OpenMed/multicare-articles huggingface dataset:
Myocardial infarction or myocarditis? A case report and review of a myocardial adverse event associated with mRNA vaccine
Authors: Roberto Badaró, Gustavo Novaes, Ana Cristina Andrade, Cesar Augusto de Araujo Neto, Bruna Aparecida Machado, Josiane Dantas Viana Barbosa, Milena Botelho Pereira Soares
Journal: Front Med (Lausanne) (2023)
Keywords: covid-19, adverse event, cardiac disease, cardiotoxicity, mrna vaccine
MeSH terms: Case Reports

A 23-year-old man started with chest pain 8 h after his first Pfizer-BioNTech COVID-19 vaccination. ECG evaluation showed sinus tachycardia with ST-segment elevation in D1, AVL, V5, and V6, the findings compatible with acute subepicardial myocardial damage. However, cardiac MRI documented myocardial fibrosis, with cardiac late enhancement non-ischemic pattern with diffuse edema. He had no other symptoms to suggest another etiology than the vaccination. The patient was hospitalized and received corticosteroid (prednisolone) daily. Then, 2 weeks after hospitalization, all laboratory parameters and ECG were normal and the patient was discharged from the hospital. The patient had a history of Wolf-Parkinson White that was corrected with ablation when he was 11 years old. This report calls attention to myocardial adverse reaction risk for mRNA COVID-19 vaccines for people with a previous cardiac disease history.
A Recent Advance in the Closure of Skin Wounds on Fragile Skin
Authors: John Ko, Jeffrey S Freed
Journal: Case Rep Emerg Med (2021)
MeSH terms: Case Reports

The delicate nature of the skin in elderly patients poses a difficult challenge to healthcare providers. Emergency departments are frequently presented with traumatic skin tears and soft tissue avulsions in this group of patients. Procedures aimed at closure of these types of wounds often result in worsening of the tears. The DermaClip® skin closure device, which can eliminate the need for anesthesia, addresses these disadvantages and allows for atraumatic, cosmetically satisfactory closure in a rapid and efficient manner, saving time, and costs.
Case Report: Juvenile Myelomonocytic Leukemia Underlying Ornithine Transcarbamylase Deficiency Safely Treated Using Hematopoietic Stem Cell Transplantation
Authors: Hiroi Eguchi, Toshihiko Kakiuchi, Masanori Nishi, Kanako Kojima-Ishii, Kei Nishiyama, Yuhki Koga, Muneaki Matsuo
Journal: Front Pediatr (2022)
Keywords: chemotherapy, hematopoietic stem cell transplantation, hyperammonemia, juvenile myelomonocytic leukemia, ornithine transcarbamylase deficiency, urea cycle disorder
MeSH terms: Case Reports

