OpenMed/multicare-articles huggingface dataset:
Cat scratch disease in a 23-year-old male-Case report
Authors: Radeyah Waseem, Muskan Seher, Sohiba Ghazal, Hussain Haider Shah, Ume Habiba
Journal: Front Public Health (2023)
Keywords: bartonella henselae, cat scratch disease, fever, infection, lymphadenopathy
MeSH terms: Bartonella henselae, Bites and Stings, Cat-Scratch Disease / diagnosis, Cat-Scratch Disease / drug therapy, Case Reports, Adolescent, Adult, Anti-Bacterial Agents / therapeutic use, Azithromycin, Child, Humans, Male, Young Adult, Anti-Bacterial Agents, Azithromycin

Cat-scratch disease (CSD) is an infectious disease that usually presents with fever, headache, loss of appetite, weight loss, tender lymphadenopathy, and other symptoms. CSD is also the most common cause of infectious lymphadenitis in children, adolescents, and young adults. This contagious disease most often results from a scratch or bite of a cat. The course of this disease depends on the patient's immune status. CSD sometimes presents as a systemic disease and leads to various disease entities. In this study, we describe the case of a 23-year-old man exhibiting fever, generalized weakness, and neck swelling. The patient was unconscious when presented to the Emergency Department. He was given at least 3-4 liters IV bolus of 0.9% normal saline, but it failed to raise the blood pressure. He was then given an inotropic drug (noradrenaline) for low blood pressure and antibiotics (azithromycin) for fever. Venereal disease research laboratory (VDRL) and human immunodeficiency virus (HIV) serology came out negative. Histopathology ruled out tuberculosis and malignancy and confirmed necrotizing/suppurative granulomatous inflammation. These features favor the diagnosis of CSD.
Cryptococcal Osteomyelitis of the Left Acetabulum: A Case Report
Authors: Changning Zhou, Jing Zhang, Yang Chen, Xing Ding, Fen Chen, Kai Feng, Kuntao Chen
Journal: Curr Med Imaging (2023)
Keywords: cryptococcus, acetabulum, case report, osteoarticular cryptococcosis, osteomyelitis, skeletal infection
MeSH terms: Cryptococcus, Hepatitis B, Chronic, Osteomyelitis / diagnostic imaging, Osteomyelitis / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Acetabulum / diagnostic imaging, Female, Humans, Retrospective Studies

Background:
Cryptococcus, as a classical "opportunistic" fungal pathogen, is capable of disseminating an invasive infection in immunocompromised hosts. The primary sites of infection include the respiratory and central nervous systems, and skeletal infection was rarely reported. In this case, we describe a case of cryptococcal osteomyelitis involving the left side of the acetabulum in a Chinese patient with chronic hepatitis B.
Case presentation:
We retrospectively reviewed the case of a female (with chronic hepatitis B) with left acetabulum pain and limited mobility, with fever occurring during the infection who presented to the Fifth Affiliated Hospital of Zunyi Medical University. Upon imaging, we found osteolytic bone destruction in the left acetabulum with inflammatory changes in the surrounding bone and soft tissue, accompanied by abscess formation. Following an 11-month of antifungal therapy, the clinical symptoms improved and the lesion area reduced in size. In addition, there was no sign of recurrence.
Conclusion:
Cryptococcus infections should be considered in the differential diagnosis of infectious osteolytic bone lesions, particularly when patients with immune insufficiency. Pathological examinations and fungal cultures are essential to provide a differential diagnosis.
Proximal 21q deletion as a result of a de novo unbalanced t(12;21) translocation in a patient with dysmorphic features, hepatomegaly, thick myocardium and delayed psychomotor development
Authors: Cathrine Jespersgaard, Ida N Damgaard, Nanna Cornelius, Iben Bache, Niels Knabe, Maria J Miranda, Zeynep Tümer
Journal: Mol Cytogenet (2016)
Keywords: 21q22, monosomy 21, partial monosomy, translocation
MeSH terms: Case Reports

