OpenMed/multicare-articles huggingface dataset:
Delayed malposition of a double-lumen hemodialysis catheter that caused hemorrhage and hypovolemic shock: A case report
Authors: I-Chen Chen, Shih-Chia Yang, Kuan-Ting Liu, Yen-Hung Wu
Journal: Medicine (Baltimore) (2019)
MeSH terms: Hemorrhage / etiology, Renal Dialysis / adverse effects, Shock / etiology, Vascular Access Devices / adverse effects, Case Reports, Aged, Blood Transfusion / methods, Catheterization, Central Venous / adverse effects, Catheterization, Central Venous / methods, Equipment Failure, Female, Femoral Vein / injuries, Fluid Therapy / methods, Hemorrhage / therapy, Humans, Iliac Vein / injuries, Intubation, Intratracheal / methods, Renal Dialysis / instrumentation, Shock / therapy, Tomography, X-Ray Computed

Rationale:
Double-lumen hemodialysis catheters are commonly used as temporary hemodialysis routes. Complications include infection, thrombosis, cardiac arrhythmia, entrapped guide wire, and malposition. We report a rare complication of delayed hemodialysis catheter malposition that caused retroperitoneal hemorrhage and hypovolemic shock during hemodialysis.
Patient concerns:
A 72-year-old female patient who was receiving hemodialysis was referred to our emergency department because of general discomfort and decreased blood pressure (BP) after her regular hemodialysis. She had undergone surgery for a left forearm arteriovenous pseudoaneurysm and received a temporary hemodialysis catheter insertion via the left femoral vein 2 weeks before. The initial blood examination revealed a mildly decreased baseline hemoglobin level (7.2 g/dL) and hyperkalemia (5.9 mmol/L). Her BP recovered after fluid resuscitation. She was administered hemodialysis again, following which her BP reduced and a change in consciousness developed.
Diagnosis:
Chest and abdominal computed tomographies were performed to exclude acute vascular problems and showed a hemodialysis catheter tip protruding from the left iliac vein and hematoma in the left retroperitoneal space and pelvic cavity.
Interventions:
Intubation, fluid resuscitation, vasopressor administration, and blood transfusion were performed. She was admitted to the intensive care unit. The left femoral hemodialysis catheter was removed.
Outcomes:
Follow-up computed tomography revealed resolution of the retroperitoneal space hematoma. She was transferred to the ordinary ward 18 days later with a stable hemodynamic status. Unfortunately, she developed hospital-acquired pneumonia and arteriovenous shunt infection, and died from respiratory failure and sepsis on the 34th day in our hospital.
Lessons:
Femoral double-lumen catheter malposition is rare and potentially fatal. Emergency physicians should be aware of situations wherein a patient's BP declines markedly soon after a hemodialysis initiation.
Class III treatment with mini-implants anchorage in young adult patients: short and long-term results
Authors: Giuliano Bortolo Maino, Giovanna Maino, Francesca Cremonini, Luca Lombardo
Journal: Dental Press J Orthod (2023)
MeSH terms: Malocclusion, Angle Class III / therapy, Case Reports, Cephalometry, Extraoral Traction Appliances, Humans, Maxilla, Palatal Expansion Technique, Young Adult

Introduction:
Class III malocclusion should be intercepted and treated at early age, to prevent the necessity of future complex and expensive procedures. The orthopedic facemask therapy has the goal to achieve skeletal changes, minimizing side effects on dentition. The use of skeletal anchorage, combined with Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol, may be effective in treating a greater number of growing Class III patients.
Objective:
To summarize the existing evidence-based literature on Class III malocclusion treatment in young adult patients, and to illustrate its application and effectiveness, by presenting an emblematic case report.
Conclusion:
The resolution of the present case, its long-term follow up, along with the studies conducted on a larger sample, demonstrate the effectiveness of the strategic combination of orthopedic and orthodontic treatments by using an hybrid rapid palatal expander and Alt-RAMEC protocol for treating Class III malocclusions in adult patients.
The combination of breast necrosis and chylothorax following the OPCAB
Authors: Feridoun Sabzi, Alireza Yaghoubi
Journal: J Cardiovasc Thorac Res (2016)
Keywords: breast necrosis, complication, coronary artery bypass grafting
MeSH terms: Case Reports

