OpenMed/multicare-articles huggingface dataset:
Anesthesia Management of Vitrectomy in a Patient with Sturge-Weber Syndrome
Authors: Fatemeh Roodneshin, Mahtab Poor Zamany Nejat Kermany, Pooya Rostami, Hamed Tanghatari
Journal: Tanaffos (2018)
Keywords: difficult airway, propofol, sturge-weber syndrome
MeSH terms: Case Reports

Sturge-Weber syndrome (SWS) is a neurocutaneous disorder, characterized by leptomeningeal angiomas involving the oral cavity, trachea, larynx, and face. Herein, we present a case of vitrectomy in a seven-year-old boy with SWS. The patient showed hemangioma on the left side of his face, as well as mental retardation and epilepsy. Preoperative examination revealed no apparent hemangioma in the oral cavity, pharynx, larynx, or trachea. However, he was predicted to have difficult airway intubation, as the oral cavity was smaller than the normal size. The minimum Mallampati score was 3-4 due to macroglossia. First, we applied awake intubation, but he failed to follow the commands. We proceeded to general anesthesia with propofol and did not use any muscle relaxants to maintain spontaneous breathing. A laryngeal mask airway was inserted to minimize any harm to possible oral angiomas. The patient was hemodynamically stable and extubated without any complications, such as bleeding or respiratory problems.
Refractory topiramate-induced angle-closure glaucoma in a man: a case report
Authors: Matthew C Willett, Deepak P Edward
Journal: J Med Case Rep (2011)

Introduction:
Topiramate is a sulphonamide derivative indicated in the treatment of epilepsy and migraine. A known adverse affect is an idiosyncratic reaction that results in angle-closure glaucoma. We describe a patient with bilateral glaucoma related to topiramate that showed some unusual clinical features.
Case presentation:
A 39-year-old Caucasian man presented with acute angle-closure glaucoma; he initially presented with intractable headaches after being treated with an escalating dose of topiramate. Clinical signs included elevated intraocular pressure that was initially refractory to treatment, shallow anterior chambers, and extensive bilateral choroidal effusions. After treatment with intravenous methylprednisolone, in conjunction with conventional glaucoma treatment, there was rapid reduction of intraocular pressure, gradual delayed resolution of the choroidal effusion and induced myopic shift; and eventually a good outcome without optic nerve damage.
Conclusion:
This case illustrates the importance of recognizing this entity in a non-ophthalmic setting and that intravenous methylprednisolone may be useful in the treatment of the condition when it is not responsive to conventional treatment. In addition, it is important to recognize that complete resolution of visual symptoms from the myopic shift may be delayed, despite normalization of intraocular pressure.
Myeloid sarcoma: a report of four cases at unusual sites
Authors: Fouzia Siraj, Manveen Kaur, Varsha Dalal, Ashima Khanna, Afaq Ahmad Khan
Journal: Ger Med Sci (2017)
Keywords: acute leukemia, extramedullary, granulocytic sarcoma, myeloid sarcoma
MeSH terms: Cerebellar Neoplasms / pathology, Cerebellopontine Angle / pathology, Nose Neoplasms / pathology, Orbital Neoplasms / pathology, Perineum / pathology, Sarcoma, Myeloid / pathology, Case Reports, Adult, Cerebellar Neoplasms / diagnosis, Child, Diagnosis, Differential, Humans, Male, Middle Aged, Nasal Cavity / pathology, Nose Neoplasms / diagnosis, Orbital Neoplasms / diagnosis, Sarcoma, Myeloid / diagnosis

