OpenMed/multicare-articles huggingface dataset:
Nonextraction Management of Severely Malaligned and Constricted Upper Arch
Authors: Manar K Hajrasi, Ahmad A Al-Fraidi, Abdulkarim A Hatrom, Ali H Hassan
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

This case report presents the treatment of a 12-year-old female with a severely crowded upper arch, severely palatally displaced upper premolars and lateral incisors, large midline diastema, lower midline deviation to the right, class III dental and skeletal relationships due to mild maxillary deficiency, retroclined lower incisors, straight profile, and retrusive lips. A nonextraction treatment approach is described, in which the upper and lower arches were expanded to their original three dimensions using a trihelix expander, a lip bumper appliance, and a fixed orthodontic appliance. Retention was also planned in accordance with the original malocclusion, which inclued a full-time-wear upper wraparound retainer, upper and lower anterior fixed lingual retainers, upper frenectomy, and fibrotomy for rotated teeth. Conclusion. Severe malalignment of teeth does not necessarily require extraction treatment. Gaining space is an art that requires a proper assessment of the anteroposterior and transverse dimensions of alveolar arches, lip prominence, and postorthodontic stability.
Sarcomatoid Renal Cell Carcinoma in an Adolescent with Sickle Cell Anaemia
Authors: H R Ahmad, J A Faruk, M A Bugaje, A Solomon, M O A Samaila, R M Akuse
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Malignancies have been reported to occur in people with sickle cell disease. Renal medullary carcinoma (RMC), also tagged seventh sickle cell nephropathy, is an aggressive cancer seen almost exclusively in people with sickle cell disease with more than 160 cases reported worldwide, but only few cases were reported in patients with sickle cell anaemia (HBSS) and from Nigeria. Sarcomatoid renal cell carcinoma is a renal tumour of any histologic variant containing foci of high-grade malignant spindle cells. We report an adolescent girl with sickle cell anaemia (HBSS) who presented with left renal tumour, histology of which confirmed a diagnosis of sarcomatoid renal cell carcinoma (sRCC). Surgical debulking and palliative care with chemotherapy were given, and she demised 10 months after. The rarity of the case and challenges of managing a cancer in the background of a chronic haematologic disorder are highlighted.
Management of Gamma-Butyrolactone Dependence with Assisted Self-Administration of GBL
Authors: Rafael Meyer, Josef Jenewein, Soenke Boettger
Journal: Case Rep Neurol Med (2014)

Gamma-hydroxybutyric acid (GHB) and its liquid precursor gamma-butyrolactone (GBL) have become increasingly popular beyond the clubbing culture resulting in daily consumption and dependence in the broader population. This case report illustrates the challenges of managing GHB-withdrawal and a possibly superior future approach of its management by titration and tapering of the addictive agent.
Peripheral Ameloblastoma of Upper Gingiva in a Patient with Port-Wine Stain
Authors: Natheer H Al-Rawi, Sahar Othman, Ab Rani Samsudin
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

The peripheral ameloblastoma (PA), also known as extraosseous ameloblastoma, is a rare soft tissue tumor of odontogenic origin, accounting for 1-5% of all ameloblastoma. In some cases, saucerization of underlying bone is the only radiological evidence of this lesion, and PA has identical histological characteristics of intraosseous ameloblastoma. However, it is slow growing, less aggressive, and less invasive in nature. The present report describes a rare case of PA in the maxillary labial gingiva of a 37-year-old man with port-wine vascular malformation. PA was clinically diagnosed as a pyogenic granuloma, and following the surgical treatment of the lesion, its histological features were of ameloblastoma. This case illustrates the importance of including peripheral ameloblastoma in the differential diagnosis of painless exophytic gingival swelling.
Case report: BCL-2 and CD31 immunoexpression related to clinical and histopathological evaluation of renal dysplasia in a Welsh Corgi Puppy
Authors: Trung Quang Le, Latticha Pluemhathaikij, Katriya Chankow, Araya Radtanakatikanon, Anudep Rungsipipat, Kasem Rattanapinyopituk
Journal: Front Vet Sci (2022)
Keywords: bcl-2, cd31, welsh corgi, canine, histopathology, renal dysplasia
MeSH terms: Case Reports