Background:
IInterstitial 21q deletions can cause a wide spectrum of symptoms depending on the size and the location of the deletion. It has previously been suggested that the long arm of chromosome 21 can be divided into three regions based on the clinical severity of the patients and deletion of the region from 32.3 Mb to 37.1 Mb was more crucial than the deletion of other regions.
Case presentation:
In this study we describe a female patient with dysmorphic features, hepatomegaly, thick myocardium and psychomotor delay. Conventional karyotyping was initially interpreted as full monosomy 21, but subsequent chromosome microarray analysis suggested an approximately 18 Mb partial monosomy. Re-evaluation of the karyotype and fluorescence in situ hybridization revealed deletion of the proximal 21q11.2-q22.11 segment and insertion of 21q22.11-qter to 12qter. The deletion of the present case overlaps with two of the proposed regions including part of the proposed crucial region.
Conclusions:
This report emphasizes the relevance of investigating suspected full monosomies with high resolution methods and FISH in order to investigate the extent of the deletion and the presence of more complex rearrangements.
Case Report: Multimodality Imaging of Infectious Sacroiliitis and Retroperitoneal Abscess Causing Hindlimb Ataxia in a Young Dog
Authors: Jeongyun Jeong, Jaeeun Ko, Jaehwan Kim, Kidong Eom, Youngkwon Cho, Kichang Lee, Hakyoung Yoon
Journal: Front Vet Sci (2021)
Keywords: computed tomography, infectious sacroiliitis, magnetic resonance imaging, osteomyelitis, ultrasonography
MeSH terms: Case Reports

A 3-month-old intact male Labrador Retriever was presented for falling trauma and hindlimb ataxia. Radiography indicated radiolucent left sacroiliac joint with irregular margin. Computed tomography revealed thickened sublumbar muscles and hypoattenuated sacroiliac joint while magnetic resonance imaging demonstrated abscess at retroperitoneum and gluteal muscle. Ultrasonography showed lytic left sacroiliac joint with retroperitoneal fluid, and fine needle aspiration resulted Staphylococcus aureus. Hindlimb ataxia was attributed to infectious sacroiliitis and its secondary retroperitoneal abscess. As far as the authors' knowledge, this is the first report of multimodality imaging of infectious sacroiliitis with retroperitoneal abscess caused by S. aureus in a dog.
Multifactorial Origin of Exertional Rhabdomyolysis, Recurrent Hematuria, and Episodic Pain in a Service Member with Sickle Cell Trait
Authors: Nyamkhishig Sambuughin, Mingqiang Ren, John F Capacchione, Ognoon Mungunsukh, Kevin Chuang, Iren Horkayne-Szakaly, Francis G O'Connor, Patricia A Deuster
Journal: Case Rep Genet (2018)
MeSH terms: Case Reports

Individuals with Sickle Cell Trait (SCT), generally considered a benign carrier state of hemoglobin S (HbAS), are thought to be at risk for exertional rhabdomyolysis and hematuria, conditions that can also be caused by various other acquired and inherited factors. We report an SCT positive service member with an exertional rhabdomyolysis event, recurrent hematuria with transient proteinuria, and episodic burning pain in the lower extremities. Clinical and genetic studies revealed the multifactorial nature of his complex phenotype. The service member was taking prescription medications known to be associated with exertional rhabdomyolysis. He carried a pathogenic mutation, NPHS2 p.V260E, reported in nephropathy and a new variant p.R838Q in SCN11A, a gene involved in familial episodic pain syndrome. Results suggest that drug-to-drug interactions coupled with the stress of exercise, coinheritance of HbAS and NPHS2 p.V260E, and p. R838Q in SCN11A contributed to exertional rhabdomyolysis, recurrent hematuria with proteinuria, and episodic pain, respectively. This case underscores the importance of comprehensive clinical and genetic evaluations to identify underlying causes of health complications reported in SCT individuals.
Acute-Onset Panhypopituitarism Nearly Missed by Initial Cosyntropin Testing
Authors: Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Introduction:
Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome.
Case:
A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin. Thereafter, norepinephrine could be tapered rapidly. On day 2, basal cortisol was 136 nmol/L with an increase to 579 nmol/L in low-dose cosyntropin testing. Polyuria had not developed again. Therefore, corticosteroids were stopped. On day 3, the patient developed again nausea, vomiting, and polyuria. Adrenal crisis and diabetes insipidus were postulated. Corticosteroids and desmopressin were restarted. Further testing confirmed panhypopituitarism. MRI showed a new sellar metastasis. After 2 weeks, stimulated cortisol in cosyntropin testing reached only 219 nmol/l, confirming adrenal insufficiency.
Discussion:
The time course showed that the adrenal glands took 2 weeks to atrophy after loss of pituitary ACTH secretion. Therefore, a misleading result of the cosyntropin test in the initial phase with low basal cortisol and allegedly normal response to exogenous ACTH may be seen. Cosyntropin testing in the critically ill should be interpreted with caution and in the corresponding clinical setting.
The use of alfaxalone for short-term anesthesia can confound serum progesterone measurements in the common marmoset: a case report
Authors: Maria Daskalaki, Charis Drummer, Rüdiger Behr, Michael Heistermann
Journal: Primate Biol (2022)