Background: Myeloid sarcoma (MS) or granulocytic sarcoma is a rare tumor consisting of myeloid blasts with or without maturation occurring at anatomic sites other than the bone marrow. MS can involve any organ system but shows a predilection for skin, bone, and soft tissues of head and neck region. Case report: We report four cases of MS occurring at unusual sites, out of which three were de novo and one was associated with acute myeloid leukemia (AML). Conclusion: Although MS is associated with AML, it can rarely present without any existent hematologic disease. Differential diagnosis of a soft tissue mass should include MS even in the absence of leukemia. Establishment of the correct diagnosis depends on morphologic, histochemical, and immunohistochemical examination.
Multisystem Inflammatory Syndrome in Children in a 15-Year-Old Male with a Retropharyngeal Phlegmon
Authors: Paul Han, Jelena Douillard, Jerry Cheng, Anusha Ramanathan, David Tieu, Timothy Degner
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

This is a case of a 15-year-old male with an initial diagnosis of a retropharyngeal phlegmon who ultimately developed new symptoms and laboratory findings consistent with MIS-C. This case report demonstrates an atypical initial presentation for MIS-C that has not been reported in the literature.
Hepatic subcapsular hematoma post-ERCP: Case report and literature review
Authors: Luca Giovanni Antonio Pivetta, Caroline Petersen da Costa Ferreira, João Paulo Venancio de Carvalho, Renata Yumi Lima Konichi, Victor Kenzo Fujikawa Kawamoto, Jose Cesar Assef, Mauricio Alves Ribeiro
Journal: Int J Surg Case Rep (2020)
Keywords: acute abdomen, case report, endoscopic retrograde cholangiopancreatography, hepatic subcapsular hematoma, subcapsular liver hematoma
MeSH terms: Case Reports

Introduction:
Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most frequently performed minimally invasive procedures currently available for diagnosis and treatment of biliary and pancreatic diseases. Though considered a safe procedure, it has the highest rate of complications among the other endoscopic procedures, such as duodenal perforation and hepatic subcapsular hematoma (HSH). We are a presenting a case report and review of the current literature.
Method:
We report one case HSH rupture, in a 25 years old female patient, 15 cm in diameter, affecting liver segments VI, VII and VIII, who underwent surgical treatment and performed a systematic literature review with the descriptors: endoscopic retrograde colangiopancreatography and hepatic subcapsular hematoma. All articles were reviewed and data on cases that presented rupture of the HSH analyzed separately.
Results:
Sixty one cases of HSH were described in the literature, fourteen of them ruptured. When analyzing only the subgroup of patients who had ruptured subcapsular hematoma, we showed a significant increase in the mortality rate of patients when compared to non-ruptured (21.4% × 2.2%). We also report that patients with rupture required some type of intervention, of which 78.6% required surgery. Conservative treatment may be the conduct and will suffice for most cases of non-ruptured hematomas. For patients who evolve with rupturing, surgical resolution, although non-mandatory, is necessary in most cases.
Conclusion:
HSH ruptured is a rare and potentially fatal post-ERCP complication whose treatment is eminently surgical.
Incidental finding of asymptomatic non-traumatic pericardial effusion in a trauma patient: a case report
Authors: Ahmed Alkathim, Dunya Alfaraj, Mohannad Ali Alghamdi, Samar Al-Nahash
Journal: J Med Life (2023)
Keywords: atls, fast, cardiac tamponade, multiple trauma, pericardial effusion, pericardiocentesis
MeSH terms: Body Fluids, Pericardial Effusion, Case Reports, Adult, Foot, Hematoma, Humans, Incidental Findings, Male

