OpenMed/multicare-articles huggingface dataset:
Eosinophilic Gastritis in a Patient Previously Treated with Dupilumab
Authors: Masaya Iwamuro, Toshi Murakami, Takehiro Tanaka, Shohei Oka, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

A 77-year-old Japanese man with bronchial asthma was treated with dupilumab. Dupilumab treatment was discontinued at the patient's request after two injections separated by a 2-week interval. The blood eosinophil count was elevated, and an esophagogastroduodenoscopy performed 3 months after dupilumab treatment revealed gastric ulcers; subsequently, eosinophilic gastritis was diagnosed from biopsy examinations. The gastric lesions were resolved by steroid administration. This case report underscores that eosinophil-associated gastrointestinal diseases should be considered in the differential diagnosis of gastric lesions occurring in patients who were treated with dupilumab.
Post-burn breast reconstruction using an artificial dermis-a long-term follow-up
Authors: Yoav Gronovich, Adi Maisel Lotan, Meir Retchkiman
Journal: Burns Trauma (2016)
Keywords: artificial skin, burn reconstruction, burned breast, integra
MeSH terms: Case Reports

Background:
Full thickness burns of the chest in childhood are a devastating problem that requires challenging reconstructive options. Integra is a bilaminate artificial dermis composed of shark chondroitin 6-sulfate and bovine collagen. The dermal matrix serves as a scaffold for fibroblasts and endothelial cells. Vascularization of the matrix begins after 2-3 weeks, and eventually, the matrix incorporates with the tissue to create a new dermis. The main advantage of the Integra is that the neodermis is of the same quality as a native dermis.
Case presentation:
In this case report, we present post-burn breast reconstruction of a 12-year-old girl using Integra, with a long follow-up of 7 years. To the best of our knowledge, there is no published follow-up of breast development after reconstruction with Integra from its beginning point at the age of puberty until after the growing process has terminated.
Conclusions:
Integra is a reliable reconstructive tool for burned breast. If done before puberty, it can help in getting normal developing tissue with satisfying esthetic results of size, shape and symmetry.
Peritoneal Tuberculosis After Robot-Assisted Laparoscopic Prostatectomy with Extended Lymph Node Dissection
Authors: Suruga Saito, Katsuhiro Ito, Keiyu Matsumoto, Motofumi Tajima, Takayuki Goto, Haruki Ito, Yumi Manabe, Mutsuki Mishina, Hiroshi Okuno
Journal: J Endourol Case Rep (2018)
Keywords: complication, extended lymph node dissection, peritoneal tuberculosis, robot-assisted laparoscopic prostatectomy
MeSH terms: Case Reports

Background: Peritoneal tuberculosis (TB) is a relatively uncommon presentation of extrapulmonary TB. Early diagnosis of peritoneal TB is difficult because of its nonspecific clinical manifestation such as abdominal pain, fever, or ascites. Especially early after surgery of abdomen or pelvis, these symptoms can be misdiagnosed as septic peritonitis. There are few reports of peritoneal TB as a postoperative complication of laparoscopic surgery. Here, we describe a first case of peritoneal TB after robot-assisted laparoscopic prostatectomy (RALP) with extended lymph node dissection. Case Presentation: A 78-year-old man presented 25 days after this surgery with fever and abdominal distension. Ultrasonography and computed tomography (CT) revealed massive abdominal ascites. Ascites sample was cloudy, with increased white blood cells and normal creatinine level. No anastomotic leak was found. Bacterial infection of a lymphocele was considered, and cefmetazole 2 g/day for 3 days was prescribed. Despite antibacterial therapy, fever persisted. Polymerase chain reaction testing of ascitic fluid was positive for Mycobacterium tuberculosis. The patient was effectively treated with anti-TB therapy. Conclusion: This is the first report of peritoneal TB as a postoperative complication of RALP with extended lymph node dissection. His preoperative chest CT showed granular shadows in left upper lung, indicating his old asymptomatic TB infection. Flare-up of TB can happen even after robot-assisted laparoscopic surgery, which is minimally invasive. Peritoneal TB must be considered especially when there is unexplained ascites unresponsive to antibiotics.
Unusual Presentation of Priapism Associated with Acute and Chronic Myeloid Leukemia in Two Patients: Emergency Management
Authors: Oumar Gaye, Ngor Mack Thiam, Ayun Cassell, Serigne Mourtalla Gueye, Yaya Sow, Boubacar Fall, Alain Khassim Ndoye
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Priapism is a rare urological emergency. It is rarely a telltale sign of myeloid leukemia. We report two cases of acute myeloid leukemia in a child and chronic myeloid leukemia in a young adult presenting with priapism. Puncture irrigation of the corpora cavernosa followed by systemic treatment to lower the hyperviscosity of the blood due to leukemia provided optimal outcome. Prompt emergency management is required to lower the complication of erectile dysfunction.
[Carotid artery perforation by fish bone - a case report]
Authors: José Julio Bechir Maués, Heather Lynn Hauter Maués, Rafael Maia de Sousa, Luiz Nazareno França de Moura, Isabela Nascimento Duarte Rodrigues
Journal: J Vasc Bras (2022)
MeSH terms: Case Reports