Due to long term patency, the internal mammary artery is considered as a conduit of choice for revascularization of the left anterior descending coronary artery. The internal mammary artery and its accessory branches in addition to perfusing the chest wall structures also contributes to supplying, part of the female breast arteries. In addition, due to the accompaniment of thoracic duct branches with the left internal mammary artery, harvesting may be associated with injury to these branches and contribute to chylothorax. We report a rare case of chylothorax and the breast necrosis following the coronary artery bypass grafting. The chylothorax was started in the second postoperative day and ceased gradually in the 12th day of operation. The breast necrosis appeared in the 3th weeks of operation with pain, and tenderness and black skin color change. The patient underwent total mastectomy in the 4th weeks of operation.
Tophaceous gout and renal insufficiency: a new solution for an old therapeutic dilemma
Authors: Anne-Kathrin Tausche, Carsten Wunderlich, Martin Aringer
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

The prevalence of gout is increasing with increased life expectancy. Approximately half of the patients with gout have some degree of renal impairment. If both conditions persistently coexist, and in severe tophaceous gout, in particular, treatment has been difficult. We here report on the case of an 87-year-old woman, who had been suffering from recurrent gouty arthritis over 4 years. Monthly polyarthritis attacks were accompanied by subcutaneous tophi. Serum uric acid levels were constantly above 600 μmol/L (10 mg/dL). Allopurinol was no option because of intolerance, while benzbromarone was ineffective because of renal impairment. Therefore, the novel xanthin oxidase inhibitor febuxostat was started, achieving rapid control of serum urate levels (<360 μmol/L). After initial worsening of inflammation in the first weeks, gouty attacks stopped and all tophi resolved within the following 10 months. Renal function remained stable.
Empyema due to Streptococcus Pneumoniae Serotype 9V in a Child Immunized with 13-Valent Conjugated Pneumococcal Vaccine
Authors: Murat Sütçü, Hacer Aktürk, Fatih Karagözlü, Ayper Somer, Nezahat Gürler, Nuran Salman
Journal: Balkan Med J (2017)
Keywords: 13-valent pneumococcal conjugate vaccine, empyema, streptococcus pneumoniae serotype 9v
MeSH terms: Empyema / etiology, Pneumococcal Vaccines / standards, Streptococcus pneumoniae / pathogenicity, Case Reports, Child, Preschool, Humans, Male, Pneumococcal Vaccines / pharmacology, Pneumococcal Vaccines / therapeutic use, Serogroup, Streptococcal Infections / epidemiology, Streptococcal Infections / physiopathology, Turkey / epidemiology, 13-valent pneumococcal vaccine, Pneumococcal Vaccines

Background:
Clinical vaccine failure is the occurence of the specific vaccine-preventable disease in an appropriately and fully vaccinated person after enough time has elapsed for protection against the antigens of the vaccine to develop. Fully immunized cases with pneumoccal vaccine may sometimes develop a complicated pneumonia with empyema caused by a vaccine serotype.
Case report:
A 2 year-old male patient was admitted with the complaints of fever. On the basis of findings and laboratory results, the patient was diagnosed as having empyema. He was successfully treated with parenteral antibiotics and chest tube drainage. The pleural fluid culture and hemoculture of the patient yielded penicillin-susceptible pneumococci and the isolate was identified as serotype 9V. The patient had been vaccinated with a 13-valent pneumococcal conjugate vaccine according to the Turkish national immunization schedule at 2, 4, 6 and 12 months of age. His medical history and basic immunological profile were inconsistent with a primary immunodeficiency.
Conclusion:
The failure of the PCV13 vaccine may results in a complicated pneumonia with empyema. It is important to investigate serotypes of pneumococci in these cases to determine other possible vaccine failures due to PCV13 and to study the underlying mechanisms.
Recurrent pericarditis in a patient with Bardet-Biedl syndrome: A case report
Authors: Angela Mauro, Francesca Casini, Emanuele Chittano Congedo, Sara L'assainato, Francesca Pinto, Valentina Ansuini, Ruggiero Mascolo, Alice Pedroli, Luca Bernardo
Journal: Front Pediatr (2022)
Keywords: bardet–biedl syndrome, anakinra, autoinflammatory disease, children, recurrent pericarditis
MeSH terms: Case Reports

