OpenMed/multicare-articles huggingface dataset:
Contraceptive Implant-Related Acute Ulnar Neuropathy: Prompt Diagnosis, Early Referral, and Management Are Key
Authors: Ayman Saeed, Nitisha Narayan, Ankur Pandya
Journal: Eplasty (2018)
Keywords: complications, contraception, implant, neuropathy, ulnar nerve
MeSH terms: Case Reports

Objective: Subdermal contraceptive implants are a well-established method of contraception. Aside from common side effects such as irregular menstrual periods, headaches, and weight gain, rarer complications related to their insertion and removal have been reported. These include traumatic peripheral neuropathy after procedures to remove nonpalpable implants. Only 2 cases of ulnar neuropathy after insertion of a contraceptive implant have been described in the literature, one which resolved spontaneously and another in which postoperative recovery was not described. We report a case of acute ulnar nerve neuropathy in a patient postinsertion of a contraceptive implant who achieved symptom resolution after prompt referral and treatment at a specialist plastic surgery center. Methods: A 22-year-old, right-hand-dominant woman presented 1 day postinsertion of a contraceptive implant (Implanon) in her left arm with paresthesia along the ulnar distribution of her hand and forearm, as well as shooting pain on palpating the course of the ulnar nerve. Ultrasonography found the implant to be lying in the subfascial plane of the inner arm. Results: The implant was found lying in the perineurium of the ulnar nerve, causing ulnar nerve neuropathy. A review 3 months after removal of the implant showed near-complete resolution of her symptoms. Conclusions: Complications related to implantable contraceptives may lead to significant morbidity. Appropriate training for health care professionals administering the devices is essential, as well as early referral to a specialist center to prevent permanent damage.
Yellow Fever Virus RNA in Urine and Semen of Convalescent Patient, Brazil
Authors: Carla M Barbosa, Nicholas Di Paola, Marielton P Cunha, Mônica J Rodrigues-Jesus, Danielle B Araujo, Vanessa B Silveira, Fabyano B Leal, Flávio S Mesquita, Viviane F Botosso, Paolo M A Zanotto, Edison L Durigon, Marcos V Silva, Danielle B L Oliveira
Journal: Emerg Infect Dis (2018)
Keywords: brazil, yfv, convalescent patient, flavivirus, semen, urine, vector-borne infections, virus diagnostics, viruses, yellow fever, yellow fever virus
MeSH terms: Semen / virology, Yellow Fever / epidemiology, Yellow fever virus / genetics, Case Reports, Research Support, Non-U.S. Gov't, Letter, Aged, Brazil / epidemiology, Humans, Male, RNA, Viral / analysis, RNA, Viral / urine, Semen / chemistry, Sequence Analysis, DNA, Yellow Fever / urine, RNA, Viral

Yellow fever virus RNA is usually detected in blood of infected humans. We detected virus RNA in urine and semen samples from a convalescent patient. A complete virus genome was sequenced for an isolate from a urine sample. This virus had a South American I genotype and unique synapomorphic changes.
Pelvic Venous Congestion Secondary to a Circumaortic Renal Collar in an Adolescent Female: Report of a Case
Authors: Verónica Alonso-Arroyo, Jose Javier Velasco, Sonia Pérez-Bertólez, Maria Elena Molina, Jose Manuel Marugan-de-Miguelsanz, Alberto Sanchez-Abuin, Oscar Dario Gomez Beltran
Journal: European J Pediatr Surg Rep (2021)
Keywords: embolization, pelvic pain, phlebographie, renal vein
MeSH terms: Case Reports

We report a 13-year-old girl who presented with a recurrent abdominal pain that started after her menarche. The abdominal palpation revealed tenderness over the left ovarian point. The laboratory study, ultrasonography, and abdominal X-ray were normal. The computed tomography and magnetic resonance imaging showed a double left renal vein with a retroaortic component, an increased left parauterine circulation, and ipsilateral ovarian vein engorgement. A diagnostic and therapeutic phlebography allowed a selective catheterization of a group of pelvic varicose veins draining to the left ovarian and to the internal iliac veins. There were no complications during the procedure and the symptoms disappeared 2 days later. Circumaortic left renal vein may cause hematuria, proteinuria, pelvic congestion syndrome, and massive hemorrhage during surgery. A conservative treatment is recommended for patients without gynecourological/renal symptoms or with mild hematuria. The endovascular treatment by gonadal venous embolization is safe and effective.
Case Report: Anti-N-Methyl-D-Aspartate Receptor Encephalitis Manifesting With an Isolated Psychiatric Episode and Normal Ancillary Tests
Authors: Denis Pavǎl, Claudia Mihaela Cîmpan, Nicoleta Gherghel, Laura Otilia Damian, Nicoleta Tohǎnean, Ioana Valentina Micluţia
Journal: Front Psychiatry (2022)
Keywords: nmda, autoimmune encephalitis, autoimmune psychosis, case report, isolated, neuronal antibodies
MeSH terms: Case Reports