Abstract:
Accidental fish bone ingestion is a common complaint at emergency departments. The majority of cases have a benign course. However, serious complications such as esophagus perforation, cervical vessel injury and cervical abscess can occur in 7.4% of cases. Mortality rates can be as high as 50% when mediastinitis occurs. We report a case of an esophageal perforation caused by a fish bone with a lesion to the right common carotid artery after 20 days of evolution. Surgical exploration occurred with corrections of the lesion in the right common carotid and esophagus. Early identification of this kind of injury is paramount to prevent potentially fatal complications.
Management of perivascular epithelioid cell tumor of the liver: A case report and review of the literature
Authors: Daren Liu, Dike Shi, Yuanliang Xu, Liping Cao
Journal: Oncol Lett (2014)
Keywords: human melanoma black-45, liver, neoplasm, perivascular epithelioid cell tumor

Perivascular epithelioid cell tumor (PEComa) is a rare tumor that originates from mesenchymal tissues. Cases of PEComa in the liver are extremely rare. The present study aimed to analyze the clinical features of PEComa in the liver and discuss its management. Here we report a 25-year-old female with multiple lesions of low density with poorly defined borders in the liver, as shown by a computed tomography (CT) scan. A partial hepatectomy was proceeded and PEComa was diagnosed by immunohistochemistry. No evidence of recurrence was observed during the one year follow-up. A total of 20 patients with hepatic PEComa, including one case from the present study and 19 cases that were reported in literature between June 2001 and December 2012, were reviewed and analyzed. The mean patient age was 43.4 years (range, 25-67 years) and the cases consisted of 18 female and two male patients. The tumor size ranged between 2.0×1.6 and 15.0×12.0 cm. Of the 20 patients, nine were asymptomatic and 11 had mild to significant complaints. Immunohistochemistry plays a key role in the diagnosis of PEComa. All the cases in this study were strongly positive for human melanoma black-45. A surgical resection is the gold standard for curative intent. All the patients underwent a surgical resection and none were administered perioperative chemotherapy or radiotherapy. In total, 13 of the 14 patients with follow-up information survived during the 8-36-month follow-up period and one patient succumbed due to recurrence two years after the surgery.
Cardiac Ambulatory Monitoring: New Wireless Device Validated Against Conventional Holter Monitoring in a Case Series
Authors: Srinivasan Murali, Nicolas Brugger, Francisco Rincon, Manoj Mashru, Stéphane Cook, Jean-Jacques Goy
Journal: Front Cardiovasc Med (2020)
Keywords: holter monitoring, smartcardia patch, atrial fibrillation, cardiac arrhythmias, electrocardiogram, wireless recorder

