntla, Parita Soni, Nishil Dalsania, Ravi Karan Patti, Somal Navjot, Seneviratne Chanaka, Yizhak Kupfer
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Pericardial tamponade results in multiple organ dysfunction and can lead to cardiac arrest. Cardiopulmonary resuscitation (CPR), a life-saving measure performed on patients in cardiac arrest, can lead to thoracic organ damage. However, CPR rarely acts as a therapeutic treatment for pericardial tamponade. Our case describes a patient admitted with pericardial tamponade in whom CPR provided therapeutic treatment with pericardial rupture and resolution of the tamponade.
Treatment of Nonclassic 11-Hydroxylase Deficiency with Ashwagandha Root
Authors: Daniel Powell, Taiga Inoue, Gül Bahtiyar, Gabriel Fenteany, Alan Sacerdote
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

An elderly woman presented with acne and male pattern alopecia, which upon diagnostic evaluation was found to be due to nonclassic 11-hydroxylase deficiency. We previously reported that Ashwagandha root ameliorates nonclassic 3-β-ol dehydrogenase and aldosterone synthase deficiencies. This is the first report of its use being associated with amelioration of nonclassic 11-hydroxylase deficiency, where its apparent effects appear to be dose-related.