Background:
Juvenile myelomonocytic leukemia (JMML), which is predominantly found in infants, is a clonal abnormality of pluripotent hematopoietic stem cells and presents with the symptoms of both myeloproliferative tumors and myelodysplastic syndromes. Estimates have shown that ~20 cases of JMML occur annually in Japan. Ornithine transcarbamylase deficiency (OTCD), the most common among all urea cycle disorders (UCDs), occurs in 1 of 80,000 people in Japan.
Case presentation:
A 10-month-old infant who had fever, vomiting, and diarrhea for 2 days was referred to our hospital for the following abnormalities in blood tests: white blood cell count, 48,200/μL; hemoglobin, 9.0 g/dL; and platelet count, 135,000/μL. Bone marrow examination showed a nucleated cell count of 396,000/mm3 and blast cell count of 5.0%, as well as decreased mature granulocyte count and slightly myeloperoxidase stain-negative blasts but no monoclonal cell proliferation on May-Giemsa staining. Colony assay showed the proliferation of spontaneous colony and high sensitivity to granulocyte-macrophage colony-stimulating factor. Genetic analysis of peripheral blood mononuclear cells showed that the patient was positive for neuroblastoma RAS (NRAS) mutation. The patient was ultimately diagnosed with JMML. Approximately 170 days after his first hematopoietic stem cell transplantation (HSCT), the patient's JMML relapsed. Shortly after the recurrence, nausea, vomiting, hyperventilation, and decreased vitality were observed, followed by a decrease in the level of consciousness. The patient's ammonia level was 472 μmol/L. A test for seven different genetic mutations for the UCD showed the presence of c. 119G>A (amino acid change p. Arg40His). As such, late-onset OTCD was added to his diagnosis. Administration of sodium phenylacetate, l-arginine hydrochloride, and carnitine was continued following the diagnosis of OTCD, after which hyperammonemia was not observed. Regarding JMML relapse, HSCT was performed on day 405 after the first transplantation.
Conclusion:
Hyperammonemia should be considered a differential diagnosis when unexplained and non-specific symptoms occur during the treatment of hematologic malignancies. Patients should be tested for UCD as a cause of hyperammonemia, and treatment for hyperammonemia should be continued until the cause is identified. The patient shows normal developmental progress, has an intact neurological status, and has not experienced another hyperammonemia attack. His JMML has remained in remission for over 3 years.
Unusual association of COVID-19, pulmonary tuberculosis and human immunodeficiency virus, having progressed favorably under treatment with chloroquine and rifampin
Authors: Fah Bouaré, Mehdi Laghmari, Felicité Nyafame Etouche, Badr Arjdal, Imane Saidi, Farouk Hajhouji, Houssine Ghannane, Lamyae Amro, Noura Tassi, Said Ait Benali
Journal: Pan Afr Med J (2020)
Keywords: covid-19, coronavirus, hiv, sars-ncov-2, anti-tubercular agents, rifampin, tuberculosis
MeSH terms: COVID-19 / diagnosis, HIV Infections / diagnosis, HIV-1, SARS-CoV-2, Tuberculosis, Pulmonary / diagnosis, Case Reports, Adult, Antimalarials / administration & dosage, Antimalarials / therapeutic use, Antiviral Agents / administration & dosage, Antiviral Agents / therapeutic use, COVID-19 / complications, COVID-19 Drug Treatment, Chloroquine / administration & dosage, Chloroquine / therapeutic use, Diagnosis, Differential, Drug Therapy, Combination, Female, HIV Infections / complications, HIV Infections / drug therapy, Humans, Rifampin / administration & dosage, Rifampin / therapeutic use, Tomography, X-Ray Computed, Tuberculosis, Pulmonary / complications, Tuberculosis, Pulmonary / diagnostic imaging, Tuberculosis, Pulmonary / drug therapy, Antimalarials, Antiviral Agents, Chloroquine, Rifampin

Infection with the new coronavirus has been declared an international health emergency. Its curative treatment is unknown and is the subject of several clinical trials. In addition, the concomitant association of COVID-19 with tuberculosis and the human immunodeficiency virus, hitherto never described, is potentially fatal. We report the illustrative case of a 32-year-old patient who presented this trifecta of infections and who did well under treatment with chloroquine and anti-mycobacterial drugs. This patient arrived at the ER with respiratory discomfort that had been evolving over a month with symptoms of flu and deterioration of her general condition. A chest CT scan revealed an aspect of lung miliary tuberculosis with isolation of Koch's bacilli in the sputum. A polymerization chain reaction (PCR) was positive for COVID-19 on a nasopharyngeal swab. HIV serology was positive. The course was marked by a spectacular clinical improvement and two negative COVID-19 PCR controls at the end of treatment (at days 9 and 10). Anti-tubercular drugs (especially, rifampin) are powerful enzyme inducers that can reduce the effectiveness of chloroquine in our patient. This therapeutic success may be linked to the effect of anti-tubercular drugs against SARS ncov-2, especially rifampin, inhibiting the formation of messenger RNAs of SARS ncov-2 or to the synergistic effect of chloroquine and rifampin. Researchers should explore the effect of these drugs on SARS ncov-2.
A case of large phyllodes tumor causing "rupture" of the breast: a unique presentation
Authors: Junaid Nabi, S M Quamrul Akhter, Fatema N Authoy
Journal: Case Rep Oncol Med (2013)