The majority of patients with anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis present with psychiatric symptoms and subsequently develop neurological features. However, isolated psychiatric episodes occur in <5% of affected individuals, less frequent at disease onset (<1%) compared to relapse (4%). We report the case of a previously healthy 24-year-old female who presented with psychotic symptoms and behavioral alterations. Despite therapy, she showed no improvement and subsequently developed catatonic features. While the ancillary tests were normal, the clinical warning signs raised the suspicion of anti-NMDAR encephalitis which we later confirmed. Given its strong association with underlying tumors, we screened the patient and found an ovarian teratoma. Once removed, the patient displayed a substantial improvement in the mental status. Besides being extremely rare, this case illustrates the need to maintain clinical suspicion of anti-NMDAR encephalitis even in the absence of neurological features or paraclinical anomalies.
Persistent Elevation of CA 19-9 Levels in the Long-term Follow-up before Laryngeal Cancer
Authors: Hasan Özkan, Fatih Karakaya, Zihni Karaeren, Sibel Perçinel
Journal: Euroasian J Hepatogastroenterol (2017)
Keywords: ca 19-9, laryngeal cancer, severe reflux disease, squamous cell carcinoma
MeSH terms: Case Reports

Introduction:
CA 19-9 is used as a tumor marker in colon, pancreas, biliary, and gastric cancers. Laryngeal cancer is the most common malignant epithelial tumor among head and neck cancers and has no specific tumor marker.
Case report:
A 66-year-old male patient had severe reflux symptoms during 5 years and had an isolated CA 19-9 elevation. Follow-up analysis revealed that he had larynx cancer and after laryngectomy, CA 19-9 levels decreased to normal range.
Discussion:
Currently, CA 19-9 is not a marker for malignancy. Laryngeal carcinoma has no specific tumor marker, but laryngeal squamous cell carcinoma may be manifested by elevated CA 19-9 levels.How to cite this article: Özkan H, Karakaya F, Karaeren Z, Perçinel S. Persistent Elevation of CA 19-9 Levels in the Long-term Follow-up before Laryngeal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(1):92-94.
Isolated jejunal perforation following bicycle handlebar injury in adults: a case report
Authors: Kyriakos Neofytou, Maria Michailidou, Athanasios Petrou, Sakis Loizou, Charalampos Andreou, Marios Pedonomou
Journal: Case Rep Emerg Med (2013)

The small intestine is the third in frequency intraperitoneal organ which is injured after blunt trauma of the abdomen. In most of the cases, this type of injuries is accompanied by other injuries, which make it more difficult to diagnose. Failure of diagnosis and delay in treating these injuries significantly increase the morbidity and mortality of these patients. Abdominal visceral injuries after flipping the handlebar of the bike are common in children. Such injuries can cause injury to both solid and hollow abdominal viscera. Unlike children, adults' abdominal visceral injuries after flipping the bike's handlebar are extremely rare. A 25-year-old man was admitted to our department due to progressively abdominal pain after an accident with the handlebar of his bike. The subsequent CT scan after per os administration of contrast medium revealed the presence of free intraperitoneal contrast. It is a rare case of jejunal perforation after flipping the handlebar of the bicycle which was treated by partial removal of the injured part of jejunum and end-to-end anastomosis. To the best of our knowledge this is the first time we describe such an injury with this mechanism to an adult.
A case of meningitis due to Achromobacter xylosoxidans in a child with a polymalformative syndrome: a case report
Authors: Mehdi Borni, Mohammed Znazen, Fatma Chaker Borni, Mohamed Zaher Boudawara
Journal: Pan Afr Med J (2021)
Keywords: achromobacter xylosoxidans, antibiotics, case report, meningitis
MeSH terms: Achromobacter denitrificans / isolation & purification, Anti-Bacterial Agents / administration & dosage, Gram-Negative Bacterial Infections / diagnosis, Meningitis, Bacterial / diagnosis, Case Reports, Retracted Publication, Abnormalities, Multiple / physiopathology, Female, Gram-Negative Bacterial Infections / microbiology, Gram-Negative Bacterial Infections / therapy, Humans, Hydrocephalus / diagnosis, Hydrocephalus / therapy, Infant, Meningitis, Bacterial / microbiology, Meningitis, Bacterial / therapy, Syndrome, Anti-Bacterial Agents