Bardet-Biedl syndrome is a rare autosomal recessive disorder characterized by rod-cone dystrophy, renal dysfunction, obesity, learning difficulties, hypogonadism, polydactyl, and many other minor features that can affect the cardiovascular, locomotive, neurological, and endocrine systems. We report the case of a 16-year-old boy affected by Bardet-Biedl syndrome who presented with recurrent pericarditis with an optimal response to treatment with Anakinra. To our knowledge, this is the first description of an association between Bardet-Biedl syndrome and recurrent pericarditis.
A Patient with an Ileocecal MiNEN and a Synchronous Squamous Non-Small-Cell Lung Cancer: Case Report and Review of the Literature
Authors: Santiago Teran, Maria Camara Jurado, Juan Antonio Nuñez Sobrino
Journal: Case Rep Oncol Med (2021)
MeSH terms: Case Reports

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare tumors composed of two different histological components, one of which is of a neuroendocrine origin. Given its suggested underdiagnosis and consequent low prevalence, no clear diagnostic and treatment guidelines are available, and treatment usually follows regimens similar to that of the most aggressive component. On the other hand, multiple primary tumors (MPTs) are also rare neoplastic entities that usually confer a challenge regarding treatment options, for a regimen that comprises both the primary and the synchronous/metachronous malignancy should be used. Here, we discuss the challenging diagnostic and therapeutic management of a patient with an ileocecal MiNEN that presented along with a synchronous squamous non-small-cell lung cancer (SQ-NSCLC). The patient presented with intestinal obstruction symptoms for which he underwent an emergency resection of the ileocecal MiNEN. An initial CT scan showed an additional lung mass later identified as an SQ-NSCLC after bronchoscopy biopsy analysis. Given the rapid hepatic metastatic progression, palliative platinum-based chemotherapy was initiated, with an adequate response of the local and metastatic lesions of the MiNEN, but suggested platinum resistance and progression of the pulmonary neoplasm. Second-line treatment with pembrolizumab directed for the SQ-NSCLC was initiated; however, it was stopped after immune-mediated toxicities developed. A third-line chemotherapy scheme with carboplatin/gemcitabine was initiated, but central nervous system (CNS) progression developed, with the patient dying 11 months after initial diagnosis.
Adrenalectomy for solitary recurrent hepatocellular carcinoma five years after living donor liver transplantation: A case report
Authors: Mohamed Abdel Wahab, Ahmed Shehta, Eman M Ibrahim, Rehab T Eldesoky, Ahmed A Sultan, Khaled R Zalata, Omar Fathy, Mohamed Elshoubary, Tarek Salah, Amr M Yassen, Mohamed Elmorshedi, Ahmed Monier, Ahmed Farouk, Usama Shiha
Journal: Int J Surg Case Rep (2019)
Keywords: adrenalectomy, direct-acting antiviral agents, hepatocellular carcinoma recurrence, living donor liver transplantation

Introduction:
The adrenal gland is a rare site for hepatocellular carcinoma (HCC) recurrence after living-donor liver transplantation (LDLT). Solitary adrenal recurrence can be managed by surgical excision, with expected better survival outcomes. We describe a rare case of successful left adrenalectomy of solitary recurrent HCC in the left adrenal gland 5 years after LDLT.
Presentation:
59 years male patient with HCC complicating chronic HCV infection received a right hemi-liver graft from his son. The actual graft weight was 1208 g and GRWR was 1.5. The patient started oral direct acting antiviral drugs for recurrent HCV 2 years after LDLT. A left adrenal mass was detected on follow up radiology. No other metastatic lesions were detected on metastatic workup. Left adrenalectomy was done by an anterior approach. The postoperative course was uneventful and was discharged a week after operation. Postoperative pathological and immune-histochemical examinations confirmed the metastatic HCC nature of the mass. The patient is under regular follow up with no recurrences 6 month after resection.
Discussion:
There is no consensus regarding the management of HCC recurrence after LDLT. Most patients had multi-organ recurrences and usually offered palliative or supportive care. Solitary HCC recurrence offers a better chance for more aggressive therapy, offering better prognosis.
Conclusion:
Solitary adrenal recurrence of HCC after LDLT is extremely rare. Strict follow up protocol is necessary to allow early detection of tumor recurrence. Curative surgical resection is a safe option associated with low morbidity and expected to have a good long-term survival.
Extraction of Unerupted Maxillary Canine Teeth in a Maned Wolf ( Chrysocyon brachyurus)
Authors: Lourdes M B Pessoa, Marcello Roza, Anderson Farias, Pedro Henrique de Jesus, Rita de Cassia Campbell, Mariângela Pereira de Pinho
Journal: Case Rep Vet Med (2016)
MeSH terms: Case Reports

