OpenMed/multicare-articles huggingface dataset:
Isolated ovarian tuberculosis mimicking ovarian carcinoma: case report and literature review
Authors: Ssen Rabesalama, Kl Mandeville, Ra Raherison, Hn Rakoto-Ratsimba
Journal: Afr J Infect Dis (2011)
Keywords: genitourinary tuberculosis, ovarian carcinoma, ovarian tuberculosis
MeSH terms: Case Reports

Although genitourinary tuberculosis is common, reports of isolated ovarian tuberculosis are rare. However, its presentation can mimick that of an ovarian tumour, leading to diagnostic difficulties. A woman of 17 years presented with chronic pelvic pain, weight loss, a right ovarian mass on ultrasound, and a significantly elevated CA-125 level. A diagnosis of ovarian carcinoma was made, and laparotomy was performed with resection of the right ovary. Postoperative histological examination, however, revealed classic tuberculoid appearances, with no signs of malignancy. Antituberculosis treatment was commenced, with full resolution of her symptoms and a decrease in CA-125 level. Isolated ovarian tuberculosis is most common in young women living in endemic zones. CA-125 can be raised in both conditions, and imaging is rarely conclusive. Intraoperative frozen section of tissue specimens can be helpful if available. Early diagnosis of ovarian tuberculosis is vital as untreated disease can lead to infertility.
Extrapyramidal side effects and suicidal ideation under fluoxetine treatment: a case report
Authors: Christos Christodoulou, Athanasia Papadopoulou, Emmanouil Rizos, Kalliopi Tournikioti, Xenia Gonda, Athanassios Douzenis, Lefteris Lykouras
Journal: Ann Gen Psychiatry (2010)

Background:
We present the case of a 52-year-old woman with depression who developed extrapyramidal symptoms (mainly parkinsonism) and suicidal ideation while on fluoxetine.
Methods:
The patient underwent neurological and neuroimaging examination.
Results:
The patient's neurological and neuroimaging examinations were normal and there was no other cause of extrapyramidal symptoms. The patient showed remission of the aforementioned symptomatology when fluoxetine was discontinued.
Conclusions:
This case shows that fluoxetine can be associated with extrapyramidal symptoms, and this may have an aggravating affect on clinical depression progress and the emergence of suicidal ideation.
Freezing of gait associated with a corpus callosum lesion
Authors: Marian L Dale, Martina Mancini, Carolin Curtze, Fay B Horak, Brett W Fling
Journal: J Clin Mov Disord (2016)
Keywords: diffusion tensor imaging, motor control
MeSH terms: Case Reports

Freezing of gait (FoG) is a debilitating feature of Parkinson's disease and other parkinsonian disorders. This case demonstrates a variant of freezing of gait in a non-parkinsonian patient with a lesion of the anterior corpus callosum. The freezing improved with increased upper extremity sensory input, suggesting that compensatory circuits for use of somatosensory inputs from the arms to postural and locomotor centers were intact.
Male infertility related to an aberrant karyotype, 47,XYY: four case reports
Authors: Faeza El-Dahtory, Hany M Elsheikha
Journal: Cases J (2009)

Background:
47,XYY syndrome is a sex chromosomal abnormality observed in humans, with a prevalence of 0.1% of male births. Sex chromosome anomalies are more frequently associated with male infertility.
Case report:
We present here four cases of infertile men with azoospermia or severe oligozoospermia attending a genetic and fertility clinic. Chromosomal analysis of the peripheral blood lymphocytes demonstrated the constitutional karyotype of 47, XYY. Using fluorescence in situ hybridization (FISH) the presence of extra Y chromosome was confirmed, supporting the cytogenetic finding.
Conclusion:
The 47,XYY syndrome is relatively uncommon and can be missed clinically because of its variable clinical presentations. Accurate diagnosis of this constitutional karyotype provides a valuable aid in the counselling and early management of the patients who undertake fertility evaluation.
Newly Diagnosed Hepatic Encephalopathy Presenting as Non-convulsive Status Epilepticus: A Case Report and Literature Review
Authors: Marco Olivero, Delia Gagliardi, Gianluca Costamagna, Daniele Velardo, Francesca Magri, Fabio Triulzi, Giorgio Conte, Giacomo P Comi, Stefania Corti, Megi Meneri
Journal: Front Neurol (2022)
Keywords: brain magnetic resonance imaging, case report, corticospinal tract, globus pallidus, hepatic encephalopathy, non-convulsive status epilepticus
MeSH terms: Case Reports