A case of renal dysplasia (RD) in the Welsh Corgi dog has been reported. Clinically, the affected 3-month-old, female, Welsh Corgi dog showed unclear symptoms of chronic kidney disease. Grossly, both left and right kidneys revealed cystic hypoplasia. Histologically, the primary lesions included immature or fetal glomeruli/tubules, proliferative arterioles, persistent metanephric ducts, persistent mesenchyme, and atypical tubular epithelium were presented. A group of degenerative and inflammatory lesions consisting of interstitial nephritis, interstitial fibrosis, and mineralization of tubules were found. Immunohistochemically, the epithelial cells of immature (fetal) tubules had BCL-2 labeling whereas CD31 (PECAM-1) was labeled in the endothelial cells of the proliferative arterioles. The immunohistochemical findings were confirmed and consolidated with the routine histopathological findings. This study was the first demonstration of the clinical, histopathological, and immunohistochemical features of RD disease in a Welsh Corgi puppy.
Lung abscess due to Streptococcus intermedius associated with SARS CoV-2 infection in pregnancy: Unusual presentation and complication of a commensal bacteria during pregnancy
Authors: Cristian Orlando Porras Bueno, Sharon Julieth González Trillos, Diana Jimena Cano Rosales, Edgar Augusto Bernal García
Journal: Clin Case Rep (2023)
Keywords: sars‐cov‐2, infectious diseases, lung abscess, pneumonia, bacterial, respiratory system
MeSH terms: Case Reports

Streptococcus intermedius is a commensal bacterium reported in a few cases as the causative agent of brain and lung abscesses, pneumonia, and endocarditis. Lung abscesses due to Streptococcus intermedius are rare, especially in pregnancy. We describe the first case of lung abscess due to Streptococcus intermedius in a pregnant woman.
Concurrent Negative-Pressure Pulmonary Edema (NPPE) and Takotsubo Syndrome (TTS) after Upper Airway Obstruction
Authors: Evan Harmon, Sebastian Estrada, Ryan J Koene, Sula Mazimba, Younghoon Kwon
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Upper airway obstruction is a potentially life-threatening emergency often encountered in the acute care, perioperative, and critical care settings. One important complication of acute obstruction is negative-pressure pulmonary edema (NPPE). We describe two cases of acute upper airway obstruction, both of which resulted in flash pulmonary edema complicated by acute hypoxic respiratory failure. Though NPPE was suspected, these patients were also found to have Takotsubo syndrome (TTS). Neither patient had prior cardiac disease, and both subsequently had a negative ischemic workup. Because TTS is a condition triggered by hyperadrenergic states, the acute airway obstruction alone or in combination with NPPE was the likely explanation for TTS in each case. These cases highlight the importance of also considering cardiogenic causes of pulmonary edema in the setting of upper airway obstruction, which we suspect generates a profound catecholamine surge and places patients at increased risk of TTS development.
Prominent 18F-FDG Uptake in the Adrenal Gland after Contralateral Adrenalectomy in a Known Case of Adrenocortical Oncocytic Carcinoma
Authors: Rakan Al-Rashdan, Mohammed Aljaberi, Ali Mohamedkhair, Akram Al-Ibraheem
Journal: Asia Ocean J Nucl Med Biol (2023)
Keywords: 18f-fdg pet/ct, adrenalectomy, adrenocortical carcinoma, mitotane
MeSH terms: Case Reports

Adrenocortical carcinoma (ACC) is a rare type of cancer that is associated with a high rate of recurrence and poor prognosis. The main diagnostic approaches to adrenocortical cancer include CT scan, MRI and the promising role of 18F-FDG PET/CT. The main therapeutic approaches include radical surgery of local disease and recurrences, as well as adjuvant mitotane therapy. The evaluation of adrenocortical carcinoma (ACC) could be difficult by using 18F-FDG PET/CT in view of the significant association between the 18F-FDG uptake and ACC. At the same time, not all adrenal glands with 18F-FDG uptake are considered to be malignant, so awareness of these various findings is substantial for ACC management, especially with limited data regarding the role of 18F-FDG PET/CT in ACC post-operative settings. This report discusses the case of a 47-year-old man with a history of left adrenocortical carcinoma who underwent adrenalectomy and received adjuvant mitotane therapy. 9 months after the surgery, a follow-up 18F-FDG PET/CT scan showed that the 18F-FDG uptake was prominent in the right adrenal gland without corresponding abnormal CT scan findings.
Case Report: Cystinosis in a Chinese Child With a Novel CTNS Pathogenic Variant
Authors: Yu-Jia Guan, Yan-Nan Guo, Wen-Tao Peng, Li-Li Liu
Journal: Front Pediatr (2022)
Keywords: ctns gene mutation, fanconi syndrome, cystinosis, genetics, renal tubular acidosis
MeSH terms: Case Reports