Alfaxan® (alfaxalone) is a steroid general anesthetic widely used in veterinary medicine for induction and maintenance of anesthesia in several species. While the use of alfaxalone in veterinary practice has several benefits compared to the use of other anesthetic agents, the fact that it is derived from progesterone may confound the measurement of the latter in the blood of animals under alfaxalone treatment. In the present case study, we report the measurement of serum progesterone in an individual common marmoset (Callithrix jacchus) during five ovarian cycles in which luteolysis was induced by PGF2 α . Blood samples were usually taken from the awake animal with the exception of the fifth cycle in which the sample was collected under alfaxalone anesthesia in connection with a tooth extraction. In contrast to the previous four cycles in which luteolysis resulted in the expected marked decrease in progesterone concentrations, the - apparent - progesterone level in the cycle under alfaxalone treatment remained unexpectedly high. Cross-reactivity of the non-specific antibody used in the progesterone assay with alfaxalone most likely explains this finding.
Case Report: Miles Surgery Ameliorates High Blood Pressure in a Rectal Carcinoma Patient With Essential Hypertension
Authors: Meng-Wan Zhang, Bo-Shi Fan, Jian-Guang Yu
Journal: Front Cardiovasc Med (2021)
Keywords: case report, gut microbiota-brain axis, hypertension, miles surgery, sympathetic tone
MeSH terms: Case Reports

Hypertension is one of the major causes of public health problems. Multiple factors affecting gastrointestinal tract function are involved in hypertension. Emerging studies have manifested that gut intervention may play significant roles in regulating blood pressure but the underlying mechanisms are complex and not fully clear. Here, we report a case of 66 years old male who had a long history of hypertension and received Miles surgery for rectal carcinoma. The blood pressure of this patient was returned to normal levels after the operation. The possible reasons could be the modulation of sympathetic tone and the gut microbiota-brain axis. This report provides evidence about the relevance between hypertension and gut intervention particularly in the colorectal sites and gives hints for investigating the possible mechanisms of hypertension and the novel strategy for blood pressure control.
Endodontic Management of an Infected Primary Molar in a Child with Agenesis of the Permanent Premolar
Authors: Saeed Asgary, Mahta Fazlyab
Journal: Iran Endod J (2017)
Keywords: cem cement, calcium-enriched mixture, endodontic, primary molar, tooth agenesis, tooth missing
MeSH terms: Case Reports

Missing of mandibular second premolar is one of the most common types of tooth agenesis. In such cases, maintenance of the primary second molar, if possible at all, can prevent many treatment procedures in future. The present case report represents the endodontic management of a necrotic left mandibular primary second molar that had developed an abscess. Considering the missing of the permanent successor, the tooth was disinfected during endodontic preparation and the root canal system was filled with calcium-enriched mixture (CEM) cement in the same session. After 12 months of regular follow-up, not only the tooth was functional and symptom-free, but also healing of the inter-radicular bone lesion and re-establishment of the lamina dura was indicative of treatment success. Further trials are suggested to confirm CEM biomaterial use for management of infected primary molars associated with endodontic lesion.
The importance of wearing a seatbelt correctly - A case report of blunt trauma causing complete shearing transection of the gastroduodenal junction
Authors: Matheesha Herath, Peter Bautz, Dominic Parker, Christopher Dobbins
Journal: Int J Surg Case Rep (2020)
Keywords: emergency surgery, road traffic accident, seatbelt, trauma, upper gastrointestinal injury
MeSH terms: Case Reports