Background:
Hepatic encephalopathy is characterized by psychiatric and neurological abnormalities, including epileptic seizure and non-convulsive and convulsive status epilepticus. Conventional brain magnetic resonance imaging is useful in supporting diagnosis since it can reveal specific radiological findings. In the literature, there is no description of hepatic encephalopathy onset as non-convulsive status epilepticus; we provide the first report.
Case summary:
We report a case of a 67-year-old woman, without history of cirrhosis, presenting altered mental state, normal brain computed tomography imaging, and electroencephalography suggestive of epileptic activity. We suspected non-convulsive status epilepticus, and we administered diazepam and levetiracetam with clinical improvement. Thus, we made a diagnosis of non-convulsive status epilepticus. A radiological study with brain magnetic resonance imaging showed bilateral hyperintensity on T1-weighted sequences of globus pallidus and hyperintensity of both corticospinal tracts on T2-weighted fluid-attenuated inversion recovery sequences. Blood tests revealed hyperammonemia, mild abnormality of liver function indices, and chronic Hepatitis B and D virus coinfection. Hepatic elastosonography suggested liver cirrhosis. The patient started antiviral therapy with entecavir and prevention of hepatic encephalopathy with rifaximin and lactulose; she was discharged with a normal mental state.
Conclusions:
Hepatic encephalopathy can present as an initial manifestation with non-convulsive status epilepticus. Electroencephalography is useful for differentiating non-convulsive status epilepticus from an episode of hepatic encephalopathy, and neuroimaging aids the diagnostic process.
Superficial myofibroblastoma of the lower female genital tract with description of the MRI features
Authors: Sarah Ann Smith, Victoria Doyle, Elizabeth Rutherford, Victoria Elliot, Richard Murray Blaquiere
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Superficial myofibroblastomas of the lower female genital tract are an unusual type of benign mesenchymal tumour. To the authors' knowledge, there has been no previous imaging description of a superficial myofibroblastoma in the literature. Here, we describe a case that presented with symptoms consistent with vaginal prolapse. However, a mass was palpable on clinical examination with unusual features on MRI. Following surgery, the histopathological features were considered consistent with superficial myofibroblastoma. By presenting the MRI and histological findings, we aim to raise awareness about this lesion so that it may be considered in the differential diagnosis of a vaginal mass.
Prevalence and characteristics of hypoxic hepatitis in the largest single-centre cohort of avian influenza A(H7N9) virus-infected patients with severe liver impairment in the intensive care unit
Authors: YiMin Zhang, JiMin Liu, Liang Yu, Ning Zhou, Wei Ding, ShuFa Zheng, Ding Shi, LanJuan Li
Journal: Emerg Microbes Infect (2016)
MeSH terms: Cell Hypoxia, Hepatitis / complications, Hepatitis / epidemiology, Influenza A Virus, H7N9 Subtype / pathogenicity, Influenza, Human / complications, Liver / pathology, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, Aged, 80 and over, Alanine Transaminase / blood, Aspartate Aminotransferases / blood, Female, Hepatitis / mortality, Hepatitis / physiopathology, Humans, Influenza, Human / mortality, Influenza, Human / therapy, Influenza, Human / virology, Intensive Care Units / statistics & numerical data, Liver / virology, Male, Middle Aged, Organ Dysfunction Scores, Prevalence, Real-Time Polymerase Chain Reaction, Young Adult, Aspartate Aminotransferases, Alanine Transaminase