Pericardial effusion can either be an incidental finding or a manifestation of systemic or cardiac disease. It has a wide range of presentations, from asymptomatic small effusion to rapidly progressive fatal tamponade. In a trauma setting, pericardial effusion is usually attributed to hematoma collection, with the concern of clinical evidence of tamponade that can lead to cardiopulmonary collapse. The Focused Assessment with Sonography for Trauma (FAST) is a widely used tool to diagnose pericardial effusion in trauma patients. We published this case report to emphasize that the presence of pericardial effusion alone in a trauma patient does not indicate the presence of tamponade. This case concerns a 39 years old male patient who presented to ER as a trauma case after a fall from two meters height and landing on his feet. ATLS protocol was followed, and FAST showed an incidental finding of massive pericardial fluid. The trauma team was consulted, and the patient was hemodynamically stable without clinical evidence of tamponade. Echocardiography showed mitral valve stenosis and large pericardial effusion. The close observation did not suggest the presence of cardiac tamponade. The pericardial catheter was inserted during admission with drainage of 900cc of serous fluid. The presence of pericardial fluid in a trauma setting does not confirm the diagnosis of tamponade. The mechanism of injury, clinical presentation, and the patient's stability are essential factors in determining further management of such patients.
Isolated inferior vena cava aneurysm: a case report
Authors: Niki Tadayon, Seyyed Mohammadreza Kalantar-Motamedi, Sina Zarrintan, Ali Tayyebi
Journal: J Cardiovasc Thorac Res (2019)
Keywords: aneurysm, inferior vena cava, right medial visceral rotation, venorrhaphy
MeSH terms: Case Reports

We report a rare case of inferior vena cava (IVC) aneurysm in a 22-year old Afghan-Iranian male patient. CT scan illustrated a saccular aneurysm of IVC originating from right side of the IVC below the renal veins (a saccular type 3 IVC aneurysm). We planned open resection and repair of the aneurysm. The patient had well recovery after the operation and his follow-up did not reveal any morbidity. IVC aneurysm is a rare clinical entity. Its diagnosis necessitates precise clinic suspicion and the management is based on anatomical location and associated anomalies.
A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis
Authors: Peter V Bui, Maan Moualla, Dona J Upson
Journal: Case Rep Med (2016)

Introduction. 3,3'-Diindolylmethane is available as a supplement in the United States for "cancer prevention" and "augmentation of physical fitness." A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism.
Oral and maxillofacial considerations in Gardner's syndrome: a report of two cases
Authors: Debora Lima Pereira, Paulo Andre Carvalho, Maria Isabel Waddington Achatz, AndreCaroli Rocha, Giovana TardinTorrezan, Fabio Abreu Alves
Journal: Ecancermedicalscience (2016)
Keywords: gardner’s syndrome, familial adenomatous polyposis, maxillofacial, osteomas
MeSH terms: Case Reports

Gardner's syndrome (GS) is a genetic disorder characterised by intestinal polyps, multiple osteomas, and soft-tissue tumours. Dentists play an important role in the syndrome diagnosis considering that craniomaxillofacial osteomas are a major criteria for Gardner's syndrome diagnosis. This study aimed to describe the main stomatological manifestation of GS and the importance of dentists in its diagnosis. Two patients presenting GS were evaluated. The first one had two osteomas in the mandible and GS was suspected. The colonoscopy confirmed the presence of polyposis and a prophylactic proctocolectomy was performed. The other patient had a late-stage diagnosis of GS and developed a rectum adenocarcinoma. The presence of craniomaxillofacial osteomas are a hallmark of the disease. Early-stage GS diagnosis may enable early diagnosis and preventive strategies in carriers. Other dental abnormalities, such as supernumerary teeth, hypercementosis and odontomas, can also be observed.
A giant colonic diverticulum presenting as a 'phantom mass': a case report
Authors: Ayman S Abdelrazeq, Anwar E Owais, Munther I Aldoori, Ian D Botterill
Journal: J Med Case Rep (2009)