Introduction:
Global mortality as a result of road traffic accidents (RTA) has reduced significantly since mandatory implementation of seatbelts. Whilst seatbelt related injury, or "seatbelt syndrome," is a recognised phenomenon, unrestrained passengers have considerably worse survival outcomes. Improper positioning of seatbelts, as is discussed in the following case, can cause extensive injury.
Presentation of case:
Our patient is a 35-year-old female who was a restrained front seat passenger in a car vs. tree collision at 80 km/h. Her seat belt was worn with the shoulder strap under her left axilla. She sustained multiple injuries including complete transection of the gastroduodenal junction. In addition to this she had splenic, liver, transverse colonic, left lower rib and humeral injury. She underwent damage control laparotomy with splenectomy; re-look with gastrojejunostomy and transverse colonic resection with defunctioning ileostomy. She made a good recovery and was discharged after a 4 week admission.
Discussion:
Improperly worn seatbelts redistribute decelerative forces to sensitive regions. A multidisciplinary approach is required to effectively manage complex multi-system trauma. In trauma the simplest reconstructive measures can be the most effective and minimise risk of further complications for the patient.
Conclusion:
Improperly worn seatbelts pose a significant risk to patients. A traumatic complete gastroduodenal transection can be effectively reconstructed with gastrojejunostomy anastomosis.
Episodic Ataxias: Primary and Secondary Etiologies, Treatment, and Classification Approaches
Authors: Anhar Hassan
Journal: Tremor Other Hyperkinet Mov (N Y) (2023)
Keywords: ataxia, cerebellum, episodic, genetic, paroxysmal, primary, secondary, treatment
MeSH terms: Ataxia / diagnosis, Ataxia / genetics, Ataxia / therapy, Cerebellar Ataxia / genetics, Systematic Review, Case Reports, Review, Acetazolamide / therapeutic use, Humans, Mutation, Acetazolamide, Episodic Ataxia

Background:
Episodic ataxia (EA), characterized by recurrent attacks of cerebellar dysfunction, is the manifestation of a group of rare autosomal dominant inherited disorders. EA1 and EA2 are most frequently encountered, caused by mutations in KCNA1 and CACNA1A. EA3-8 are reported in rare families. Advances in genetic testing have broadened the KCNA1 and CACNA1A phenotypes, and detected EA as an unusual presentation of several other genetic disorders. Additionally, there are various secondary causes of EA and mimicking disorders. Together, these can pose diagnostic challenges for neurologists.
Methods:
A systematic literature review was performed in October 2022 for 'episodic ataxia' and 'paroxysmal ataxia', restricted to publications in the last 10 years to focus on recent clinical advances. Clinical, genetic, and treatment characteristics were summarized.
Results:
EA1 and EA2 phenotypes have further broadened. In particular, EA2 may be accompanied by other paroxysmal disorders of childhood with chronic neuropsychiatric features. New treatments for EA2 include dalfampridine and fampridine, in addition to 4-aminopyridine and acetazolamide. There are recent proposals for EA9-10. EA may also be caused by gene mutations associated with chronic ataxias (SCA-14, SCA-27, SCA-42, AOA2, CAPOS), epilepsy syndromes (KCNA2, SCN2A, PRRT2), GLUT-1, mitochondrial disorders (PDHA1, PDHX, ACO2), metabolic disorders (Maple syrup urine disease, Hartnup disease, type I citrullinemia, thiamine and biotin metabolism defects), and others. Secondary causes of EA are more commonly encountered than primary EA (vascular, inflammatory, toxic-metabolic). EA can be misdiagnosed as migraine, peripheral vestibular disorders, anxiety, and functional symptoms. Primary and secondary EA are frequently treatable which should prompt a search for the cause.
Discussion:
EA may be overlooked or misdiagnosed for a variety of reasons, including phenotype-genotype variability and clinical overlap between primary and secondary causes. EA is highly treatable, so it is important to consider in the differential diagnosis of paroxysmal disorders. Classical EA1 and EA2 phenotypes prompt single gene test and treatment pathways. For atypical phenotypes, next generation genetic testing can aid diagnosis and guide treatment. Updated classification systems for EA are discussed which may assist diagnosis and management.
Abdominal wall endometriosis: a case report
Authors: Daniel Paramythiotis, Eleni Karlafti, Ioannis Tsomidis, George Iraklis, Petra Malliou, Anestis Karakatsanis, Michalopoulos Antonios
Journal: Pan Afr Med J (2022)
Keywords: endometriosis, abdominal wall mass, case report, endometrioma, rectus abdominus
MeSH terms: Abdominal Wall / pathology, Abdominal Wall / surgery, Endometriosis / diagnosis, Endometriosis / pathology, Endometriosis / surgery, Case Reports, Adult, Cesarean Section / adverse effects, Cicatrix / pathology, Female, Humans, Neoplasm Recurrence, Local / pathology, Pregnancy