Avian influenza A(H7N9) virus (A(H7N9)) emerged in February 2013. Liver impairment of unknown cause is present in 29% of patients with A(H7N9) infection, some of whom experience severe liver injury. Hypoxic hepatitis (HH) is a type of acute severe liver injury characterized by an abrupt, massive increase in serum aminotransferases resulting from anoxic centrilobular necrosis of liver cells. In the intensive care unit (ICU), the prevalence of HH is ∼1%-2%. Here, we report a 1.8% (2/112) incidence of HH in the largest single-centre cohort of ICU patients with A(H7N9) infection. Both HH patients presented with multiple organ failure (MOF) involving respiratory, cardiac, circulatory and renal failure and had a history of chronic heart disease. On admission, severe liver impairment was found. Peak alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values were 937 and 1281 U/L, and 3117 and 3029 U/L, respectively, in the two patients. Unfortunately, both patients died due to deterioration of MOF. A post-mortem biopsy in case 1 confirmed the presence of centrilobular necrosis of the liver, and real-time reverse transcription polymerase chain reaction of A(H7N9)-specific genes was negative, which excluded A(H7N9)-related hepatitis. The incidence of HH in A(H7N9) patients is similar to that in ICU patients with other aetiologies. It seems that patients with A(H7N9) infection and a history of chronic heart disease with a low left ventricular ejection fraction on admission are susceptible to HH, which presents as a marked elevation in ALT at the time of admission.
Mixed Germ Cell Tumour in a Case of Pure Gonadal Dysgenesis (Swyer Syndrome) - A Case Report
Authors: Naveen P Kumar, Venugopal M, Anitha Mathews, Francis V James
Journal: Cureus (2016)
Keywords: germ cell tumour, mature teratoma, swyer syndrome
MeSH terms: Case Reports

Swyer syndrome or pure gonadal dysgenesis 46, XY is a medical condition associated with 46 XY karyotype and primary amenorrhea in a phenotypic female. In this syndrome, there is an abnormality in testicular differentiation. Patients with disorders in sexual differentiation have an increased risk for development of genital malignancies. A 14-year-old female admitted with abdominal pain was diagnosed to have Swyer syndrome and a pelvic tumor after clinical and laboratory investigations. She underwent surgery, and the histology report revealed a mixed germ cell tumor in a dysgenetic gonad. She recurred three months later and was successfully treated with chemotherapy and a second surgery to remove the differentiated teratoma. The early diagnosis of patients with Swyer syndrome is important because of the increased risk for the development of malignancy. Early surgical treatment is required. Recurrent and metastatic disease respond well to chemotherapy.
A Rare Complication of Appendicostomy
Authors: Romain Lacrosse, Cristina Dragean
Journal: J Belg Soc Radiol (2022)
Keywords: malone appendicostomy, antegrade continence enema, appendicolith
MeSH terms: Case Reports

Teaching Point: The acute appendicitis in a context of Malone appendicostomy complication is very rare but can occur and may be challenging to diagnose due to its unusual position.
MonoMAC syndrome with GATA2 novel mutation: A case report
Authors: Petra Belohlavkova, Katerina Hrochova, Ilona Fatorova, Pavel Zak
Journal: Leuk Res Rep (2022)
Keywords: gata2 deficiency, monomac syndrome, myelodysplastic syndrome
MeSH terms: Case Reports

GATA2 deficiency was first identified in 2011 and have been reported over 500 individuals with GATA2 mutations. The onset of symptoms ranges from early childhood to late adulthood but very often the diagnosis is made between adolescence and early adulthood. These patients can be relatively asymptomatic or have life threatening diseaseas (myelodysplastic syndrome, acute leukemia). We describe case of 30-years old women with GATA2 novel mutation who present by primary lymphedema, myelodysplastic changes in bone marrow, monocytopenia and history of several recurrent infections (bacterial, mycobacterial). The case illustrates the diagnostic difficulties in identifying GATA2 deficiencies.
Redo-EVAR After Surgical Repair in Ruptured Abdominal Aortic Aneurysm
Authors: Şahin Bozok, Sedat Ozan Karakişi, Şaban Ergene, Nebiye Tufekçi, Gökhan Ilhan, Hakan Karamustafa
Journal: J Cardiovasc Thorac Res (2015)
Keywords: abdominal aorta, aneurysm, evar, endovascular aneurysm
MeSH terms: Case Reports

