OpenMed/multicare-articles huggingface dataset:
Relationship between anal swab PCR for SARS-CoV-2 with gastrointestinal clinical manifestations and severity of COVID-19 infection in Indonesia
Authors: Virly Nanda Muzellina, Murdani Abdullah, Juferdy Kurniawan, Aulia Rizka
Journal: F1000Res (2023)
Keywords: covid-19, sars-cov-2, anal swab, gastrointestinal clinical manifestations, the severity of covid-19
MeSH terms: COVID-19 / diagnosis, SARS-CoV-2 / genetics, Research Support, Non-U.S. Gov't, COVID-19 Testing, Cross-Sectional Studies, Gastrointestinal Tract, Humans, Indonesia / epidemiology, Polymerase Chain Reaction

Introduction: Coronavirus disease 2019 (COVID-19) cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Indonesia remain high. The virus can bind with ACE2 receptor which is not only found in the lungs, but also in the digestive tract. Thus, it allows SARS-CoV-2 infection in the gastrointestinal tract, gastrointestinal manifestations, and detection of viral RNA on anal swab using polymerase chain reaction (PCR). There hasn't been similar study about the role of anal swab in Indonesia yet. Therefore, this study aims to determine the relationship between SARS-COV-2 anal swab PCR with gastrointestinal clinical manifestations, and the severity of COVID-19 in Indonesia. Methods: This is an analytical study with cross-sectional design. Samples were obtained from hospitalized COVID-19 patients from July 2020 to January 2021. Demographic data, clinical manifestations, severity, and SARS-CoV-2 anal swabs PCR were collected using case report form. Results: A total of136 patients were analyzed. 52 patients (38.2%) had positive SARS-CoV-2 anal swabs PCR and 84 patients (61.8%) had negative results. The most common gastrointestinal clinical manifestations were nausea and vomiting in 69 patients (50.7%), anorexia in 62 patients (45.6%), and abdominal pain in 31 patients (22.8%). There were 114 patients (83,8%) classified as mild-moderate symptoms and 22 patients (16,2%) classified as severe-critical symptoms. There was a statistically significant relationship between the gastrointestinal tract SARS-CoV-2 infection and gastrointestinal clinical manifestations (P=0.031). There was no statistically significant relationship between the gastrointestinal SARS-CoV-2 infection and the severity of COVID-19 infection (P = 0.844). Conclusions: This study showed there is a significant relationship between SARS-CoV-2 anal swab PCR with gastrointestinal clinical manifestations. There is no significant relationship between anal swab PCR with the severity of COVID-19 infection.
When Maxillofacial CBCT Permits Fortuitously to Diagnose Primary Non-Hodgkin's Lymphoma: A Case Report
Authors: Pierre-Louis Polard, Adrian Tempescul, Karen Vallaeys
Journal: J Belg Soc Radiol (2024)
Keywords: intrabone malignant non-hodgkin’s lymphoma, lymphoma large b-cell diffuse, maxillary, upper jaw bone radiography
MeSH terms: Case Reports

A 47-year-old male with an unremarkable medical history was referred for atypical endodontic pain and treatment of his left upper molars. Clinical and radiographic examinations revealed an extensive, undefined osteolytic area around these teeth. A subsequent bone biopsy diagnosed diffuse large B-cell lymphoma, a high-grade non-Hodgkin's lymphoma. The hematology team prescribed six cycles of chemotherapy, supplemented by two cycles of methotrexate. Practitioners should be alerted by atypical tooth pain to consider 3D imaging to exclude malignant pathology as early as possible. Teaching point: An atypical tooth pain should alert the practitioner and guide them towards 3D imaging to eliminate diagnostic of malignant pathology as early as possible.
Methotrexate-Induced Leukoencephalopathy as a Clinical and Radiological Mimicker of Acute Ischemic Stroke Leading to Thrombolysis
Authors: Vishal V Panicker, Sunesh E Radhakrishnan, Gigy V Kuruttukulam, Jithin A Bose, T T Favas
Journal: Cureus (2024)
Keywords: b-cell acute lymphoblastic leukemia, intravenous thrombolysis, ischemic stroke, methotrexate-induced leukoencephalopathy, stroke mimic
MeSH terms: Case Reports