Background: Cardiac arrhythmias are very common but underdiagnosed due to their transient and asymptomatic nature. An optimization of arrhythmia detection would permit to better treat patients and could substantially reduce morbidity and mortality. The SmartCardia ScaAI wireless patch is a novel CE IIa approved, single-lead electrocardiographic (ECG) ambulatory monitor designed for cardiac arrhythmias detection. Hypothesis: The accuracy of the new SmartCardia wireless patch to detect arrhythmias is comparable to the conventional Holter monitoring. Methods: Patients referred for a suspicion of arrhythmia between February and March 2020 were included in the trial. Simultaneous ambulatory ECG were recorded using a conventional 24-h Holter and the SmartCardia. The primary endpoint was the detection of cardiac arrhythmias over the total wear time of the devices, defined as premature atrial contraction (PAC), supraventricular tachycardia ≥3 beats, premature ventricular contraction (PVC), and ventricular tachycardia ≥3 beats. Conduction abnormalities, pause ≥2 s and atrioventricular block (AVB), were also tracked. McNemar's test was used to compare the matched pairs of data from both devices. Results: A total of 40 patients were included in the trial. Over the total wear time, there was no significant difference between the devices for ventricular and supraventricular arrhythmias detection. Pauses and AVB were equally identified by the two devices in three patients. Conclusion: Over the total wear time, the SmartCardia device showed an accuracy to detect arrhythmia similar to the 24-h Holter monitoring: single-lead, adhesive-patch monitoring might become an interesting alternative to the conventional Holter monitoring.
Diagnostic Dilemma of Disseminated Histoplasmosis Mimicking Hemophagocytosis Lymphohistiocytosis in Patient with Rheumatoid Arthritis on Anti-TNF Therapy: Case Report and Review of the Literature
Authors: Saurav Suman, Aleksander Lenert
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Tumor necrosis factor inhibitors (TNFi) have become the cornerstone for the treatment of rheumatoid arthritis and other systemic autoimmune conditions. However, these biologic DMARDs can lead to various opportunistic infections such as viral infection, tuberculosis, and histoplasmosis. Furthermore, these biologics can also cause severe systemic inflammatory reactions known as hemophagocytosis lymphohistiocytosis (HLH) that can lead to multiorgan failure and high mortality. Due to overlapping clinical features and time-intensive microbiological culture methods, distinguishing between HLH and opportunistic infections can be challenging early in the disease course. We present a similar situation with our patient where the patient met the diagnostic criteria for HLH however was found to have disseminated histoplasmosis. This case uniquely evaluates the utility of the HLH diagnostic criteria and hemophagocytosis for accurate diagnosis of HLH.
Torsion of an Accessory Hepatic Lobe with Embedded Gallbladder: In an 11-Month-Old Boy
Authors: Chiman Lal Thakral, Ganji Shivalingam, Faizan Manzoor Dar, Nimish Thakral
Journal: European J Pediatr Surg Rep (2017)
Keywords: accessory hepatic lobe, omphalocele, torsion of accessory liver lobe
MeSH terms: Case Reports

An accessory lobe of the liver is a rare entity in clinical practice which is diagnosed incidentally. Infrequently, it may present as torsion with a clinical picture of an acute abdomen, a palpable mass, and may be associated with liver function abnormalities. Many of these patients have a history of previous surgery for congenital abdominal wall defects such as omphalocele. We present an extremely rare case of torsion of an accessory hepatic lobe in an 11-month-old male patient who presented in a state of shock. The infant underwent laparotomy and excision of the accessory lobe. Here, we aim to emphasize the importance of prompt management and early resection which is the cornerstone of a favorable outcome.
Acute eosinophilic pneumonia associated with smoking: a case report
Authors: Beenish Fayyaz
Journal: J Community Hosp Intern Med Perspect (2018)
Keywords: acute eosinophilic pneumonia, bronchoalveolar lavage, community-acquired pneumonia, cortcicosteroids, peripheral eosinophilia, tobacco smoking
MeSH terms: Case Reports

Acute eosinophilic pneumonia (AEP) is commonly misdiagnosed as infectious pneumonia due to presence of fever and radiological features. However, development of peripheral eosinophilia within days of presentation should raise the concern of AEP especially in previously heathy adults with history of recent tobacco smoking.
Development of New Deep Venous Thrombosis While on Apixaban
Authors: Munish Sharma, Sabarina Ramanathan, Koroush Khalighi
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