Objective:
To report a rare case of cystinosis with a novel CTNS pathogenic variant in the Chinese population.
Methods:
Retrospective analysis of the clinical manifestations, laboratory results, and gene detection data of a child with cystinosis.
Results:
A Chinese Zang ethnic girl could not stand or walk until 3 years old, with additional symptoms including a loss of appetite. Since then, the girl gradually exhibited "X" leg, double wrist joints, a bilateral ankle deformity, and rickets. At the age of 9 years, the girl was hospitalized. Laboratory testing showed that her blood phosphorus, blood calcium and blood potassium levels were significantly decreased. At the same time, the girl's urine glucose and urine protein were positive, although her fasting blood glucose, glycosylated hemoglobin, and 75 g glucose tolerance were not significantly abnormal. Further, blood gas analysis showed metabolic acidosis. These symptoms corresponded to Fanconi syndrome. Gene analysis showed that there was a homozygous pathogenic variant c.140 ≤ 5G > A (p.?) in the CTNS gene, which was a small variation in the intron region. To our knowledge, this is the first report of the rare variant.
Conclusion:
Attention should be paid to the differential diagnosis of cystinosis by gene analysis in children whose clinical manifestations include exercise dysplasia, renal damage, or multiple organ damage (including bone, thyroid, etc) and who cannot be firmly diagnosed for the time being.
Evaluation and Treatment of a Ureterosciatic Hernia Causing Hydronephrosis and Renal Colic
Authors: Keyan Salari, Emily M Yura, Mukesh Harisinghani, Brian H Eisner
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

An 87-year-old female presented with complaints of intermittent severe right renal colic. CT imaging demonstrated a ureterosciatic hernia and moderate hydronephrosis proximal to the portion of the ureter that was herniated through the sciatic foramen. A retrograde pyelogram demonstrated a transition point in the ureter at the location of the hernia. A ureteral stent was placed resulting in straightening of the ureter, resolution of hydronephrosis, and complete resolution of the patient's symptoms.
Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst
Authors: Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama, Yuki Sakurai, Nobumasa Ohara, Go Hasegawa
Journal: Case Rep Neurol Med (2021)
MeSH terms: Case Reports

Prolonged postoperative pyrexia (PPP) due to Mollaret's meningitis following endoscopic transsphenoidal surgery (eTSS) for an intracranial epidermoid cyst can be confused with postoperative meningeal infection after transsphenoidal resection, especially in the middle of the COVID-19 pandemic. Anosmia, as well as dysgeusia, cannot be evaluated in patients of eTSS for a while after surgery. We report a case of an infundibular epidermoid cyst with post-eTSS Mollaret's meningitis (MM). The post-eTSS MM caused vasopressin-analogue-resistant polyuria (VARP) in synchronization with PPP. A 59-year-old man experiencing recurrent headaches and irregular bitemporal hemianopsia over three months was diagnosed with a suprasellar tumor. The suprasellar tumor was an infundibular cyst from the infundibular recess to the posterior lobe of the pituitary, which was gross-totally resected including the neurohypophysis via an extended eTSS. Since awakening from general anesthesia after the gross total resection (GTR) of the tumor, the patient continuously had suffered from headache until the 13th postoperative day (POD13). The patient took analgesics once a day before the surgery and three times a day after the surgery until POD11. Pyrexia (37.5-39.5 degree Celsius) in synchronization with nonnephrogenic VARP remitted on POD18. Intravenous antibiotics had little effect on changes of pyrexia. Serum procalcitonin values (reference range <0.5 ng/mL) are 0.07 ng/mL on POD12 and 0.06 ng/mL on POD18. His polyuria came to react with sublingual desmopressin after alleviation of pyrexia. He left the hospital under hormone replacement therapy without newly added neurological sequelae other than hypopituitarism. After GTR of an infundibular epidermoid cyst, based on values of serum procalcitonin, post-eTSS MM can be distinguished from infection and can be treated with symptomatic treatments. The postoperative transient nonnephrogenic VARP that differs from usual central diabetes insipidus can react with sublingual desmopressin after alleviation of PPP in the clinical course of post-eTSS MM. An infundibular epidermoid cyst should be sufficiently resected in one sitting to minimize comorbidities, its recurrence, or postoperative MM to the utmost.
The fourth branchial complex anomaly: a rare clinical entity
Authors: Alpen B Patel, Michael L Hinni
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies.
Significance of collateral circulation in managing persistent sciatic artery: Two case reports
Authors: Woo-Sung Yun, Hyeon Ju Kim, Deokbi Hwang, Hyung-Kee Kim
Journal: Front Surg (2023)
Keywords: collateral circulation, conservative treatment, embolectomy, embolism and thrombosis, persistent sciatic artery
MeSH terms: Case Reports