Endovascular aneurysm repair (EVAR) is an adequate means for treating infrarenal abdominal aortic aneurysms (AAA). However, secondary interventions are required in approximately 15% to 20% of patients. The aim of this paper was to report our knowledge with stent grafts in secondary interventions after EVAR in a 73-year-old patient. One of the exceptional complications of EVAR are endoleaks which may lead to expansion of aneurysm and rupture if not repaired.
Late onset atypical pantothenate-kinase-associated neurodegeneration
Authors: Natalie Diaz
Journal: Case Rep Neurol Med (2013)

Introduction. Pantothenate-kinase-associated neurodegeneration (PKAN) is a rare genetic disease and a form of neurodegeneration with brain iron accumulation (NBIA). It most commonly begins in the first two decades of life but should be considered in the differential diagnosis of patients at any age with an atypical progressive extrapyramidal disorder and cognitive impairment. Few late-adult cases have been reported. Case Report. A 50-year-old woman presented with a history of progressive dysarthria and dysphagia secondary to orolingual dystonia. Initial work-up was normal. There was no family history. Her initial symptoms were followed by the onset of blepharospasm, cervical dystonia, Parkinsonism, and cognitive impairment. Follow-up MRI four years after presentation revealed the diagnostic "eye-of-the-tiger" sign. Genetic testing confirmed a homozygous missense mutation consistent with the diagnosis of PKAN. Conclusion. Although PKAN is a rare genetic disorder most commonly seen in childhood, it should be considered in adult patients with a history of progressive focal dystonia or atypical Parkinsonism. As the radiographic findings are quite characteristic, genetic testing should be performed if the MRI shows evidence of iron accumulation. Optimal treatment strategies are not known, and at the current time therapies should be directed at the specific manifestations of the disease.
An Incidental Finding of Butterfly Vertebrae in a Case of Vertebral Defects, Anal Atresia, Cardiac Defects, Tracheo-Esophageal Fistula, Renal Anomalies, and Limb Abnormalities (VACTERL)
Authors: Ashritha Rao, Sarika Gaikwad, Amar Taksande, Mayur B Wanjari
Journal: Cureus (2023)
Keywords: anal atresia, butterfly vertebrae, lower back pain (lbp), tetralogy of fallot, vacterl
MeSH terms: Case Reports

Butterfly spine is a rare benign congenital abnormality. The onset of a minimum of three of the congenital malformations of vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities often characterises the VATER/VACTERL relationship. Recognising this anomaly is crucial for diagnosis, although this rare aberration is thought to be asymptomatic most of the time. Here we are describing a case of a one-year-old female child who has tetralogy of Fallot, congenital anal atresia, vesicovaginal fistula, and butterfly vertebrae which were found as an incidental finding. Furthermore we suggest screening all the children with any one abnormality of VACTERL, usually vertebral anomalies are screened.
A Critically Ill Child with Gangrenous Appendicitis Masquerading as Hollow Viscous Perforation
Authors: Ashish Lal Shrestha, Santosh Maharjan, Anil Dev Pant, Pankaj Bahadur Nepali
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Background:
Severe complications of acute appendicitis (AA) hitherto well described are less common in clinical practice nowadays. When a septic child is encountered with a short history of abdominal symptoms and disproportionate signs of peritonitis further complicated by radiological findings causing a diagnostic conundrum, management becomes exceedingly demanding. Case Presentation. A 10-year-old previously healthy boy presented to the emergency room with generalized abdominal pain associated with fever and jaundice for a day. Blood workup revealed leucopenia, hyperbilirubinemia, hyponatremia, and elevated CRP. Initial radiological evaluation suggested hollow viscous perforation. He was diagnosed to have hollow viscous perforation peritonitis in severe sepsis. At laparotomy, generalized peritoneal contamination was found, the source of which could be traced down to the gangrenous perforated appendix.
Conclusion:
Complicated appendicitis, in children, can present with baffling findings. Timely identification of an ill child, adequate workup, prompt resuscitation, and source control are imperative for a successful outcome.
Ordinary AV Nodal Reentry Tachycardia-Unusual Ablation: A Case Report and Review of the Literature
Authors: Franz Haertel, P Christian Schulze, Anett Große, Dirk Prochnau, Ralf Surber
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