The efficacy of novel oral anticoagulants (NOACs) in preventing deep venous thrombosis (DVT) has been established in large multicenter trials. Predictable pharmacokinetics, avoidance of routine laboratory monitoring, and lesser drug interactions have made NOACs safer and more tolerable treatment option in comparison to warfarin. However, cases of treatment failure mainly due to interindividual variation in plasma drug levels can be seen rarely. In this report we describe a case of acute DVT of right lower extremity in a patient who was on apixaban for prevention of venous thromboembolism (VTE) due to underlying nonvalvular atrial fibrillation (NVAF).
A practical update of surgical management of merkel cell carcinoma of the skin
Authors: Patricia Tai
Journal: ISRN Surg (2013)

The role of surgeons in the treatment of Merkel cell carcinoma (MCC) of the skin is reviewed, with respect to diagnosis and treatment. Most of the data in the literature are case reports. Surgery is the mainstay of treatment. A wide local excision, with sentinel node (SLN) biopsy, is the recommended treatment of choice. If SLN is involved, nodal dissection should be performed; unless patient is unfit, then regional radiotherapy can be given. Surgeons should always refer patients for assessment of the need for adjuvant treatments. Adjuvant radiotherapy is well tolerated and effective to minimize recurrence. Adjuvant chemotherapy may be considered for selected node-positive patients, as per National Comprehensive Cancer Network guideline. Data are insufficient to assess whether adjuvant chemotherapy improves survival. Recurrent disease should be treated by complete surgical resection if possible, followed by radiotherapy and possibly chemotherapy. Generally results of multimodality treatment for recurrent disease are better than lesser treatments. Future research should focus on newer chemotherapy and molecular targeted agents in the adjuvant setting and for gross disease.
The Effect of a New Therapy for Children with Tics Targeting Underlying Cognitive, Behavioral, and Physiological Processes
Authors: Julie B Leclerc, Kieron P O'Connor, Gabrielle J-Nolin, Philippe Valois, Marc E Lavoie
Journal: Front Psychiatry (2016)
Keywords: tourette disorder, children, cognitive–behavioral therapy, psychophysiological, tics, treatment

Tourette disorder (TD) is characterized by motor and vocal tics, and children with TD tend to present a lower quality of life than neurotypical children. This study applied a manualized treatment for childhood tics disorder, Facotik, to a consecutive case series of children aged 8-12 years. The Facotik therapy was adapted from the adult cognitive and psychophysiological program validated on a range of subtypes of tics. This approach aims to modify the cognitive-behavioral and physiological processes against which the tic occurs, rather than only addressing the tic behavior. The Facotik therapy lasted 12-14 weeks. Each week 90-min session contained 20 min of parental training. The therapy for children followed 10 stages including: awareness training; improving motor control; modifying style of planning; cognitive and behavioral restructuring; and relapse prevention. Thirteen children were recruited as consecutive referrals from the general population, and seven cases completed therapy and posttreatment measures. Overall results showed a significant decrease in symptom severity as measured by the YGTSS and the TSGS. However, there was a discrepancy between parent and child rating, with some children perceiving an increase in tics, possibly due to improvement of awareness along therapy. They were also individual changes on adaptive aspects of behavior as measured with the BASC-2, and there was variability among children. All children maintained or improved self-esteem posttreatment. The results confirm the conclusion of a previous pilot study, which contributed to the adaptation of the adult therapy. In summary, the Facotik therapy reduced tics in children. These results underline that addressing processes underlying tics may complement approaches that target tics specifically.
A case report of steroid-refractory bullous pemphigoid induced by immune checkpoint inhibitor therapy
Authors: Shasha Guan, Linlin Zhang, Junyan Zhang, Wenjing Song, Diansheng Zhong
Journal: Front Immunol (2023)
Keywords: bullous pemphigoid, immune checkpoint inhibitor, intravenous immunoglobulin, lung carcinoma, pembrolizumab
MeSH terms: Carcinoma, Non-Small-Cell Lung / drug therapy, Lung Neoplasms / complications, Lung Neoplasms / drug therapy, Pemphigoid, Bullous / chemically induced, Pemphigoid, Bullous / diagnosis, Pemphigoid, Bullous / drug therapy, Case Reports, Aged, Blister / drug therapy, Humans, Immune Checkpoint Inhibitors / adverse effects, Male, Steroids / therapeutic use, Immune Checkpoint Inhibitors, Steroids