Abdominal wall endometriosis is the development of endometrial tissue in the anterior abdomen usually due to an operation in which the uterus is manipulated. We herein delineate the presentation, clinical investigation, and surgical treatment of an abdominal wall endometriosis case. A 42-year-old female presented with acute abdominal pain in the lower quadrants in the margins of an old cesarean scar. Two masses in the abdominal wall highly suspected of consisting of endometrial tissue were found during the investigation of the patient. These ones were removed in surgery and endometrial tissue secondary to previous cesarean section was confirmed after histological analysis. Consequently, although rare, if a painful mass in a surgical scar, such as a Pfannenstiel incision, is found in women of reproductive age with a history of obstetric surgery, the differential diagnosis shall include endometriosis. There is a portion of cases in which endometriosis recurs within five years following conservative surgery.
Granulocytic sarcoma of the breast without development of bone marrow involvement: a case report
Authors: Teresa A Vela-Chávez, Myrna D Arrecillas-Zamora, L Yolanda Quintero-Cuadra, Falko Fend
Journal: Diagn Pathol (2009)

A 29-year-old woman presented with a breast tumor with a primary diagnosis of MALT lymphoma. A repeat biopsy revealed a hematological neoplasm with diffuse, Indian file, and targetoid patterns. The cells were intermediate size with eosinophilic granules; the immunophenotyping showed monocytic differentiation, and no lymphoepithelial lesion was observed. The diagnosis was granulocytic sarcoma. Three different bone marrow biopsies were negative for neoplastic infiltration. After treatment, she developed secondary pancytopenia which contributed to her death 16 months after primary diagnosis. Granulocytic sarcoma of the breast is uncommon. A complete panel of immunohistochemistry is necessary to perform this diagnosis.
Correction of Vertical Smile Discrepancy through Ceramic Laminate Veneers and Surgical Crown Lengthening
Authors: Paula Bernardon, Carlos Estevão Lagustera, Luiz Roberto Coutinho Manhães Junior, Bruno de Castro Figuêiredo, Danielle Shima Luize, Rolando Plumer Pezzini, George Borja de Freitas, José Luiz Cintra Junqueira
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

In cases where malocclusion is associated with intrinsic discoloration and/or discrepancies in tooth size and shape, such as peg-shaped laterals, orthodontics alone may not improve the aesthetics. In these situations, veneers may be considered as an adjunct to orthodontic treatment to improve the overall aesthetics. The aim of this study is to report a clinical case where an uneven occlusal plane was corrected, and the positioning of gingival zeniths, color, shape, and size of the dental elements involved were improved by means of gingivectomy and rehabilitation with 10 ceramic laminate veneers. It was possible to conclude that multidisciplinary treatment, when properly planned and indicated, respecting the limits and established techniques of periodontics, prosthesis, and dentistry, makes small occlusal leveling predictable and possible through these tools.
Concurrent acute pancreatitis and pericardial effusion
Authors: Yusuf Kayar, Kenan Ahmet Turkdogan, Birol Baysal, Nigar Gultekin, Ahmet Danalioglu, Ali Tuzun Ince, Hakan Senturk
Journal: Pan Afr Med J (2015)
Keywords: acute pancreatitis, pericardial effusion, pleural effusion
MeSH terms: Pancreatitis / etiology, Pericardial Effusion / etiology, Pericarditis / etiology, Case Reports, Acute Disease, Adult, Female, Humans, Pancreatitis / physiopathology, Pericardial Effusion / physiopathology, Pericarditis / physiopathology, Severity of Illness Index, Virus Diseases / complications

While pleural effusion and ascites secondary to acute pancreatitis are common, clinically relevant pericardial effusion and cardiac tamponade are observed rarely. In a study by Pezzilli et al., pleural effusion was noted in 7 of the 21 patients with acute pancreatitis whereas the authors detected pericardial effusion development in only three. The authors asserted that pleural effusion was associated with severe acute pancreatitis, while pericardial effusion and the severity of acute pancreatitis were not significantly related.