Achromobacter xylosoxidans (AX), also called alcaligenes xylosoxidans, is an aerobic, non-fermenting mobile, gram-negative bacillus which was first isolated in an otorrhea samples in 1971. Infections with these species are quite rare and have often been described in immunocompromised and in premature infants. However, very few cases of meningitis related to AX have been reported in the literature. The authors report a new case of meningitis due to AX in a 45-day-old female infant with polymarformative syndrome meningitis was confirmed by a cyto-biochemical analysis and culture of the cerebrospinal fluid and was treated by antibiotherapy. Hydrocephalus was managed initially with external ventricular drainage followed by a ventriculoperitoneal shunt after rigorous cerebrospinal fluid (CSF) sterilization, with good clinical and radiological outcomes. The prompt and adequate antibiotic adjustment following bacterial isolation has been shown to rapidly modify the clinical outcomes.
Living Donor Liver Transplantation for Hepatic Venoocclusive Disease/Sinusoidal Obstruction Syndrome Originating from Hematopoietic Stem Cell Transplantation
Authors: Kentaro Ichimura, Norio Kawamura, Ryoichi Goto, Masaaki Watanabe, Yoshikazu Ganchiku, Tsuyoshi Shimamura, Akinobu Taketomi
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Background:
Venoocclusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a life-threatening hematopoietic stem cell transplantation (HSCT) complication. Cases of mild and moderate VOD/SOS are self-limiting; however, the mortality for severe VOD/SOS has reached 80%. Recently, defibrotide became available and has been used for VOD/SOS; however, the outcome for patients with severe VOD/SOS is not satisfactory, and liver transplantation is attempted in these severe cases.
Method:
We describe a case of living donor liver transplantation (LDLT) for acute liver failure secondary to VOD/SOS that originates from HSCT.
Result:
Liver regeneration after LDLT was impaired, and several infections were developed before liver regeneration completion. Our patient suffered sepsis and finally died of multiorgan failure.
Conclusion:
Severe VOD/SOS originating from HSCT is associated with a very poor prognosis. The liver transplantation outcome for VOD/SOS has not been satisfied, but it may provide long-term survival if successful. We considered liver transplantation as a therapeutic option, especially in cases where sufficient graft volume is secured, considering impaired liver regeneration under bone marrow suppression after HSCT.
Pneumocystis Jirovecii Pneumonia in a Kidney Transplant Recipient 13 Months after Transplantation: A Case Report and Literature Review
Authors: Dominykas Varnas, Augustina Jankauskienė
Journal: Acta Med Litu (2021)
Keywords: kidney transplant recipients, pneumocystis jirovecii, pneumocystis pneumonia, case report
MeSH terms: Case Reports

Summary background:

Pneumocystis jirovecii pneumonia (PCP) is an opportunistic and prevalent fungal infection in immunocompromised hosts, including patients after kidney transplantation (KTx). It is a life threatening infection. While with effective prophylaxis it became less common, it still remains an issue among solid organ transplant (SOT) recipients during the first year. There are no specific clinical signs for PCP. Computed tomography (CT) is a better method for detecting PCP, but definite diagnosis can only be made by identification of the microorganism either by a microscopy or by a polymerase chain reaction (PCR).
Clinical case:
We present a case of a 17 year old with severe PCP 13 months after KTx followed by reduction in kidney function and respiratory compromise. The pathogen was detected by PCR from bronchoalveolar lavage fluid (BALF) and patient was treated successfully with trimethoprim-sulfamethoxazole (TMPSMX). Patient's condition, respiratory status and kidney function gradually improved. Our presented case is unusual because patient had no known risk factors for PCP and he was more than one year after KTx, what is considered rare. In addition patient and his parents delayed in notifying the treating physician about ongoing symptoms because did not deem them important enough.
Conclusions:
Clinicians treating patients in risk groups for PCP must always remain vigilant even in era of effective prophylaxis. The vigilance should also extend to the patient and patient's family.
Peritoneal tunnels: A site at risk for treatment failure when performing treatments for peritoneal metastases. A case series of 2 patients
Authors: Paul H Sugarbaker
Journal: Int J Surg Case Rep (2019)
Keywords: cytoreductive surgery, hipec, hepatic bridge, inguinal canal, pseudomyxoma peritonei, reoperative surgery, residual disease