Introduction. Phyllodes tumors are rare fibroepithelial tumors which constitute less than 1% of all known breast neoplasms. The importance of recognizing these tumors lies in the need to differentiate them from fibroadenomas and other benign breast lesions to avoid inappropriate surgical management. We report a case of large phyllodes tumor which caused rupture of the breast and presented as an external fungating breast mass, a presentation which is exceedingly rare. Case Presentation. A 32-year-old female presented with a 1-year history of a mass in her right breast and eruption of the mass through the skin for the last 3 months. On physical examination, an ulcerated, irregular, and nodular mass measuring 9 × 8 cms was found hanging in the lower and outer quadrant of the right breast. Ultrasonography revealed an exophytic mass with heterogeneous echotexture and vascularity. Under general anesthesia, the tumor was excised. The resected specimen was 9.5 × 8.5 × 4.5 cm in size and the tumor was not invasive to the surrounding tissues. Histological examination confirmed a benign case of Phyllodes tumor. Conclusion. Clinicians should be aware of the myriad ways in which Phyllodes can present. A rapidly growing breast mass in a female should raise strong suspicion for Phyllodes. It is necessary to differentiate it from fibroadenomas to avoid inappropriate surgical management which may lead to local recurrence.
Pulmonary Complications in Children Following Hematopoietic Cell Transplantation: A Case Report and Review of the Diagnostic Approach
Authors: Lama Elbahlawan, Jenny McArthur, Cara E Morin, Hafeez Abdelhafeez, M Beth McCarville, Robert E Ruiz, Saumini Srinivasan, Amr Qudeimat
Journal: Front Oncol (2021)
Keywords: broncho alveolar lavage (bal), diagnostic approach, diagnostic imaging, hematopoietic (stem) cell transplantation (hct), lung biopsy, pulmonary complications
MeSH terms: Review

Pulmonary complications are common in children following hematopoietic cell transplantation (HCT) and contribute to their morbidity and mortality. Early diagnosis is essential for management and prevention of progression of lung injury and damage. In many cases, diagnosis can be challenging and may require diagnostic imaging and more invasive testing such as bronchoscopy and lung biopsy. We report the case of a 12-year-old girl who developed recurrent episodes of acute respiratory failure requiring intensive care unit admission in the post-HCT phase and describe the diagnostic and multidisciplinary approach for her management. In addition, we review the diagnostic approach of pulmonary complications post-HCT and highlight the utility and risks of bronchoscopy and lung biopsy in these children.
Pulmonary focal fibrosis associated with microscopic arterio-venous fistula manifesting as focal ground-glass opacity on thin-section CT
Authors: Noriko Sudo, Atsushi Nambu, Takana Yamakawa, Masashi Kawamoto, Shozo Fujino, Masato Watanabe, Kunio Mizuguchi, Masao Tago
Journal: BMC Pulm Med (2013)
MeSH terms: Adenocarcinoma / diagnosis, Arteriovenous Fistula / complications, Lung Neoplasms / diagnosis, Pulmonary Fibrosis / diagnosis, Pulmonary Fibrosis / etiology, Tomography, X-Ray Computed / methods, Case Reports, Adenocarcinoma, Bronchiolo-Alveolar / diagnosis, Diagnosis, Differential, Female, Humans, Middle Aged, Pulmonary Fibrosis / diagnostic imaging

Background:
Focal ground-glass opacity (GGO) on thin-section computed tomography (CT) may be seen in atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ that has recently been renamed from bronchioloalveolar carcinoma (BAC) and various benign conditions.
Case presentation:
We report a case of pulmonary focal fibrosis associated with microscopic arterio-venous fistula (AVF), which showed a focal area of GGO on thin-section CT. The patient was a 58-year-old woman with a GGO on thin-section CT which had increased in size over the period of 2 years. Slightly dilated vessels and thickened interlobular septa were also noted around the GGO. It was diagnosed preoperatively as adenocarcinoma in situ and a partial lung resection by video-assisted thoracic surgery (VATS) was performed. Pathological examination yielded a diagnosis of focal fibrosis associated with microscopic AVF.
Conclusion:
We speculate that the focal fibrosis was produced by a prolonged congestion due to the AVF and that the dilated vessels and thickening of interlobular septa on thin-section CT related to the AVF. Microscopic AVF may be one of the etiologies of focal fibrosis showing focal GGO on thins-section CT. Dilated vessels and thickened interlobular septa around the GGO might offer a clue to the diagnosis of this disease entity. In addition, it should be noted that focal fibrosis may increase in size.
Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction after Ingestion of a Naphazoline-Containing Antiseptic
Authors: Yuko Ono, Nozomi Ono, Kazuaki Shinohara
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express α2-adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.
Bortezomib a safe treatment for patients with multiple myeloma and cystic fibrosis
Authors: Fabiana Gentilini, Anna Levi, Vincenzo Federico, Eleonora Russo, Robin Foà, Maria Teresa Petrucci
Journal: Mediterr J Hematol Infect Dis (2012)
MeSH terms: Case Reports

