OpenMed/multicare-articles huggingface dataset:
Subdural hematoma after cesarean delivery without symptoms: a case report
Authors: Syuhei Domoto, Manzo Suzuki, Shinpei Suzuki, Hiroyasu Bito
Journal: JA Clin Rep (2018)
Keywords: neuraxial anesthesia, subdural hematoma, symptom-free

Background:
Subdural hematoma (SDH) after accidental dural puncture (ADP) is rare but may be lethal. We experienced a patient who developed SDH after combined spinal and epidural anesthesia without a headache.
Case presentation:
A 41-year-old parturient female with an unruptured cerebral aneurysm, was scheduled to undergo elective cesarean delivery. Cerebrospinal fluid leakage was identified during puncture of the epidural space, and a catheter was placed after re-puncture. The postoperative course was normal except for incisional pain. The patient complained of slight neck stiffness on the second postoperative day. Magnetic resonance imaging (MRI) was performed to ensure that there was no intracranial problem on the fourth postoperative day and showed a bilateral subdural hematoma. Increase in size of hematoma was shown on computed tomography (CT) on the ninth postoperative day. Epidural blood patch was performed. A decrease in the size of the hematoma was confirmed on the CT images on the 11th postoperative day, and the patient was discharged. The patient has not developed any additional symptoms.
Conclusions:
We experienced a patient who developed a SDH without a remarkable headache. It may be better to perform brain imaging studies, even if the patient does not complain of headache.
Primitive Tumour of the Pulmonary Valve: Discussion of the Differential Diagnosis
Authors: A Hannecart, D Ndjekembo-Shango, F Vallot, O Simonet, M De Kock
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

There is a paucity of information concerning cardiac tumours of the pulmonary valve due to their rarity at this location. We report a case of a 47-year-old patient suffering from haemoptysis, asthenia, and acute kidney injury (AKI). A transthoracic echocardiography (TTE) revealed a mass on the pulmonary valve. Further diagnostic investigation was completed until he exhibited worsening hemodynamic instability. This case emphasizes the lack of information regarding the management of a pulmonary valve tumour.
Methicillin-resistant Staphylococcus aureus enterocolitis sequentially complicated with septic arthritis: a case report and review of the literature
Authors: Yukari Ogawa, Takeshi Saraya, Takashi Koide, Ken Kikuchi, Kosuke Ohkuma, Koji Araki, Hiroshi Makino, Shota Yonetani, Hajime Takizawa, Hajime Goto
Journal: BMC Res Notes (2014)
MeSH terms: Arthritis, Infectious / microbiology, Cross Infection / microbiology, Enterocolitis / microbiology, Hip Joint / microbiology, Methicillin-Resistant Staphylococcus aureus / isolation & purification, Staphylococcal Infections / microbiology, Case Reports, Review, Aged, Anti-Bacterial Agents / therapeutic use, Arthritis, Infectious / etiology, Bacteremia / microbiology, Bacterial Typing Techniques, Catheter-Related Infections / microbiology, Catheters / microbiology, Clone Cells, Community-Acquired Infections / complications, Community-Acquired Infections / drug therapy, Cross Infection / complications, Diabetes Mellitus, Type 2 / complications, Diagnosis, Differential, Disease Susceptibility, Enterocolitis / complications, Enterocolitis / diagnosis, Enterocolitis, Pseudomembranous / diagnosis, Equipment Contamination, Evolution, Molecular, Feces / microbiology, Humans, Male, Methicillin-Resistant Staphylococcus aureus / classification, Methicillin-Resistant Staphylococcus aureus / genetics, Pneumonia, Pneumococcal / complications, Pneumonia, Pneumococcal / drug therapy, Shock, Septic / diagnosis, Staphylococcal Infections / complications, Synovial Fluid / microbiology, Vancomycin / therapeutic use, Anti-Bacterial Agents, Vancomycin