Background:
Peritoneal metastases from gastrointestinal cancer can be treated by a combination of surgery to remove visible evidence of disease and perioperative intraperitoneal chemotherapy to eradicate microscopic disease. Complete cytoreduction is necessary for long-term benefit.
Methods:
Two sites for incomplete cytoreduction because tumor is hidden from visual inspection were identified. Patients who developed recurrence at these anatomic sites were studied.
Results:
A peritoneal tunnel along a patent processus vaginalis allowed tumor to be sequestered along the inguinal canal in a female patient. A peritoneal tunnel beneath a hepatic bridge over the round ligament obscured mucinous tumor in a male patient.
Conclusions:
Peritoneal tunnels in the inguinal region or at the porta hepatis should be opened by surgical dissection so that all foci of peritoneal metastases are removed at a complete cytoreductive surgery and these sites treated with chemotherapy.
Multiple symmetric lipomatosis: a diagnostic dilemma
Authors: Mladen Mimica, Danijel Pravdic, Emina Nakas-Icindic, Maja Karin, Emil Babic, Monika Tomic, Milenko Bevanda
Journal: Case Rep Med (2013)

Introduction. Multiple symmetric lipomatosis, or Madelung's disease, is a rare condition which is characterized with large symmetrical accumulation of noncapsulated fat tissue in upper arms, neck, and shoulder areas. The disease etiology is unknown, with the highest incidence in the Mediterranean region. Case Presentation. Here, we present the case of Madelung's disease with symmetric fat distribution throughout the neck and history of alcoholism. The patient was treated from several diseases associated with alcoholism and hospitalized several times, but the diagnosis of Madelung's disease was omitted. The thyroid gland disease was excluded, while enlargement of the neck adipose tissue was attributed to obesity. Conclusions. This study points out possible diagnostic mistakes when a physician is not aware of a differentiation diagnosis of symmetrically enlarged neck masses, especially in geographic regions with high incidence of this disease.
Primary Pancreatic Burkitt's Lymphoma: A Case Report and Review of the Literature
Authors: Venkata Rajesh Konjeti, Gerald M Hefferman, Sravanthi Paluri, Prerna Ganjoo
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Primary pancreatic lymphoma (PPL) is of very rare occurrence as an extra nodal site of Non-Hodgkin's lymphoma (NHL). It represents less than 1% of NHL. Out of which Burkitt lymphoma of pancreas is of a rare presentation. It usually occurs in children and presenting in adults is uncommon. The prevalence of pancreatic Burkitt lymphoma is not known as the incidence is significantly low. Clinical features of PPL are predominantly nonspecific and can become difficult with associated inflammation of pancreas. Differentiation of lymphoma to adenocarcinoma is important as chemotherapy is the main stay of treatment in lymphoma. We report a case of 68-year-old female who presented with nonspecific symptoms and was found to have obstructive jaundice secondary to pancreatic head neoplasm which was proved to be pancreatic Burkitt lymphoma which is a rare presentation.
Creutzfeldt-jakob disease as a cause of cognitive decline and seizures in the elderly: diagnostic pointers and strategy for investigation
Authors: R Williams, F Cresswell, M McClure, R Lane
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Cognitive decline affects one in twenty people over the age of 65. There is often a paucity of clues as to the underlying pathology, and while the diagnosis will usually prove to be either Alzheimer's disease or vascular dementia, there may be clinical features suggesting rarer alternatives. This case of a 71-year-old lady with a 3-month history of progressive cognitive decline illustrates clinical features suggestive of Creutzfeltd-Jakob disease such as rapid decline in conscious level and myoclonic jerking. Diagnosis was confirmed by 3 means: (1) Electroencephalogram demonstrating periodic sharp wave complexes, (2) MRI brain showing cortical ribboning and high signal in the caudate nucleus, and (3) presence of protein S100 and protein14-3-3 in the cerebrospinal fluid. Postmortem brain histology confirmed a typical spongiform encephalopathy. Establishing an underlying aetiology is dementia is important not only for prognostic reasons but in order to detect potentially reversible causes. In cases of an atypical dementing illness our proposed investigations may assist in confirming or excluding underlying Creutzfeltd-Jakob disease.
Can Orthodontic Treatment Be Stable 20 Years after the End of the Treatment Scheme? Treatment of a Class 2, Division 1 Malocclusion with Severe Skeletal Discrepancy and Its 20-Year Follow-Up
Authors: Domenico Aiello, Riccardo Nucera, Stefania Costa, Michele Mario Figliuzzi, Sergio Paduano
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Class II malocclusions, after class I malocclusions, are the most frequent in the juvenile Italian population. They are most often skeletal in origin and due to mandibular retrusion. Functional devices seem to have a beneficial effect on the growth of the jaw. Long-term maintenance of the achieved results is essential for therapeutic success in any orthodontic treatment; moreover, the retention phase should last as long as possible, especially in the lower anterior sector. A female patient aged 10 years and 3 months presented a visibly convex profile and a severe mandibular retrusion. The anamnesis brought to light the habit of oral breathing and lower-lip sucking. The cephalometric analysis showed a normodivergent skeletal class II. The first treatment phase involved the use of a Bass type for 12 months at the end of the functional treatment; the second phase of fixed therapy was carried out following the principles of bioprogressive techniques. The photos at the end of treatment show an important improvement in the profile; a full class I ratio of molar and canine teeth was achieved with an excellent interarch relationship and a correction of the V-shaped upper arch. The result is occlusally and profilometrically stable after 2, 4, 5, 10, 14, and 20 years. The maintenance of a stable orthodontic result over time is the result not only of a correct and physiological occlusion but also and above all of a correct diagnosis and correct identification of problems that can cause the malocclusion itself. Flawed habits such as interposition of the lower lip and oral breathing must be intercepted and corrected early in order to correct them and not affect the long-term result of orthodontic treatment. In this case, a functional device associated with an orthodontic fixed finishing and a correct retention phase were necessary to correctly treat a second-class mandibular retrusion whose result remained stable 20 years after the end of therapy.
Case report: Coronavirus Disease 2019 (COVID-19) modified RNA vaccination-induced Adult-Onset Still's Disease with fulminant myocarditis as initial presentation
Authors: Mi Zhou, Chun Ka Wong, Wan Yin Winnie Yeung, Chung Wah Siu, Lixue Yin
Journal: Front Cardiovasc Med (2023)
Keywords: adult-onset still's disease (aosd), autoimmune disease, mrna vaccine, myocarditis, vaccine
MeSH terms: Case Reports