A 72-year-old woman was referred to us with typical symptoms of paroxysmal supraventricular tachycardia for electrophysiological diagnostics and catheter ablation. During the first session of catheter ablation, a probing of the right ventricle was not successful. Therefore, an angiography of the central veins was performed. A rare anatomical variation with atresia of the inferior vena cava below the hepatic veins with azygos persistence was detected. The blood of the lower half of the body was drained via the dilated azygos into the superior vena cava; the blood of the liver veins enters into the right atrium directly. By atypical catheter placement over the azygos vein in the right ventricle and coronary sinus, an AV nodal reentry tachycardia (AVNRT) could be confirmed as the mechanism of tachycardia. However, a stable position of the ablation catheter could not be achieved by the femoral approach, so the successful AV node modulation with ablation of the slow pathway was performed via jugular access.
Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999
Authors: Man-huei Chang, M Kathleen Glynn, Samuel L Groseclose
Journal: Emerg Infect Dis (2003)
MeSH terms: Bioterrorism, Communicable Diseases / epidemiology, Research Support, U.S. Gov't, P.H.S., Adolescent, Adult, Aged, Anthrax / epidemiology, Botulism / epidemiology, Brucellosis / epidemiology, Child, Child, Preschool, Cholera / epidemiology, Ethnicity, Female, Geography, Humans, Incidence, Infant, Male, Middle Aged, Plague / epidemiology, Population Surveillance, Racial Groups, Seasons, Tularemia / epidemiology, United States / epidemiology

Little information is available in the United States regarding the incidence and distribution of diseases caused by critical microbiologic agents with the potential for use in acts of terrorism. We describe disease-specific, demographic, geographic, and seasonal distribution of selected bioterrorism-related conditions (anthrax, botulism, brucellosis, cholera, plague, tularemia, and viral encephalitides) reported to the National Notifiable Diseases Surveillance System in 1992 to 1999. Tularemia and brucellosis were the most frequently reported diseases. Anthrax, plague, western equine encephalitis, and eastern equine encephalitis were rare. Higher incidence rates for cholera and plague were noted in the western United States and for tularemia in the central United States. Overall, the incidence of conditions caused by these critical agents in the United States is low. Individual case reports should be considered sentinel events. For potential bioterrorism-related conditions that are endemic and have low incidence, the use of nontraditional surveillance methods and complementary data sources may enhance our ability to rapidly detect changes in disease incidence.
Retrograde Balloon-Assisted Deep Enteroscopy in the Diagnosis of Metastatic Melanoma
Authors: William Barge, Mark R Albertini, Christopher Cold, Daniel Abbott, Deepak Gopal
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

A 74-year-old male with a history of metastatic melanoma presents with persistently abnormal small bowel findings on PET-CT scan. The patient had persistent FDG uptake near the ileocolic junction on imaging, concerning for metastatic melanoma. Capsule endoscopy demonstrated ulcerated mucosa in the distal ileum. This area was biopsied and tattooed via retrograde double-balloon enteroscopy to confirm the diagnosis of metastatic melanoma and facilitate subsequent small bowel resection. The case illustrates a unique case of metastatic melanoma to the small bowel and the utility of capsule endoscopy and balloon-assisted enteroscopy to assist in diagnosis and management of metastatic disease.