Background:
Although most reports describing patients infected with methicillin-resistant Staphylococcus aureus enterocolitis have been published in Japan, this concept remains a matter of debate and diagnostic criteria have not yet been defined.
Case presentation:
The general status of a 74-year-old Japanese man referred to our hospital (day 1) with severe community-acquired pneumococcal pneumonia gradually improved with antibiotic therapy. Thereafter, up to 4 L/day of acute watery diarrhea that started on day 19 was refractory to metronidazole but responded immediately to oral vancomycin. Gram staining stool samples was positive for abundant fecal leukocytes from which dominant methicillin-resistant Staphylococcus aureus (10(4) CFU/mL) were isolated, suggesting methicillin-resistant Staphylococcus aureus enterocolitis. High fever with methicillin-resistant Staphylococcus aureus bacteremia was evident at day 30, and suppurative right hip arthritis developed around day 71. All methicillin-resistant Staphylococcus aureus strains isolated from stools, blood and aspirated synovial fluid separated in the same manner on pulsed-field gel electrophoresis, as well as two other strains isolated from sputum, belonged to the same clone as sequence type (ST) 764 (complex clonal 5), and carried SCCmec type II.
Conclusion:
The clinical, microbiological and molecular biological findings of this patient indicated methicillin-resistant Staphylococcus aureus enterocolitis that led to septic methicillin-resistant Staphylococcus aureus arthritis.
Enhanced skin toxicity with concurrent ipilimumab and radiation in vaginal/vulvar melanoma: a case report and literature review
Authors: Shane Mesko, Gottfried E Konecny, Paul C Tumeh, Mitchell Kamrava
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Ipilimumab is a monoclonal cytotoxic T-lymphocyte-associated protein 4 antibody that has demonstrated improved survival in cutaneous melanoma. Little is known about the clinical impact of combining anti-cytotoxic T-lymphocyteassociated protein 4 therapy with radiation. Here we report a case of severe cutaneous desquamation in a 70-year-old female with vaginal/vulvar melanoma receiving concurrent ipilimumab and radiation therapy. The toxicity was successfully treated with oral/topical steroids and a break from treatment. This case underscores the importance of future research on optimal strategies for combining radiation with novel anti-tumour agents.
Loss of daptomycin susceptibility in clinical Staphylococcus epidermidis infection coincided with variants in WalK
Authors: Nicholas F Brazeau, Kara J Levinson, Asher Schranz, Kara A Moser, Ian Hollis, Prashanth Iyer, Christopher Chien, Amanda Bowen, David van Duin, Anne Lachiewicz, Tessa Andermann, Melissa Jones, Melissa Miller, Jonathan J Juliano, Luther A Bartelt
Journal: Evol Med Public Health (2020)
Keywords: staphylococcus epidermidis, antibiotic resistance, daptomycin
MeSH terms: Case Reports

Daptomycin (DAP) is key in treating multidrug-resistant Staphylococcus infections. Diminished susceptibility to DAP is emerging among Staphylococcus epidermidis strains although mechanisms for non-susceptibility (NS) remain poorly understood. We report a case of persistent S. epidermidis bacteremia in which loss of DAP susceptibility arose during prolonged treatment. Whole genome sequencing identified two mutations, Q371del and P415L, in a single-affected gene, WalK, that coincided with the emergence of DAP-NS. Protein modeling of the mutations predicted a disruption of WalK protein configuration. The emergence of mutations in a single-gene during DAP exposure raises concerns in an era of increasingly treatment-resistant infections. Lay summary: Daptomycin is an important antibiotic for fighting Staphylococcus infections. We identified variants in the WalK gene that were coincident with resistance in a clinical Staphylococcus epidermidis infection. Clinicians, hospital epidemiologists, and microbiology laboratories need to be aware of the potential for the evolution of drug resistance during prolonged daptomycin therapy.
Infantile hypertrophic pyloric stenosis with unusual presentations in Sagamu, Nigeria: a case report and review of the literature
Authors: Tinuade Adetutu Ogunlesi, Opeyemi Temitola Kuponiyi, Collins Chigbundu Nwokoro, Ibukunolu Olufemi Ogundele, Gbenga Fakunle Abe, Olusoga Babatunde Ogunfowora
Journal: Pan Afr Med J (2016)
Keywords: abdominal mass, gastric outlet obstruction, newborn, pyloric stenosis, pyloromyotomy, vomiting
MeSH terms: Fever / etiology, Pyloric Stenosis, Hypertrophic / diagnosis, Vomiting / etiology, Case Reports, Review, Dehydration / etiology, Female, Humans, Infant, Newborn, Nigeria, Pyloric Stenosis, Hypertrophic / diagnostic imaging, Pyloric Stenosis, Hypertrophic / physiopathology