Persistent sciatic artery (PSA) is a rare congenital anomaly considered an embryologic remnant of the internal iliac artery. Traditionally, the classification systems categorized PSA based on the completeness of PSA and superficial femoral artery (SFA) alongside the origin of PSA. The most common class has been known as type 2a in Pillet-Gauffre classification, meaning complete PSA with incomplete SFA. The mainstay of these patients with limb ischemia has been surgical bypass alongside excision or ligation of PSA aneurysm if present. However, the current PSA classification system does not account for collateral blood flow. Herein, we described two cases of type 2a PSA with distal embolization and explored therapeutic choices for PSA based on collateral presence. The first patient was treated with thromboembolectomy and patch angioplasty, and the second with conservative management. Despite distal embolization in both patients, bypass surgery was avoided, and distal circulation was maintained via collaterals from deep and superficial femoral arteries without increased risk of recurrent embolization. Thus, carefully examining collateral circulation and customized strategy is essential for managing PSA.
Topical Glucocorticoid Use and the Risk of Posttransplant Diabetes
Authors: Simon Bøtker, Henrik Birn, Lara Aygen Øzbay
Journal: Case Rep Endocrinol (2023)
MeSH terms: Case Reports

Systemically administered glucocorticoids constitute an essential part of the immunosuppressive regimen for transplant recipients, yet their known risks of causing hyperglycemia or posttransplant diabetes require close monitoring and minimisation of use, when possible, to prevent detrimental effects on patient morbidity and graft survival. Topical glucocorticoids, on the other hand, are rarely considered to affect glucose metabolism and therefore seldomly monitored, despite their wide and in some cases, long-term use. We report a case of a renal transplant recipient presenting with acute hyperosmolar hyperglycemia after treatment with topical glucocorticoids and present a mini review of the literature.
Bilateral Breast Metastases from Vulvar Carcinoma: A Case Report and Literature Review
Authors: D C Papatheodorou, C G Liakou, K Kalogerakos, Johannes Carl Athanasios Dimopoulos, N Kalinoglou
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Vulvar carcinoma is a rare disease that accounts for 3-5% of all gynecologic malignancies. Breast represents an unusual site of metastasis and only a few cases are reported. We describe the first case of bilateral metastatic breast carcinoma of vulvar origin, at an 80-year-old female patient. Six months after treatment of her primary disease, she presented with bilateral metastatic squamous cell breast carcinoma. Diagnosis was based on clinical, radiological, and histological facts. Breast although rare is another potential site of metastasis in vulvar cancer and thus mammary gland examination should be considered in the follow-up of these patients. Differential diagnosis between primary and metastatic lesions is of utmost importance for appropriate management.
Invasive Streptococcus agalactiae ST283 infection after fish consumption in two sisters, Lao PDR
Authors: Manophab Luangraj, Jasmin Hiestand, Othila Rasphone, Swaine L Chen, Viengmon Davong, Timothy Barkham, Andrew J H Simpson, David A B Dance, Valy Keoluangkhot
Journal: Wellcome Open Res (2022)
Keywords: laos, streptococcus agalactiae, food-borne infection
MeSH terms: Case Reports