Myocarditis is a rare complication of Coronavirus Disease 2019 (COVID-19) vaccination. We report a case of an elderly female who presented initially with acute myocarditis, fulminant heart failure, and atrial fibrillation after receiving a modified ribonucleic acid (mRNA) vaccine (BNT162b2). Unlike other patients with vaccine-induced myocarditis, she developed persistent fever, sore throat, polyarthralgia, diffuse macular rash, and lymphadenopathy. After extensive investigation, she was diagnosed with post-vaccination Adult-Onset Still's Disease. The systemic inflammation gradually subsided after the use of non-steroidal anti-inflammatory drugs and systemic steroids. She was discharged from hospital with stable hemodynamics. Methotrexate was subsequently given to maintain long-term remission.
Perinatal/Neonatal case presentation: pulmonary artery sling associated with respiratory distress
Authors: David Healey, Nitin Ron, Andrew Hromada, Manoj Chhabra
Journal: Springerplus (2016)
Keywords: cardiovascular, congenital, developmental origins of health and disease, infant, neonate, pulmonary artery sling, stovepipe trachea

Pulmonary artery sling is a very rare cause of pediatric respiratory distress. The estimated prevalence of the disease was first determined by Yu et al. in 2008 as 59 per million school-aged children. Associated symptoms are cough, wheezing, and feeding difficulty, all of which are common in routine outpatient pediatric clinical encounters. We report a case of a premature male neonate twin who was admitted to the neonatal intensive care unit with respiratory distress and pneumothorax. His presentation, as well as the etiology of his pulmonary disease, was felt to be consistent with those of numerous other premature infants. Akin to this was his delayed discharge on account of his slow progress with oral feeding. Parents gave a history of tachypnea and feeding difficulty to his doctors. He presented twice to the emergency room in respiratory distress. At 4 months of age, while in hospital for a pulmonary infection, he had an echocardiogram that revealed a pulmonary artery sling. We review the literature on this vascular anomaly, discuss its diagnosis and management, and critique the clinical thinking that determined this child's course from the perspective of availability heuristics.