OpenMed/multicare-articles huggingface dataset:
Fatal drug-induced immune hemolytic anemia due to cefotetan; A case study
Authors: Jim Perkins
Journal: Asian J Transfus Sci (2008)
Keywords: cefotetan, direct antiglobulin test, drug-induced immune hemolytic anemia
MeSH terms: Case Reports

A case is described here of drug-induced immune hemolytic anemia (DIIHA) due to cefotetan administered to a post-partum woman who received the drug for infection prophylaxis at the time of caesarean section. Renewed fatal hemolysis occurred when the drug was given a second time 12 days after the first dose. The initial immunohematologic findings included a positive direct antiglobulin test (DAT) due to IgG and complement coating of the patient's RBCs as well as an eluate that did not react with RBCs in the absence of drug. The antibody was drug-dependent, reacting with both drug-coated RBCs as well as when the drug was added to a mixture of her serum and donor RBCs. Cefotetan has been a common cause of this uncommon problem. The clinical features of cefotetan DIIHA, classification of drug-induced antibodies, and the differential diagnosis of a positive DAT are briefly discussed.
Recurrent Episodes of Dissociative Fugue with Comorbid Severe Depression and Alcohol Dependence Syndrome
Authors: Dennis Bomansang Daliri, Agani Afaya, William H F Koomson, Emmanuel Akatibo
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

The rarity and close resemblance to other mental health conditions of dissociative fugue make it difficult to diagnose. Akin to a culture-bound syndrome, most African countries have their local explanation for this unique presentation and therefore people may not seek evidence-based health care but rather may resort to faith-based-treatment which may not give the best results. This is the case of a 39-year-old man who has experienced about five episodes of dissociative fugue over nine years. This case points out the comorbidities associated with the condition. We report this case to increase awareness of the condition and to bring to the fore the need for further studies into psychopathology and the treatment modalities.
Case Report: First Report of T-Cell Large Granular Lymphocytic Leukemia With NPL-DHX9 Gene Fusion Successfully Treated With Cladribine: Clinical Experience and Literature Review
Authors: Qin Hu, Yunfei Li, Ying Zhang, Shusen Sun, Hui Wang, Zhiping Jiang, Sheng Deng
Journal: Front Oncol (2022)
Keywords: npl-dhx9, agranulocytosis with fever, cladribine, invasive pulmonary aspergillosis, large granular lymphocyte leukemia
MeSH terms: Case Reports

Background:
T-cell large granular lymphocytic leukemia (T-LGLL) is a rare lymphoproliferative disorder that starts in T cells and is usually indolent. Long-term use of immunosuppressants, combined with agranulocytosis, is a double-edged sword, as both can lead to serious infections, especially in patients with combined hematologic malignancies and immune defects.
Case presentation:
A 30-year-old female patient was admitted to the hospital because of agranulocytosis for five years, with chest tightness, fatigue, and fever for two days. Pathology and metagenomic next-generation sequencing (mNGS) detected Aspergillus. Although she received cyclosporine and methylprednisolone, the patient showed drug intolerance and progression with invasive pulmonary fungal infections. After a bone marrow aspiration biopsy and other related examinations, she was diagnosed with T-LGLL and invasive pulmonary aspergillosis (IPA). T-cell immunophenotype was CD45+CD3dim+CD5-CD4-CD8+CD7+CD57p+CD25-CD30-, TCRγδ+, transducer and activator of transcripton-3 (STAT3) Y640F mutation and fusion gene NPL-DHX9 rearrangement were confirmed, which has never been reported in hematological diseases. After voriconazole regimen adjustment during treatment based on therapeutic drug concentration monitoring (TDM) and improvement in lung infection, the patient finally treated with purine nucleoside analogues (PNA) cladribine as a single agent at 0.14 mg/kg/d for 5 days. Complete response was achieved after four-cycles cladribine treatment (WBC 2.1*109/L, HGB 117 g/L, PLT 196*109/L, ANC 1.6*109/L, and ALC 0.2*109/L).
Conclusions:
To our knowledge, this is the first case of T-LGLL with a rare γδ type and fusion gene NPL-DHX9 rearrangement. The patient was successfully treated with cladribine, suggesting that this regimen could be a promising therapeutic strategy for patients with aggressive T-LGLL.
Hepatocellular carcinoma in identical twins in Chile: case report
Authors: Christian Caglevic, Shirley Silva, Mauricio Mahave, Javiera Torres, Christian Rolfo, Jorge Gallardo, Paula Carrasco
Journal: Ecancermedicalscience (2016)
Keywords: brothers, genetics, hepatocarcinoma (hcc), relatives, twins
MeSH terms: Case Reports