Introduction:
Bortezomib is a proteasome inhibitor that targets myeloma cell and its bone marrow microenvironment. Intravenous Bortezomib with or without dexamethasone, is effective and well tolerated in patients with relapsed/refractory multiple myeloma (MM).
Methods:
We used Bortezomib without corticosteroids, to avoid the risk of lung infection reactivations due to patient's Pseudomonas aeruginosa colonization, in a MM patient with Cystic Fibrosis. Four 21-day cycles of Bortezomib were administrated at 1.3 mg/m(2) on days 1,4,8 and 11 with a 10 day rest period. Treatment response and toxicity were evaluated.
Results:
After four cycles of therapy the patient achieved a very good partial response (VGPR) according to the IMWG response criteria, without clinically significant side effects.
Conclusions:
Bortezomib can be successfully utilized for the management of this difficult disease situation.
Brief Tale of a Bacteraemia by Rhodococcus equi, With Concomitant Lung Mass: What Came First, the Chicken or The Egg?
Authors: Vincenzo Savini, Prassede Salutari, Marco Sborgia, Iole Mancini, Gioviana Masciarelli, Chiara Catavitello, Daniela Astolfi, Claudio D'Amario, Giuseppe Fioritoni, Antonio Spadaro, Domenico D'Antonio
Journal: Mediterr J Hematol Infect Dis (2011)
MeSH terms: Case Reports

Rhodococcus equi is an uncommon Gram positive, variably acid-fast pathogen, that appears as hard to treat mostly owing to the establishment of intracellular niches. Lack of interpretive criteria for susceptibility testing may lead to under-reporting or overestimation of resistances, whereas knowledge about this pathogen's clinical impact may be affected by erroneous phenotype-based characterization at a genus and species level.We present the case of a bacteraemia with a concomitant lung mass in a lymphoma patient, that further highlights the emergence of rhodococcal diseases as a matter for concern in the fields of infectious diseases and haematology.
Intestinal Obstruction of Congenital Origin: A Case Report
Authors: Mandeeep Guragai, Suzit Bhusal, Anwesh Bhatta
Journal: JNMA J Nepal Med Assoc (2020)
MeSH terms: Digestive System Abnormalities / diagnosis, Digestive System Abnormalities / physiopathology, Digestive System Abnormalities / surgery, Intestinal Obstruction / congenital, Intestinal Obstruction / diagnosis, Intestinal Obstruction / physiopathology, Intestinal Obstruction / surgery, Intestines / abnormalities, Intestines / diagnostic imaging, Intestines / surgery, Surgical Procedures, Operative / methods, Tomography, X-Ray Computed / methods, Case Reports, Diagnosis, Differential, Humans, Infant, Male, Radiography, Abdominal / methods, Treatment Outcome, Vomiting / diagnosis, Vomiting / etiology

Congenital bands are rare causes of intestinal obstruction and often leads to diagnostic challenges. Diagnostic delays in cases of mechanical obstruction might lead to irreversible bowel ischemia and perforation. Presently described is a case of an 18 month young child with severe vomiting developed for one day. The child was initially thought to have acute viral enteritis and treated accordingly. Due to the severity, an X-Ray and computed tomography scan were sent which pointed towards the possibility of having congenital bands. He was treated operatively. The child was kept under observation for eleven days and was discharged. Although rare, intestinal obstruction due to congenital bands must be considered when treating a child with severe vomiting. Keywords: case reports, congenital abnormalities, intestinal obstruction, vomiting.
Case Report: Optimizing Pre- and Intraoperative Planning With Hyperaccuracy Three-Dimensional Virtual Models for a Challenging Case of Robotic Partial Nephrectomy for Two Complex Renal Masses in a Horseshoe Kidney
Authors: Riccardo Campi, Francesco Sessa, Anna Rivetti, Alessio Pecoraro, Paolo Barzaghi, Simone Morselli, Paolo Polverino, Rossella Nicoletti, Vincenzo Li Marzi, Pietro Spatafora, Arcangelo Sebastianelli, Mauro Gacci, Graziano Vignolini, Sergio Serni
Journal: Front Surg (2021)
Keywords: horseshoe kidney, hyperaccuracy three-dimensional model, partial nephrectomy, planning, robotics
MeSH terms: Case Reports