A 24-day old female Nigerian neonate presented with protracted vomiting, fever and dehydration but without palpable abdominal tumour or visible gastric peristalsis. There was no derangement of serum electrolytes. The initial working diagnosis was Late-Onset Sepsis but abdominal ultrasonography showed features consistent with the diagnosis of IHPS. This case report highlights the atypical presentation of this surgical condition and the need to investigate cases of protracted vomiting in the newborn with at least, ultrasonography to minimize complications and reduce the risk of mortality in a resource-poor setting.
How Point-of-Care Ultrasound Led to a Diagnosis of May-Thurner Syndrome
Authors: Daniel L Belkin, Mitchell D Belkin, Maedeh Ashrafi, Charan Vegivinti, Yung-Hsien Wang, Leonidas Palaiodimos
Journal: POCUS J (2021)
Keywords: dvt, may- thurner syndrome, pocus, vascular, deep vein thrombosis, point-of-care ultrasound, thrombectomy
MeSH terms: Case Reports

A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin. Laboratory studies revealed leukocytosis. Lymphadenopathy secondary to infectious or inflammatory etiology was suspected. However, point-of-care ultrasound (POCUS) identified extensive deep vein thrombosis (DVT) of the lower left limb. Follow-up imaging revealed this to be secondary to May-Thurner syndrome, a mechanical compression of an iliocaval vein against the lumbar vertebrae by a common iliac artery. This report demonstrates how POCUS can be used to identify lower extremity DVT, thereby expediting diagnosis and treatment and potentially preventing complications.
Spontaneous Intracranial Hypotension Presenting With Frontotemporal Dementia: A Case Report
Authors: Ahmet Ozyigit, Costas Michaelides, Konstantinos Natsiopoulos
Journal: Front Neurol (2018)
Keywords: cerebrospinal fluid, dementia, dysarthria, intracranial hypotension, narcolepsy
MeSH terms: Case Reports

Spontaneous intracranial hypotension (SIH) is a rare and often underdiagnosed condition, which commonly results from a cerebrospinal fluid leak. The classic clinical presentation of SIH is a postural headache and dizziness. Less frequent complications include nausea, neck stiffness, and even coma. This case report describes a 70-year-old woman with an initial complaint of postural headaches and sleep attacks, who developed a 22-month progressive history of personality and behavioral changes, cognitive decline, urinary incontinence, chorea, and dysarthria. Although no specific cerebrospinal fluid leak was identified, the patient was suspected of having SIH and her symptoms completely reversed after a 2-month course of steroids. This case highlights that SIH represents a rare and reversible cause of a wide spectrum of neurological symptoms, including dementia. Neurologists should be aware of this diagnosis when evaluating patients with neurological signs and symptoms that cannot otherwise be explained.
Contemporary empyema thoracis necessitans in an adult male caused by Staphylococcus aureus: decortication is superior to traditional under water seal intercostal tube in chronic empyema
Authors: Liaqat Ali Chaudhry, Ahmed A Ba Mousa, Marwan Zamzami, Asirvatham Alwin Robert
Journal: Pan Afr Med J (2015)
Keywords: empyema, staphylococcus aureus, paraplegis
MeSH terms: Empyema, Pleural / therapy, Staphylococcal Infections / therapy, Staphylococcus aureus / isolation & purification, Case Reports, Anti-Bacterial Agents / administration & dosage, Chronic Disease, Drainage, Empyema, Pleural / etiology, Empyema, Pleural / microbiology, Humans, Male, Middle Aged, Staphylococcal Infections / microbiology, Staphylococcal Infections / pathology, Thoracic Injuries / complications, Thoracostomy / methods, Anti-Bacterial Agents

Empyema thoracis necessitans is a rare clinical finding nowadays. We report 55 years old Saudi male with past history of road traffic accident, poly trauma, chest surgery and paraplegia admitted for rehabilitation in Sultan Bin Abduaziz Humanitarian City (SBAHC), Riyadh, Saudi Arabia and diagnosed with empyema thoracis necessitans due to Staphylococcus aureus, treated initially with traditional thoracostomy under water seal intercostal intubation and antibiotics but subsequently required decortication.
A Large Sporadic Intra-abdominal Desmoid-Type Fibromatosis in a Young Male: A Case Report
Authors: Natasha A Sioda, Andre A Wakim, Tina Wong, Shyamal Patel, Kathryn Coan, David Row
Journal: Front Surg (2020)
Keywords: case report, desmoid, intra-abdominal, retroperitoneal, surgery
MeSH terms: Case Reports