The widespread use of immune checkpoint inhibitors in several malignancies has revealed new immune-related adverse events. Bullous pemphigoid (BP) is an antibody-driven autoimmune disease characterized by skin inflammation and fluid-filled bullae. Herein, a 69-year-old man with lung squamous cell carcinoma developed multiple vesicles and tense bullae 3 weeks after the initiation of a programmed death-1 (PD-1) inhibitor, pembrolizumab, and chemotherapy. Biopsy revealed a subepidermal bulla with lymphocytic and eosinophil infiltration, and immunohistochemical studies predominantly showed CD4+ cells, a few CD8+ cells, and the occasional CD20+ lymphocyte. The serum anti-BP180 antibody level, as well as the interleukin-6 and interleukin-10 levels, were elevated compared to the lower levels of tumor necrosis factor-α. Eosinophil levels were high and consistent with the development of blisters. A diagnosis of BP associated with PD-1 inhibitor therapy was made, and the Common Terminology Criteria for Adverse Events classification was grade 3. Immunotherapy was permanently discontinued, and the patient's bullous lesions failed to react to high-dose systemic corticosteroids combined with minocycline and niacinamide. Intermittent blister recurrence occurred in 2 months, eventually improving with the administration of two courses of intravenous immunoglobulin. At 5 weeks of follow-up, the patient's tumor was reduced on a computed tomographic scan. Despite stable BP treatment, however, he repeatedly developed complications due to the complexity of his underlying disease and could not be treated with anti-tumor therapy. Early recognition and management of serious immune-related bullous dermatologic toxicity are essential for patient safety.
Case Report: Talaromyces marneffei Infection in a Chinese Child With a Complex Heterozygous CARD9 Mutation
Authors: Hongjun Ba, Huimin Peng, Liangping Cheng, Yuese Lin, Xuandi Li, Xiufang He, Shujuan Li, Huishen Wang, Youzhen Qin
Journal: Front Immunol (2021)
Keywords: card9 deficiency, card9 mutation, talaromyces marneffei infection, fungal immunodeficiency, immunodeficiency disease
MeSH terms: CARD Signaling Adaptor Proteins / genetics, Liver Diseases / diagnosis, Mycoses / diagnosis, Talaromyces / isolation & purification, Case Reports, Research Support, Non-U.S. Gov't, Antifungal Agents / therapeutic use, China, Exome Sequencing, HIV Seronegativity, Heterozygote, High-Throughput Nucleotide Sequencing, Humans, Infant, Liver Diseases / drug therapy, Liver Diseases / microbiology, Male, Mutation, Mycoses / drug therapy, Mycoses / microbiology, Talaromyces / genetics, Antifungal Agents, CARD Signaling Adaptor Proteins, CARD9 protein, human, Talaromyces marneffei, talaromycosis

Talaromyces marneffei (TM) infection is rarely seen in clinical practice, and its pathogenesis may be related to deficiency in antifungal immune function. Human caspase recruitment domain-containing protein 9 (CARD9) is a key molecule in fungal immune surveillance. There have been no previous case reports of TM infection in individuals with CARD9 gene mutations. Herein, we report the case of a 7-month-old Chinese boy who was admitted to our hospital with recurring cough and fever with a papular rash. A blood culture produced TM growth, which was confirmed by metagenomic next-generation sequencing. One of the patient's sisters had died of TM septicaemia at 9 months of age. Whole exome sequencing revealed that the patient had a complex heterozygous CARD9 gene mutation with a c.1118G>C p.R373P variation in exon 8 and a c.610C>T p.R204C variation in exon 4. Based on the culture results, voriconazole antifungal therapy was administered. On the third day of antifungal administration, his temperature dropped to within normal range, the rash gradually subsided, and the enlargement of his lymph nodes, liver, and spleen improved. Two months after discharge, he returned to the hospital for a follow-up examination. His general condition was good, and no specific abnormalities were detected. Oral voriconazole treatment was continued. Unexplained TM infection in HIV-negative individuals warrants investigation for immune deficiencies.