Introduction:
Diverticulosis coli is the most common disease of the colon in Western countries. Giant colonic diverticulum, defined as a colonic diverticulum measuring 4 cm in size or larger, represents an unusual manifestation of this common clinical entity.
Case presentation:
A 68-year-old Caucasian British woman with a history of intermittent lower abdominal mass, leg swelling and focal neurological symptoms underwent extensive non-diagnostic investigations over a significant period under a number of disciplines. The reason for a diagnosis being elusive in part related to the fact that the mass was never found on clinical and ultrasound examination. As a result, the patient's validity was questioned. Ultimately, this 'phantom-mass' was diagnosed as a giant colonic diverticulum causing intermittent compression of the iliac vein and obturator nerve.
Conclusion:
Intermittent compression of the iliac vein and the obturator nerve by a colonic diverticulum has not previously been reported. A giant colonic diverticulum presenting as an intermittent mass is very rare. This case also illustrates two factors. First, the patient is often right. Second, the optimal mode of investigation for any proven or described abdominal mass with referred symptoms is cross-sectional imaging, typically a computed tomography scan, irrespective whether the mass or symptoms are constant or intermittent.
Krabbe Disease: Report of a Rare Lipid Storage and Neurodegenerative Disorder
Authors: Pratyusha Pavuluri, Sabitha Vadakedath, Rajkumar Gundu, Sushmitha Uppulety, Venkataramana Kandi
Journal: Cureus (2017)
Keywords: autosomal recessive sphingolipidosis, galactosyl cerebroside, globoid cell leukodystrophy, krabbe disease, progressive neurologic degeneration
MeSH terms: Case Reports

Krabbe disease is a rare (one in 100,000 births) autosomal recessive condition, usually noticed among children. It causes sphingolipidosis (dysfunctional metabolism of sphingolipids) and leads to fatal degenerative changes affecting the myelin sheath of the nervous system. We report a case of a six-year-old male child who presented with symptoms of muscle spasticity and irritability. Diagnosis of this disease can only be made with clinical suspicion. Laboratory diagnosis includes brain magnetic resonance imaging (MRI), magnetic resonance (MR) spectroscopy, biochemical analysis of cerebrospinal fluid, and genetic analysis for detecting mutation in genes coding for galactosyl cerebroside (GALC). We report a case of late infantile Krabbe disease.
Thoracoscopic Resection of a Rare Case of Hemangioma of the Azygos Venous Arch
Authors: Ma Husai, Cai Yixin, Zhang Ni, Wang Wenxin, Fu Xiangning
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Hemangioma of the azygos venous arch is an exceedingly rare incident. This is a case of a thoracoscopic complete resection of a hemangioma of the azygos venous arch in a 37-year-old woman.
Optic Neuritis in a Child With Poorly Controlled Type 1 Diabetes Mellitus: A Case Report
Authors: Anood Alassaf, Khalid Mohamed, Abdullah Al Otaiby, Mohammad Al Wraidat, Abdulqadir J Nashwan
Journal: Cureus (2023)
Keywords: diabetes type 1, diabetic eye disease, ophthalmology, optic neuritis, pediatric diabetes
MeSH terms: Case Reports

Type 1 diabetes stands among the most prevalent endocrinological diseases in the pediatric age group. The incidence rate continues to rise globally. Optic neuritis has been described in the literature in association with type 2 diabetes; however, cases of optic neuritis with type 1 diabetes are very few. Here we describe a rare case of a 15-year-old patient with type 1 diabetes mellitus presenting with optic neuritis. Due to the hyperglycemia that steroids can induce in some patients, management with steroids can be difficult. A multidisciplinary team approach is required to ensure that these patients' optic neuritis is properly handled while avoiding steroid side effects.
Recurrent Multivalvular Staphylococcus Lugdunensis Endocarditis Causing Complete Heart Block after TAVR
Authors: Preeti Singhal, Somsupha Kanjanauthai, Wilson Kwan
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Prosthetic valve endocarditis after transcatheter aortic valve replacement (PVE after TAVR) is a feared complication most often observed during the early postprocedural period. We report a case of severe, multivalvular PVE after TAVR with complete heart block caused by an uncommon organism. A 78-year-old female with prior Streptococcus agalactiae mitral valve endocarditis treated with antibiotics presented one year later with severe, symptomatic aortic insufficiency. She subsequently underwent TAVR given high surgical risk. Six weeks post-TAVR, she presented with syncope, fever, and complete heart block. Transthoracic echocardiogram was not demonstrative of vegetation. Blood cultures were positive for Staphylococcus lugdunensis. Transesophageal echocardiogram (TEE) demonstrated vegetations of the aortic, mitral, and tricuspid valves and aorto-mitral continuity. While awaiting surgery, the patient developed cardiac arrest; she was resuscitated and taken to surgery emergently. The patient underwent TAVR explantation, bovine pericardial tissue aortic and porcine bioprosthetic mitral valve replacements, and tricuspid valve repair. Additionally, left main coronary artery endarterectomy was performed due to presence of infectious vegetative material. Staphylococcus lugdunensis is an unusual but virulent organism that may damage both native and prosthetic valves. Early surgery is recommended for PVE after TAVR, especially in cases with perivalvular disease causing conduction abnormalities. Learning Objectives. TAVR has revolutionized the management of severe aortic stenosis and has even been successfully utilized in select cases of aortic regurgitation. Unfortunately, there are a number of associated complications that can be difficult to diagnose, such as prosthetic valve endocarditis (PVE). We emphasize maintaining a high clinical suspicion for PVE after TAVR in patients presenting with conduction abnormalities and highlight the importance of early surgical management in cases complicated by heart block, abscesses, or destructive penetrating lesions.
A Rare Case of Pancreatic Actinomyces
Authors: Marguerite Poche, Kyle Liu, Codey Pham, Shilpa Jain, Robert Sealock
Journal: ACG Case Rep J (2023)
Keywords: actinomyces, gi, mass, pancreas
MeSH terms: Case Reports