Objective: To report a case of robot-assisted partial nephrectomy (RAPN) for two highly complex renal tumors in a patient with a Horseshoe kidney (HSK), focusing on the utility of hyperaccuracy three-dimensional (HA3D) virtual models for accurate preoperative and intraoperative planning of the procedure. Methods: A 74-year-old Caucasian male patient was referred to our Unit for incidental detection of two complex renal masses in the left portion of a HSK. The 50 × 55 mm, larger, predominantly exophytic renal mass was located at the middle-lower pole of the left-sided kidney (PADUA score 9). The 16 × 17 mm, smaller, hilar renal mass was located at the middle-higher pole of the left-sided kidney (PADUA score 9). Contrast-enhanced CT scan images in DICOM format were processed using a dedicated software to achieve a HA3D virtual reconstructions. RAPN was performed by a highly experienced surgeon using the da Vinci Si robotic platform with a three-arm configuration. A selective delayed clamping strategy was adopted for resection of the larger renal mass while a clampless strategy was adopted for the smaller renal mass. An enucleative resection strategy was pursued for both tumors. Results: The overall operative time was 150 min, with a warm ischemia time of 21 min. No intraoperative or postoperative complications were recorded. Final resection technique according to the SIB score was pure enucleation for both masses. At histopathological analysis, both renal masses were clear cell renal cell carcinoma (ccRCC) (stage pT1bNxMx and pT3aNxMx for the larger and smaller mass, respectively). At a follow-up of 7 months, there was no evidence of local or systemic recurrence. Conclusions: Surgical management of complex renal masses in patients with HSKs is challenging and decision-making is highly nuanced. To optimize postoperative outcomes, proper surgical experience and careful preoperative planning are key. In this regard, 3D models can play a crucial role to refine patient counseling, surgical decision-making, and pre- and intraoperative planning during RAPN, tailoring surgical strategies and techniques according to the single patient's anatomy.
Twenty-Nail-Dystrophy / Trachyonychia: a case report in a five year old girl seen at the Paediatric Out-patient Department of a Tertiary Hospital in Lafia North-Central Nigeria
Authors: Bello Surajudeen Oyeleke, Kure Ibrahim Shekwonyadu
Journal: Pan Afr Med J (2020)
Keywords: case report, trachyonychia, paediatric out-patient, tertiary
MeSH terms: Nail Diseases / diagnosis, Nails, Malformed / diagnosis, Case Reports, Child, Preschool, Female, Hospitals, Pediatric, Humans, Hyperpigmentation / diagnosis, Hyperpigmentation / pathology, Keratoderma, Palmoplantar / diagnosis, Keratoderma, Palmoplantar / pathology, Nail Diseases / pathology, Nails, Malformed / pathology, Nigeria, Outpatients, Tertiary Care Centers, Hyperkeratosis-Hyperpigmentation Syndrome, Twenty-Nail Dystrophy

Twenty-Nail-Dystrophy (TND) also referred to as Trachyonychia is a disorder of the nails. It can affect all the nails hence the name. Trachyonychia is characterized by nail roughness, longitudinal ridging, fragility and hyper-pigmentation. It can occur in all ages and respond poorly to treatment. With this background, we report the case of a five year old girl with this disorder.
Colonoscopic Splenic Injury: A Simplified Radiologic Approach
Authors: Tara Chen, Qiu Tong, Alexander Kurchin
Journal: Case Rep Gastrointest Med (2016)
MeSH terms: Case Reports

Colonoscopy is a commonly performed procedure for diagnosis and treatment of large bowel diseases. Recognized complications include bleeding and perforation. Splenic injury during colonoscopy is a rare complication. We report a case of a 73-year-old woman who presented with left-sided abdominal pain after colonoscopy with finding of splenic injury on CT scan. She was managed conservatively. We discuss the diagnostic and therapeutic approach to colonoscopic splenic injury.