Liver cancer is the second leading cause of cancer death worldwide, with hepatocellular carcinoma (HCC) being the most common type of primary malignant liver tumour, with a typically poor prognosis, growing incidence and a well-documented relationship with chronic inflammation factors of the liver tissue. Despite the fact that family medical history has been identified as a risk factor for the development of HCC, its significance in terms of etiopathogenesis and prognosis is not well documented. With a view to contributing to this discussion, we will report the clinical case of two identical twins with HCC, both diagnosed within a short period of time, by providing relevant clinical data, and relating this to other medical literature reports that could contribute to a deeper understanding of this illness.
Successful Nonoperative Management of Spontaneous Splenic Hematoma and Hemoperitoneum due to CMV Infection
Authors: Georgios Lianos, Eleftheria Ignatiadou, Christina Bali, Haralampos Harissis, Christos Katsios
Journal: Case Rep Gastrointest Med (2012)

Introduction. Spontaneous splenic hematoma or splenic rupture due to CMV infection in immunocompetent adults is rare and life-threatening. Case Report. Herein we report a rare case of spontaneous splenic hematoma and hemoperitoneum due to CMV infection in a 23-year-old Caucasian male in whom conservative management was successful. Conclusion. Spontaneous splenic hematoma and spontaneous splenic rupture are extremely rare conditions during primary CMV infection. Though rare, they must be always considered by the operating surgeon, because any misinterpretation may result in unfavorable outcomes.
Persistent urine leakage around a suprapubic catheter: the experience of a person with chronic tetraplegia
Authors: Subramanian Vaidyanathan, Jerry Ward, Bakul M Soni, Peter Hughes, Tun Oo
Journal: Spinal Cord Ser Cases (2018)

Introduction:
Persistent urine leakage after suprapubic cystostomy in tetraplegic subjects occurs due to shrinkage of the urinary bladder and bladder spasms. The patient's social life is adversely affected as clothes become wet, smelly, and require frequent changing, thus increasing the workload of carers.
Case presentation:
A 48-year-old male sustained C-4 complete (AIS:A) tetraplegia while swimming in 2007. Suprapubic cystostomy was performed in 2009. From 2012, this patient had urine leakage around the suprapubic catheter, which became progressively more frequent. Propiverine, then oxybutynin tablets instead of propiverine, oxybutynin transdermal patches, and mirabegron in addition to oxybutynin were tried. An indwelling urethral catheter was used in addition to the suprapubic catheter to alleviate urine leakage when the bladder was undergoing spasms. This patient continued to have leakage around the suprapubic catheter. Leakage of urine was occasionally accompanied by autonomic dysreflexia. Leakage of urine caused huge amounts of extra work for carers, and family. Furthermore, leakage of urine had a significant impact on quality of life, and going out with friends and family. Bladder wall injection of Botox was performed in 2015 and in 2016, which reduced urine leakage.
Discussion:
Bladder wall injection of Botox to treat persistent urine leakage around the suprapubic catheter in spinal cord injury patients with suprapubic cystostomy has not been mentioned in NICE guidelines or publications indexed in PubMed. While recommending suprapubic cystostomy to subjects with tetraplegia, leakage of urine around the suprapubic catheter, which may occur sometime after suprapubic cystostomy, should be included in the conversation so that patients and carers become aware of this potential complication.
Respiratory support with nasal high-flow therapy helps to prevent recurrence of postoperative atelectasis: a case report
Authors: Yasuyuki Suzuki, Yasushi Takasaki
Journal: J Intensive Care (2014)
Keywords: atelectasis, nasal high flow, postoperative respiratory complication
MeSH terms: Case Reports