Background: Streptococcus agalactiae is a normal commensal of the human gastro-intestinal and female genital tracts. It causes serious disease in neonates and pregnant women, as well as non-pregnant adults. Food-borne outbreaks have also been described. A link between invasive Group B streptococcus (GBS) infection in humans caused by S. agalactiae serotype III-4, sequence type 283 (ST283) and the consumption of raw fresh-water fish was first described in Singapore in 2015. Case presentation: We report the simultaneous occurrence of acute fever and myalgia in two sisters who were visiting Laos. Both were found to have invasive GBS ST283 infection, confirmed by blood culture. Infection was temporally linked to fish consumption. They responded well to intravenous antibiotics within 48 hours. Conclusions: Food-borne transmission of Streptococcus agalactiae is an important and under-recognised source of serious human disease throughout Southeast Asia and possibly beyond.
Benign tumours leading to total penile denudation treated with Manuka honey dressings: A case report and review of literature
Authors: Amalie Sylvester-Hvid, Magnus B Avnstorp, Tobias Fjeld, Bjørn Crewe
Journal: Int J Surg Case Rep (2019)
Keywords: balanitis, manuka honey, penile denudation, penile reconstruction, split-thickness skin graft, wound infection

Introduction:
Penile denudation is a devastating condition often reconstructed with a split-thickness skin graft(STSG). As this kind of reconstruction is challenging, we present an non-invasive treatment using Manuka honey dressings with a satisfying result. This was performed as a salvage procedure after failed STSG.
Case:
A 55-year-old non-smoking male was admitted from his general practitioner with a newly onset of phimosis and lower urinary tract symptoms. Benign tumours complicated with infection were found on all segments of the penis causing dehiscence of the skin. After surgical removal of tumours and an unsuccessful STSG, Manuka honey dressings was used. Full sexual function was regained, and the patient was satisfied with the result.
Discussion:
Alternatives to STSG are full-thickness skin graft using the inguinal or scrotal borrowing method, or using a dermal matrix before a STSG. A rediscovered method is using Manuka honey, with its unique combination of bactericidal, anti-inflammatory and healing-promoting properties. A wide range of wound types may benefit from Manuka honey dressings. A recent Danish in vitro study on honey derived from various Danish floras even shows high antibacterial effect superior to commercial medical grade honey. Considering a growing resistance to antibiotics, medical honey may contribute as a alternative to extensive wound care.
Conclusion:
We successfully treated a penile denudation with Manuka honey following a failed STSG. Wounds, ulcers, and burns may be infected, and can be challenging, time consuming, and expensive to treat. Manuka honey may be a good alternative to reconstructive surgery and can be managed on an out-patient basis.
Two Cases of Ectopic Pregnancy Mimicking Gestational Trophoblastic Disease
Authors: Haruka Suzuki, Yoshitsugu Chigusa, Junzo Hamanishi, Masaki Mandai, Eiji Kondoh
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

A well-known typical feature of ectopic pregnancy is an evident gestational sac structure outside of the uterus. However, some cases show atypical appearance that is described as a heterogeneous hypervascular mass. We report two cases of ectopic pregnancy that presented heterogeneous findings mimicking gestational trophoblastic diseases but were correctly diagnosed as ectopic pregnancies on MRI. The first case was an interstitial pregnancy in which the patient underwent surgical treatment. The second case was a cesarean scar pregnancy that was treated conservatively but showed spurious enlargement of pregnancy-related lesions after the treatment. Both cases lacked myometrial invasion on MRI, and the patients were diagnosed with ectopic pregnancies. Invasive findings on MRI may discriminate ectopic pregnancy from trophoblastic tumors and avoid unnecessary hysterectomy.
Severe Thrombocytopenia Associated with Dengue Fever: An Evidence-Based Approach to Management of Thrombocytopenia
Authors: Sulagna Das, Charles Abreu, Micah Harris, John Shrader, Satish Sarvepalli
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Dengue is a mosquito-borne viral illness common in tropical and subtropical countries but very rare in the United States. Patients infected with dengue often present with thrombocytopenia. In the setting of dengue, platelet transfusions as a treatment for thrombocytopenia have no clear benefits in reduction of severe bleeding or improvement of the platelet count. Here, we present a case of a traveler infected with dengue virus and discuss the approach to treat thrombocytopenia.