Desmoid type fibromatosis (DTF) is a rare benign tumor of connective tissue origin. While these tumors are typically not malignant, they can exhibit aggressive growth patterns causing mass effect on surrounding organs. These tumors typically present in the extremities and abdominal wall, rarely occurring in the mesentery, and abdominal organs. Due to the rarity of this tumor and the variable size and origin, it is difficult to provide exact prognosis, recurrence, and treatment efficacy regarding desmoid tumors arising from the ileocolic mesentery. We present a case of a young male with a sporadic 31 × 25 × 12 cm DTF arising from the ileocolic mesentery that was complicated by mass effect on bowel and intra-abdominal organs requiring surgical intervention. On presentation, the patient exhibited weight gain and abdominal pressure. Abdominal distension without tenderness on palpation was noted on physical examination. The tumor biopsy confirmed the diagnosis of DTF. No evidence of familial adenomatous polyposis or Gardner syndrome was identified. The tumor was surgically excised and intimately associated with the bowel requiring ileocolonic resection with primary anastomosis. At 3-months follow up, surveillance MRI showed no residual or recurrent lesion. A multi-disciplinary approach to this patient's diagnosis and treatment allowed for an accurate diagnosis, efficient treatment, and follow up plan.
Single lesion multibacillary leprosy, a treatment enigma: a case report
Authors: Bishwa R Sapkota, Kapil D Neupane, Ram K Maharjan
Journal: J Med Case Rep (2009)

Introduction:
Leprosy exhibits a wide spectrum of presentation, varying from the tuberculoid to the lepromatous pole, with immunologically unstable borderline forms in-between, depending upon the immune status of the individual. The clinical system of classification for the purpose of treatment includes the number of skin lesions and nerves involved as the basis for classifying the patients into multibacillary and paucibacillary.
Case presentation:
A 20-year-old man belonging to a moderately endemic leprosy area in the Terai region of Nepal reported a large single, hypopigmented, well defined anaesthetic lesion on his left thigh extending to his knee which had been present for 2 years. There was no other nerve involvement. Clinical diagnosis was tuberculoid leprosy and immunological lateral flow test for anti-Phenolic glycolipid-I antibody was positive. Six months of paucibacillary multidrug treatment was advised immediately. However, the patient was reclassified as multibacillary on the basis of a positive skin smear and appropriate treatment of 24 months multibacillary multidrug regimen was commenced after only 1 week. Slit skin smear examination for Mycobacterium leprae from the lesion revealed a bacterial index of 4+ while it was negative from the routine sites. Histopathological examination from skin biopsy of the lesion further supported the bacterial index of the lesion granuloma which was 2+ and the patient was diagnosed as borderline tuberculoid. Bacteriological, histological, and immunological findings of this patient were borderline tuberculoid leprosy and he should have been treated with multibacillary regimen from the beginning. Five months after commencement of treatment, the patient developed a leprae reaction of Type 1 or reversal reaction with some nerve function impairment and enlargement of the lateral popliteal nerve of the left leg. This reversal reaction was managed by standard oral prednisolone whilst continuing the multibacillary multidrug regimen.
Conclusion:
This case illustrates and emphasizes the importance of slit-skin smear and biopsy as routine in all new cases to help differentiate multibacillary from paucibacillary for correct treatment. It further suggests that there are factors yet undetermined which play a significant role in determining the host response to M. leprae which is a remaining challenge in this disease.
Primary hydatid cyst of the kidney and ureter with hydatiduria in a laboratory worker: a case report
Authors: Venkatesh Seetharam, Vinay Khanna, Padmapriya Jaiprakash, Kranthi Kosaraju, Joseph Thomas, Chiranjay Mukhopadhayay
Journal: Case Rep Nephrol (2012)

Hydatid disease is frequent in endemic regions and sheep farming areas. Most common localization of hydatid cyst occurs in liver followed by lungs. Renal hydatid cyst constitutes about 2-4% of all locations. We report a case of left renal hydatid from a laboratory technician admitted in a tertiary care hospital. There were few cases of renal hydatid disease reported in India among general population but to the best of our knowledge never reported from laboratory worker. The possibility of laboratory-acquired infection cannot be ruled out in this case due to lack of precautionary measures and containment facilities in resource-constrained setting.
A Rare Case of Unilateral Morning Glory Disc Anomaly in a Patient with Turner Syndrome: Report and Review of Posterior Segment Associations
Authors: Dev R Sahni, Michael Wallace, Mansi Kanhere, Hind Al Saif, Natario Couser
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