Postoperative atelectasis should be avoided in surgical patients with impaired pulmonary function. Nasal high-flow (NHF) therapy delivered by the Optiflow™ system (Fisher & Paykel Healthcare Ltd., Auckland, New Zealand) is a new, simple device that supplies heated and humidified oxygen gas at >30 L/min via a large-bore nasal cannula. We herein describe a case in which respiratory support with NHF therapy was useful for the prevention of postoperative atelectasis recurrence. A 67-year-old man with an upper digestive tract perforation underwent emergency laparoscopic surgery. He appeared malnourished because of severe untreated diabetes mellitus. The proposed surgery was uneventfully completed. On postoperative day (POD) 5, he experienced massive atelectasis of the left lower lobe with desaturation to <90%. After restoration of normal oxygenation by tracheal suction and postural drainage, noninvasive positive-pressure ventilation (NPPV) at a continuous positive airway pressure (CPAP) of 8 cm H2O was conducted to prevent repeated atelectasis. Fifteen hours after the cessation of NPPV on POD 7, he developed recurrence of massive atelectasis. Bronchoscopic suction removed a mucous plaque in the tracheobronchial tree, and NHF therapy at 40 L/min was subsequently performed, delivering a low level of CPAP instead of NPPV. Under the respiratory support with NHF therapy, his condition was more stable than with NPPV, and his respiratory rehabilitation continued uneventfully. In addition, the NHF therapy delivered optimally humidified gas, which improved the bronchial secretion quality. No further atelectasis occurred throughout the remaining stay in the intensive care unit. We conclude that respiratory support with NHF therapy may contribute to the prevention of postoperative atelectasis by delivering CPAP in combination with progressive respiratory rehabilitation.
High-resolution ultrasound as an aid in the diagnosis and treatment of post-brachioplasty injury to the medial brachial and the medial antebrachial nerves - Two case reports
Authors: Mohammad M Al-Qattan, Ahmed K Thallaj
Journal: Int J Surg Case Rep (2020)
Keywords: brachioplasty, high-resolution ultrasound, injury, medial antebrachial nerve, medial brachial nerve
MeSH terms: Case Reports

Introduction:
Injury to the medial brachial and the medial antebrachial nerves may occur after brachioplasty and may lead to severe pain. We report on two cases to demonstrate that high-resolution ultrasound may be used as an aid in the diagnosis and treatment of post-brachioplasty injury to these small cutaneous nerves.
Case reports:
We report on two cases. The first case was a 29-year old female with severe arm pain secondary to a neuroma of the right medial brachial nerve. The diagnosis of a neuroma was done using high-resolution ultrasound and proximal nerve block led to immediate complete relief of pain. Recurrent but milder pain occurred and this was treated with multiple nerve blocks. The second case was a 34-year-old female with severe arm/forearm pain secondary to entrapment of the left medial antebrachial cutaneous nerve by a suture in the middle arm. The diagnosis was reached using high-resolution ultrasound and proximal nerve block led to immediate complete relieve of pain. Recurrent but milder pain occurred and this was treated by surgical nerve decompression.
Discussion:
Previous literature confirms that high-resolution ultrasound can accurately identify small sensory nerves of the arm and forearm.
Conclusion:
We demonstrate that high resolution ultrasound may be used as an aid in the diagnosis and treatment of post-brachioplasty injury to the medial brachial and the medial antebrachial nerves. Proximal nerve block is extremely effective to relief the severe pain in these patients. However, recurrence of pain is expected and further management may be done by a trial of repeated injections or by surgical exploration.
Genomic and Pathological Characterization of Multiple Renal Cell Carcinoma Regions in Patient With Tuberous Sclerosis Complex: A Case Report
Authors: Tetsuya Yamamoto, Taigo Kato, Koji Hatano, Atsunari Kawashima, Takeshi Ujike, Shinichiro Fukuhara, Hiroshi Kiuchi, Ryoichi Imamura, Naokazu Ibuki, Kazuma Kiyotani, Masako Kurashige, Eichi Morii, Kazutoshi Fujita, Norio Nonomura, Motohide Uemura
Journal: Front Oncol (2021)
Keywords: cancer gene, papillary renal cell carcinoma, renal cell carcinoma, tuberous sclerosis complex, whole-exome sequencing
MeSH terms: Case Reports