Actinomyces israelii is a filamentous, gram-positive anaerobic bacterium commonly found in the upper gastrointestinal tract, colon, and female genital tract. Rarely, actinomycosis can infect the pancreas most commonly after pancreatic instrumentation, often mimicking malignancy. We describe a case of a 26-year-old woman who presented with epigastric abdominal pain and nausea without prior pancreatic instrumentation. Abdominal imaging demonstrated a mass in the pancreatic head with fine-needle biopsy revealing Actinomyces. The patient was successfully treated with long-term antibiotic therapy resulting in resolution of the mass. Our case emphasizes the importance of considering nonmalignant etiologies in the differential diagnosis of pancreatic masses.
Staphylococcus aureus bacteremia with a mediastinal abscess in a 9-month-old infant: a case report and literature review
Authors: Jouhadi Zineb, Chrislaine Moboula, Nassid Meryem, Fatene Abdallah, Chbani Kamilia, Boubia Souhail
Journal: Pan Afr Med J (2023)
Keywords: mediastinal abscess, staphylococcus aureus bacteremia, case report
MeSH terms: Bacteremia / complications, Bacteremia / diagnosis, Mediastinitis / diagnosis, Mediastinitis / etiology, Mediastinitis / therapy, Sepsis / diagnosis, Staphylococcal Infections / diagnosis, Staphylococcal Infections / drug therapy, Review, Case Reports, Abscess / etiology, Child, Drainage / methods, Humans, Infant, Necrosis / complications, Staphylococcus aureus

Non-traumatic mediastinal abscesses are very rare in children; we can classify them into 2 types: descending mediastinitis (or mediastinitis by extension or by contiguity) complicating an otorhinolaryngological or esophageal etiology and mediastinitis generated by direct blood inoculation in a context of a septicemia or primary mediastinitis which is exceptional. We describe a case of right pleuropulmonary staphylococcal disease with bilateral mediastinal localization in a previously healthy 9-month-old infant. It was revealed by sepsis with severe respiratory distress. The germ was isolated from the pleural puncture fluid. A thoracic computed tomography was indicated due to a widening mediastinum noted on chest X-ray in addition to pleuropulmonary involvement. Thoracic computed tomography revealed a huge bilateral mediastinal abscess which was curbed thanks to right pleural drainage with adapted antibiotic therapy. Other investigations did not show any immune abnormalities in this infant. Mediastinitis represents a diagnostic and therapeutic emergency; those that are secondary to direct blood or lymphatic dissemination even very rare; should be considered in any context of severe sepsis including staphylococcus or streptococcus pneumonia. Since 1985 only 11 cases of such mediastinal abscesses have been reported.