The purpose of this case report is to describe the diagnosis and treatment of unerupted canine teeth in a maned wolf. After physical examination, complete blood count, and serum biochemical profile, the animal underwent general anesthesia and head radiography was performed to confirm the diagnosis. The treatment consisted of the extraction of both maxillary canine teeth and clinical and radiographic follow-up of the right mandibular canine tooth.
Radiographically negative, asymptomatic, sentinel lymph node positive cutaneous T-cell lymphoma in a 3-year-old male: a case report
Authors: Jeffrey Carson, Jiri Bedrnicek, Shahab Abdessalam
Journal: Case Rep Pediatr (2012)

We present a case of a 3-year-old male originally diagnosed with a CD30+ anaplastic cutaneous T-cell lymphoma with no evidence of systemic disease after CT scan, PET scan, and bone marrow aspiration. Sentinel lymph node biopsy (SLNB) was performed as an additional step in the workup and showed microscopic disease. Current management/recommendations for cutaneous T-cell lymphoma do not include SLNB. Medical and surgical management of cutaneous malignancies is dramatically different for local versus advanced disease. Therefore adequate evaluation is necessary to properly stage patients for specific treatment. Such distinction in extent of disease suggests more extensive therapy including locoregional radiation and systemic chemotherapy versus local excision only. Two international case reports have described SLNB in cutaneous T-cell lymphoma with one demonstrating evidence of node positive microscopic disease despite a negative metastatic disease workup. This case is being presented as a novel case in a child with implications including lymphoscintigraphy and SLNB as a routine procedure for evaluation and staging of cutaneous T-cell lymphoma if the patient does not demonstrate evidence of metastatic disease on routine workup.
Collagenous fibroma (desmoplastic fibroblastoma) with vertebral body erosion
Authors: Vladimir Osipov, Guillermo F Carrera
Journal: Sarcoma (2009)
MeSH terms: Case Reports

Collagenous fibroma (desmoplastic fibroblastoma) is a recently described rare benign tumor affecting mainly males in the fifth through seventh decades. This tumor occurs predominantly in the peripheral sites, with predilection for upper and lower extremities. The patients present with a painless mass of involving subcutis, with one quarter of all cases involving skeletal muscle. Both radiographically and histologically these tumors are well-circumscribed small lesions from one to several centimeters in diameter, though lesions as large as 20 cm have been reported. We report a case of collagenous fibroma presenting symptomatically as a 2.4 cm mass within the pedicle and adjacent transverse process of the L5 vertebral segment. Bone erosion by desmoplastic fibroblastoma is very rare event. This tumor should be in the differential diagnosis of the soft tissue lesions presenting with bony erosion.
Effects of pioglitazone on nonalcoholic steatohepatitis in a patient with anorexia nervosa: A case report
Authors: Tomohiko Ohno, Yoichi Nishigaki, Tetsuya Yamada, Yuko Wakahara, Hiroyasu Sakai, Kotaro Yoshimura, Masahito Shimizu, Toshio Usui, Masaya Saito, Ichiro Yasuda, Hisashi Tsurumi, Eiichi Tomita, Hisataka Moriwaki
Journal: Exp Ther Med (2014)
Keywords: malnutrition, pioglitazone, steatohepatitis