Methotrexate (MTX) is used to treat acute lymphoblastic leukemia (ALL). It acts by inhibiting cell proliferation through its role as a folate antagonist. Despite its positive impact on patients' survival, high-dose MTX therapy carries risks, notably neurotoxic side effects such as subacute leukoencephalopathy that can mimic stroke symptoms. Recognizing and managing MTX-induced neurotoxicity promptly is crucial. We present a case involving an 18-year-old male diagnosed with B-cell ALL who presented with symptoms of MTX-induced leukoencephalopathy, initially resembling a stroke. The initial neurological examination and imaging results closely resembled those of a stroke, prompting the activation of a stroke code. Due to uncertainty regarding whether it was an acute ischemic stroke, the patient underwent thrombolysis. However, a thorough assessment of the medical history, treatment timeline, and imaging features, combined with the absence of large vessel occlusions on the magnetic resonance angiogram, led to the diagnosis of MTX-induced leukoencephalopathy. Our patient demonstrated complete clinical and radiological improvement within the following ten days. This underscores the significance of thorough history-taking, especially regarding drug history, to distinguish stroke mimics and contemplate MTX-induced leukoencephalopathy as a potential factor in ALL patients receiving MTX treatment. Recognizing these cases is essential to preventing unnecessary thrombolysis.
Large tumoral pseudoangiomatous stromal hyperplasia with ER/PR stromal negativity in a 20-year-old female: A rare case report
Authors: Somar Mansour, Seif-Aldin Abdul Rahman, Ali Kazour, Ibrahim Salama, Hussain Shmayes, Samer Rajab, Rana Issa
Journal: Clin Case Rep (2024)
Keywords: breast tumor, case report, gigantomastia, pseudoangiomatous, stromal hyperplasia
MeSH terms: Case Reports

Pseudoangiomatous stromal hyperplasia (PASH) is a rare lesion of the breast stromal tissue with unknown mechanism. Hormonal stimulation of mammary myofibroblasts is the most important theory due to stromal positivity of progesterone receptor (PR) or/and estrogen receptor (ER). We report a case of PASH with stromal PR/ER negativity.
A rare case of concurrent left ventricular aneurysm and ventricular septal rupture complicating an inferior myocardial infarction: a case report
Authors: Mariem Drissa, Fares Azaiez, Fekher Jaoued, Rouaida Khelifa, Elyes Lagha, Rim Ben Romdhane, Rami Tlili, Youssef Ben Ameur
Journal: Pan Afr Med J (2023)
Keywords: myocardial infarction, case report, left ventricular aneurysm, ventricular septal rupture
MeSH terms: Heart Aneurysm / diagnostic imaging, Heart Aneurysm / etiology, Inferior Wall Myocardial Infarction / complications, Inferior Wall Myocardial Infarction / diagnosis, Myocardial Infarction / complications, Myocardial Infarction / diagnosis, Ventricular Septal Rupture / diagnosis, Ventricular Septal Rupture / etiology, Case Reports, Humans, Middle Aged, Shock, Cardiogenic

Complications following acute myocardial infarction (MI) such as ventricular septal rupture (VSR) and left ventricular (LV) aneurysm are rare and can be dreadful. Their simultaneous presence in the same patient is extremely rare. We aimed to present a rare case of concomitant association of ventricular aneurysm and VSR complicating an inferior myocardial infarction. We report the unusual case of Mr. A. D, a 63-year-old, active smoker, with a history of diabetes mellitus and hypertension, admitted for the management of inferior MI within 6 days. The MI was complicated by an LV aneurysm in the inferoposterior and the inferoseptal walls associated with a VSR in the inferoseptal wall. The patient had only signs of right heart failure on admission. This observation illustrates on the one hand the rarity of the association of VSR and LV aneurysm after an inferior myocardial infarction, and on the other hand the possibility of founding them at an early stage of MI without any signs of cardiogenic shock.
Bicuspid Aortic Valve Endocarditis Caused by Streptococcus sanguinis: A Case Report
Authors: Sravani Singu, Robert Chory, Vamsi K Singu, Michael Pursley, Glenn Harris
Journal: Cureus (2024)
Keywords: aortic insufficiency, aortic regurgitation, aortic valve insufficiency, bicuspid aortic valve, dental procedure, infective endocarditis, prophylactic antibiotics, streptococcus sanguinis
MeSH terms: Case Reports