Turner syndrome is a common sex chromosome disorder affecting females. The disorder is caused by a partial loss, complete absence, or structural abnormality of one X chromosome. The clinical presentation is broad and ranges from the classic phenotype to minimal clinical manifestations. Ocular abnormalities associated with the syndrome are common. Reports describing abnormal eye features in individuals with Turner syndrome generally involve refractive errors (myopia or hyperopia), strabismus, and external or anterior segment abnormalities including hypertelorism, epicanthal folds, and ptosis. Posterior ocular segment anomalies involving the optic nerve and retina in Turner syndrome have been rarely reported. We report a rare presentation of an 11-year-old female with Turner syndrome and unilateral morning glory disc anomaly.
Diaphragmatic hernia after laparoscopic esophagomyotomy for esophageal achalasia in pregnancy
Authors: Meena Khandelwal, Chad Krueger
Journal: ISRN Gastroenterol (2011)
MeSH terms: Case Reports

Background. The optimal treatment for management of esophageal achalasia in pregnancy is controversial. Little information exists about pregnancy outcome after successful myotomy. Case. Achalasia in pregnancy was diagnosed when a patient presented with pneumomediastinum from microrupture of the overdistended esophagus. An attempt at surgical correction failed due to the development of aspiration pneumonia with general anesthesia. Conservative medical therapy was undertaken, but fetal growth restriction developed. The patient underwent interval surgical correction, but subsequent pregnancy 6 months later was complicated by acute diaphragmatic hernia necessitating preterm delivery. Conclusion. Prior to surgery in pregnancy, emptying the dilated esophagus via nasoesophageal tube suctioning maybe warranted to avoid aspiration. Women, despite having undergone successful myotomy, should be counseled on the risks of pregnancy and to avoid pregnancy for at least 1 year thereafter.
Minimally Invasive Treatment of Sporadic Burkitt's Lymphoma Causing Ileocaecal Invagination
Authors: Paolo Panaccio, Michele Fiordaliso, Domenica Testa, Lorenzo Mazzola, Mariangela Battilana, Roberto Cotellese, Federico Selvaggi
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Primary NHL (non-Hodgkin lymphoma) of the colon represents only 0.2% to 1.2% of all colonic malignancies. Burkitt's lymphoma (BL) is usually a disease reported in children and young people, most of them associated with EBV or HIV infection. We describe a rare case of intestinal obstruction due to sporadic Burkitt's lymphoma causing ileocaecal invagination explaining our experience Methods. A 31-year-old man presented with diffuse colic pain and weight loss. Clinical examination revealed an abdominal distension with pain in the right iliac fossa. Colonoscopy documented a caecal large lesion with ulcerated mucosa. Computed tomography (CT) have shown a 60 × 50 mm right colic parietal lesion with signs of ileocolic intussusception.
Results:
Laparoscopic right hemicolectomy was performed. Postoperative period was uneventful. CD20+ high-grade B-cell Burkitt's lymphoma was confirmed by immunohistochemistry (CD20+, CD79+, and CD10+) and FISH test (t (8;14) (q24; q32). The patient was subsequently treated with adjuvant combination chemotherapy (Hyper-CVAD) and is alive and disease-free at 8 months follow-up.
Discussion:
Adult sporadic Burkitt's lymphoma (BL) causing intestinal obstruction due to ileocaecal intussusception is an extremely rare occurrence and a diagnostic dilemma. Despite the surgical approach is selected based on patient's conditions and surgeon's expertise, minimally invasive method could be preferred.
Management of Severe Epistaxis during Pregnancy: A Case Report and Review of the Literature
Authors: Maria Grazia Piccioni, Martina Derme, Laura Salerno, Elisa Morrocchi, Francesco Pecorini, Maria Grazia Porpora, Roberto Brunelli
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Epistaxis is a common problem during pregnancy. Few cases of severe epistaxis, not associated with nasal lesions or clotting disorders, were described in the literature. We reported a case of severe epistaxis in a pregnant patient, exploring all the different possible management options.
Case:
A 33-year-old primigravida, who was 38 weeks pregnant, presented with spontaneous severe left-sided epistaxis. Her blood pressure was into normal ranges. Clotting disorders and nasal lesions were excluded. The patient clinical worsening, due to severe anemia, and the failure of conservative treatment have imposed an emergency caesarean section, with an immediate resolution of the nasal bleeding.
Conclusion:
Treatment of severe epistaxis must always consider conservative measures first-line with early recourse to otolaryngologist. In general, delivery of the fetus is considered curative.