Diseases associated with metabolic syndromes are of major concern in developed countries. Nonalcoholic steatohepatitis (NASH) is one of the manifestations of metabolic syndrome in the liver. Previous studies have shown that NASH is also caused by malnutrition. In the present study, a case of malnutrition-associated NASH in a 66-year-old female with anorexia nervosa is reported. The patient had a body mass index (BMI) of only 11.1 kg/m2 and serum alanine aminotransferase levels of 1,495 IU/l. Steatohepatitis with fibrosis was confirmed by percutaneous liver needle biopsy. Total parenteral nutrition was conducted at first, followed by the administration of Stronger Neo-Minophagen C (a glycyrrhizin-containing preparation), ursodeoxycholic acid and prednisolone. The abnormal elevation of aminotransferase levels of the patient was prolonged and total bilirubin levels increased. Pioglitazone (15 mg/day), which has been identified to be effective for nonalcoholic steatohepatitis, was then administered. This resulted in marked reductions in aminotransferase and bilirubin levels within three months. Histological improvement of the liver was also confirmed by percutaneous liver needle biopsy after one year. The observations in the present case suggest that pioglitazone may be useful for the treatment of malnutrition-associated NASH.
Pseudaneurysm of the superolateral genicular artery following an anterior cruciate ligament reconstruction
Authors: L Glanz
Journal: Int J Surg Case Rep (2020)
Keywords: anterior cruciate ligament, complications, false aneurysm, pseudoaneurysm, pulsatile mass, vascular injury
MeSH terms: Case Reports

Introduction:
Arthroscopic procedures are a safe way nowadays to do anterior cruciate ligament reconstruction. Rare complications involve injuries to popliteal vessels or one of its branches.
Presentation of case:
We present a case of a young patient who undergone an anterior cruciate ligament reconstruction. This procedure was associated with a meniscal suture. The follow-up was marked by pseudoaneurysm of the supero-lateral genicular artery.
Discussion:
This is the first time a pseudoaneurysm of this branch is described in the literature as we discovered it. The treatment by an ultrasonography-guided embolization with thrombin was proceeded and suceeded.
Conclusion:
We stress the fact with new arthroscopic procedures and techniques, new complications can occur, and we should be attentive to them and new symptoms consequently, as a painless mass on the lateral side of the knee, to ensure a fast and optimal treatment.
Kikuchi-Fujimoto Disease in an Old Italian Woman: Case Report and Review of the Literature
Authors: A D'Introno, A Perrone, A Schilardi, A Gentile, C Sabbà, N Napoli
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Kikuchi-Fujimoto disease (KFD) is a rare, benign, generally self-limiting disease that has higher prevalence in Asian people with a few cases reported in European countries. It generally affects young subjects under 40 years of age and is characterized by regional lymphadenopathy. Here, we present a case of a 66-year-old Italian woman who was extensively examined for right unilateral laterocervical lymph nodes associated with fever, night sweats, fatigue, and weight loss. She was diagnosed as having the KFD only after an excision biopsy of the largest laterocervical lymph node and was then managed symptomatically with NSAIDs. We also made a review of the literature for better awareness of the disease among physicians especially in those countries, like Italy, where the disease is not prevalent and may be frequently misdiagnosed. In fact, to our best knowledge, only seven Italian cases of KFD have been published in the last 15 years with patients being younger than 40 years. We finally highlight that it is noteworthy to consider KFD as differential diagnosis of lymphadenopathy even in old patients, and, since a misdiagnosis of lymphoma is actually feasible, an early biopsy has to be taken into account for confirming diagnosis and helping in the timely and appropriate management.
Wound Infection with an Unusual Pathogen after Liver Transplantation
Authors: Sara Ghaderkhani, Zahra Ahmadinejad, Habibollah Dashti, Masoomeh Safaei, Fereshteh Ghiasvand
Journal: Case Rep Transplant (2020)
MeSH terms: Case Reports

Mucormycosis is a rare and highly invasive fungal infection caused by Mucorales fungi of the class Zygomycetes. Cutaneous mucormycosis typically has a good survival rate when diagnosed early. In this report, we presented a patient with surgical site mucormycosis after liver transplant surgery. Our patient was a 50-year-old man with cirrhosis due to nonalcoholic steatohepatitis who received liver transplant from a deceased donor. On the 8th day of transplant, the patient had fever and purulent discharge from the surgical site. The wound became black and necrotic in the next day. A microbiologic study showed mycelium in wound culture. The smear of the discharge was positive for aseptate hyphae, and the report of fungal culture revealed Rhizopus sp. In the histopathologic examination, mucormycosis was confirmed. The combination of antifungal and surgical debridement was a successful treatment in this case. Cutaneous fungal infections should be considered in the differential diagnosis of any nonhealing or black scar-infected wound that does not respond to broad-spectrum antibiotics.