Tuberous sclerosis complex is a genetic disorder characterized by facial angiofibromas, intellectual disability, epilepsy, and tumor formation in multiple organs, including the kidney. Renal cell carcinoma occurs in 2%-4% of patients with tuberous sclerosis complex, often developing multiply and bilaterally. Renal cell carcinoma associated with this genetic disorder may include complex tumor heterogeneity caused by the spatially different mutational landscape. Herein, we report the case of a female patient with tuberous sclerosis complex who developed multiple renal tumors. A 44-year-old female patient with tuberous sclerosis complex developed three different histological types of tumor-angiomyolipoma, clear cell renal cell carcinoma, and papillary renal cell carcinoma-in the left kidney at first renal cell carcinoma recurrence. The papillary renal cell carcinoma was morphologically atypical, indicating that its occurrence was associated with the genetic disorder. Furthermore, whole-exome sequencing revealed distinct patterns of somatic mutation in the three tumor types, and the atypical papillary renal cell carcinoma possessed a different mutational landscape than that of typical papillary renal cell carcinomas. Our findings indicate that tumors associated with tuberous sclerosis complex may be diagnosed with careful pathological examination. Furthermore, somatic mutation profiles of these tumors revealed their unique features, providing important information for further understanding the mechanism of multiple tumor development in patients with tuberous sclerosis complex.
Aortitis as a Harbinger of Occult Malignancy
Authors: Erik W O'Connell, Jennifer Reams, Alfred E Denio
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Noninfectious aortitis can be associated with an occult malignancy. Although glucocorticosteroids are often used, there is no clear evidence-based therapy and there is little consensus regarding treatment. Identifying and treating an underlying trigger is the most efficacious therapy. We present an unusual case initially concerning acute bacterial endocarditis of the native mitral valve; however, aseptic ischemic valvitis manifested on pathology. Concurrent aortitis was diagnosed with angiography. Occult colon adenocarcinoma was discovered during diagnostic abdominal imaging. Treatment of this underlying malignancy was associated with dynamic mitigation of inflammation affecting the entire aorta and a reduction in associated symptoms. This is an unusual case of a paraneoplastic secondary large vessel vasculitis involving the entire aorta, a diagnosis of exclusion but a consideration that can have dramatic impact on both morbidity and mortality.
AngioVac System Used for Vegetation Debulking in a Patient with Tricuspid Valve Endocarditis: A Case Report and Review of the Literature
Authors: Hossam Abubakar, Ahmed Rashed, Ahmed Subahi, Ahmed S Yassin, Mohamed Shokr, Mahir Elder
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

AngioVac is a vacuum-based device approved in 2014 for percutaneous removal of undesirable materials from the intravascular system. Although numerous reports exist with regard to the use of the AngioVac device in aspiration of iliocaval, pulmonary, upper extremity, and right-sided heart chamber thrombi, very few data are present demonstrating its use in treatment of right-sided endocarditis. In this case report, we describe the novel device used in debulking a large right-sided tricuspid valve vegetation reducing the occurrence of septic embolisation and enhancing the efficacy of antibiotics in clearance of bloodstream infection. Further research is needed in larger RSIE patient populations to confirm the benefits and the potential of improved outcomes associated with the AngioVac device as well as identify its potential complications.
Cardiovascular Malformations in CHARGE Syndrome with DiGeorge Phenotype: Two Case Reports
Authors: Kazushi Yasuda, Eiji Morihana, Naoki Fusazaki, Shiro Ishikawa
Journal: Case Rep Pediatr (2016)

Both CHARGE syndrome and DiGeorge anomaly are frequently accompanied by cardiovascular malformations. Some specific cardiovascular malformations such as interrupted aortic arch type B and truncus arteriosus are frequently associated with 22q11.2 deletion syndrome, while conotruncal defects and atrioventricular septal defects are overrepresented in patients with CHARGE syndrome. CHD7 gene mutation is identified in approximately two-thirds of patients with CHARGE syndrome, and chromosomal microdeletion at 22q11.2 is found in more than 95% of patients with 22q11.2 deletion syndrome. CHARGE syndrome is occasionally accompanied by DiGeorge phenotype. We report two patients with dysmorphic features of both CHARGE syndrome and 22q11.2 deletion syndrome. Although both of the two cases did not have 22q11.2 deletion, they had typical dysmorphic features of 22q11.2 deletion syndrome including cardiovascular malformations such as interrupted aortic arch type B. They also had characteristic features of CHARGE syndrome including ear malformation, genital hypoplasia, limb malformation, and endocrinological disorders. CHD7 gene mutation was confirmed in one of the two cases. When a patient with cardiovascular malformations frequently associated with 22q11.2 deletion syndrome does not have 22q11.2 deletion, we suggest that associated malformations characteristic of CHARGE syndrome should be searched for.
Rupture of the distal biceps tendon combined with a supinator muscle tear in a 51-year-old woman: a case report
Authors: Samir Nayyar, Martin Quirno, Saqib Hasan, Leon Rybak, Robert J Meislin
Journal: Case Rep Radiol (2011)
MeSH terms: Case Reports

Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequent confirmation at surgery. Surgical repair was performed for the distal biceps tendon only through a single incision approach using the Endobutton technique.
Combination of bone marrow aspirate, cancellous bone allograft, and platelet-rich plasma as an alternative solution to critical-sized diaphyseal bone defect: A case series
Authors: Dwikora Novembri Utomo, Kukuh Dwiputra Hernugrahanto, Mouli Edward, Lukas Widhiyanto, Ferdiansyah Mahyudin
Journal: Int J Surg Case Rep (2019)
Keywords: bone marrow aspirate, case series, critical-sized bone defect, tissue engineering

Introduction:
Nonunion due to a critical-sized bone defect is a complicated problem. The healing process must fulfill three mandatory elements of osteogenesis, osteoinduction, and osteoconduction. One ideal source to provide an abundant number of osteogenic cells is from the process of the culture of bone marrow stem cells which demands the availability of processing facility. Unfortunately, this sophisticated option is not always feasible in every hospital in low-income to middle-income countries. We tried to fulfill the requirement of osteogenic cells by using simple and cost-effective bone marrow aspirate. We presented two cases of critical-sized diaphyseal bone defect treated with the combination of bone marrow aspirate, cancellous bone allograft, and platelet-rich plasma (PRP). Presentation of cases: The defect sizes were five and six centimeters in humerus and tibia respectively. We applied a combination of bone marrow aspirate, cancellous bone allograft, and PRP to promote bone healing in the defect sites. Both patients have achieved the good clinical and radiological outcome.
Discussion:
Critical-sized bone defects require the application of tissue engineering. Aspirated bone marrow can be used as a more affordable option to provide the element of osteogenic cells in bone healing. Combined with cancellous bone allograft and PRP, they fulfill the required ingredients to promote bone regeneration.
Conclusion:
Bone defects remain one of the most challenging conditions to treat in orthopedic. There are many options to treat the defect but the fundamental prerequisites of cells, scaffolds and growth factors for healing have developed into the concept of tissue engineering: osteogenesis, osteoinduction, and osteoconduction.
Pantoea agglomerans Bacteremia: Is It Dangerous?
Authors: Ikwinder Preet Kaur, Sindhura Inkollu, Amulya Prakash, Haresh Gandhi, Mohsin Sheraz Mughal, Doantrang Du
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Introduction. Pantoea agglomerans, an anaerobic Gram-negative bacillus, is a rare cause of opportunistic infections affecting premature infants to seniors. We present a 34-year-old man who was presented for the management of diabetic ketoacidosis and developed Pantoea agglomerans bacteremia after one week of hospitalization. Case Presentation. A 34-year-old African-American male with uncontrolled diabetes mellitus type I and recurrent skin infections was admitted with diabetic ketoacidosis. He had left upper extremity abscess, preliminary wound cultures were positive for Gram-positive cocci, and an initial set of blood cultures were negative. He was started empirically on vancomycin. One week after admission, he started having chills followed by a recurrent increase in body temperature to 102 degrees Fahrenheit. The wound was healing, without active infection. Chest X-ray and CT scan of abdomen and pelvis to rule out infection were negative. Repeat blood cultures showed P. agglomerans in both the tubes. The patient was successfully treated with intravenous ceftriaxone, and he recovered fully without any complication. Discussion. Pantoea agglomerans is a bacteria associated with plants; however, it can infect humans and vertebrate animals. The outcome seems favourable with the institution of appropriate antibiotics even in immunocompromised patients.
Progeria syndrome: a case report
Authors: Rajul Rastogi, S M Chander Mohan
Journal: Indian J Orthop (2008)
Keywords: acrogeria, dwarfism, progeria

Progeria is a rare and peculiar combination of dwarfism and premature aging. The incidence is one in several million births. It occurs sporadically and is probably an autosomal recessive syndrome. Though the clinical presentation is usually typical, conventional radiological and biochemical investigations help in confirming the diagnosis. We present a rare case of progeria with most of the radiological features as a pictorial essay.