Antibiotic prophylaxis prior to dental work in bicuspid aortic valve (BAV) patients is currently a matter of debate. The American Dental Association does not require those with native BAV to receive antibiotic prophylaxis prior to dental work as BAV is considered an "intermediate" risk for infective endocarditis (IE). We present the case of a 63-year-old male, with a medical history of BAV, who acquired Streptococcus sanguinis IE after a routine dental cleaning four months prior to initial onset of symptoms. He exhibited new-onset and severe aortic regurgitation at presentation, requiring urgent aortic valve replacement to restore valve function. BAV patients are at high risk of IE, emphasizing the need for prophylactic antibiotics in dental cleaning as well as invasive dental procedures in those with BAV.
Eosinophilic oesophagitis in a Nigerian adolescent: a case report
Authors: Ikobah Joanah Moses, Ikwuagwu Elekwachi, Ita Ukpabio, Theophilus Ugbem, Omeodu Chimankpan Okechukwu, Emmanuel Ekanem
Journal: Pan Afr Med J (2024)
Keywords: eosinophilic oesophagitis, case report, eosinophils, gastro-oesophageal reflux disease, oesophagogastroduodenoscopy
MeSH terms: Enteritis, Eosinophilia, Eosinophilic Esophagitis / diagnosis, Eosinophilic Esophagitis / pathology, Eosinophilic Esophagitis / therapy, Gastritis, Case Reports, Adolescent, Biopsy, Eosinophils, Female, Humans, Vomiting, Eosinophilic enteropathy

Eosinophilic oesophagitis (EoE) is a chronic immune and antigen-mediated disease characterized by symptoms related to oesophageal dysfunction, and histologically, is marked by eosinophilic infiltrate in the oesophageal mucosa. It is prevalent in developed countries and considered rare in developing countries. There is an interplay of allergic and genetic factors in the aetiology of EoE. This is a report of EoE in a 15-year-old female adolescent in Nigeria who presented to the University of Calabar Teaching Hospital with recurrent vomiting, abdominal pain, weight loss, and dysphagia. She had received treatment for Gastro-oesophageal disease three years earlier and was lost to follow-up. Weight on admission was 39 kg and height 170 cm with a BMI below the 3rd centile. Peripheral blood showed an eosinophil count of four percent. The abdominal computed tomography (CT) scan and upper gastrointestinal (GI) series were normal. Faecal antigen for H. pylori and ova for stool parasites were negative. Histologic findings of proximal and distal oesophageal mucosal biopsies showed greater than 20 eosinophils per high power field. The histology of the stomach and duodenum were normal. She was initially treated with a protein pump inhibitor, with no improvement. Swallowed fluticasone propionate and eliminating peanuts, wheat, egg, and milk from her diet were introduced. Symptoms improved with the patient no longer vomiting and had an increase in weight gain. She was discharged to follow up. This case shows that EoE occurs in developing countries, but diagnosis may be missed. There is a need for a high index of suspicion among gastroenterologists in patients with symptoms suggestive of GERD not responding to therapy.
Case Report: Chronic inflammatory demyelinating polyradiculoneuropathy rather than hemophagocytic lymphohistiocytosis-the initial phenotype of PRF1 gene mutation
Authors: Lin-Yan Hu, Lin Wan, Qiu-Hong Wang, Xiu-Yu Shi, Yan Meng, Xiao-Fan Yang, Guang Yang, Li-Ping Zou
Journal: Front Immunol (2023)
Keywords: chronic inflammatory demyelinating polyradiculoneuropathy, demyelination of the central nervous system, familial hemophagocytic lymphohistiocytosis, perforin, perforinopathy
MeSH terms: Lymphohistiocytosis, Hemophagocytic / diagnosis, Lymphohistiocytosis, Hemophagocytic / genetics, Lymphohistiocytosis, Hemophagocytic / therapy, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / genetics, Case Reports, Research Support, Non-U.S. Gov't, Child, Female, Humans, Mutation, Missense, Perforin / genetics, Phenotype, Perforin, PRF1 protein, human

Perforin is essentially involved in the granule-dependent killing activities of cytotoxic T lymphocytes and NK cells. Monoallelic PRF1 mutation increases the risk of autoimmune diseases, and biallelic PRF1 mutation causes familial hemophagocytic lymphohistiocytosis-2. Here, we report a case of a 12-year-old girl with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), followed by a rapidly progressive onset of hemophagocytic lymphohistiocytosis (HLH) 9 months later, alongside manifestations of demyelinating encephalopathy. Genetic sequencing revealed a heterozygous nonsense mutation in the PRF1 gene (c.984G>A; p.W328*) and a heterozygous missense mutation in the PRF1 gene (c.1349C>T; p.T450M). Eventually, she died because of no suitable allogeneic hematopoietic stem cell available in time. Our observations suggest that CIPD might represent the initial phenotype of biallelic PRF1 mutation and could serve as an early sign of subsequent HLH. A comprehensive understanding of this condition is paramount for timely diagnosis, treatment, and ultimately improved patient outcomes.
DNA methylation-based diagnosis confirmation in a pediatric patient with low-grade glioma: a case report
Authors: Daria Morgacheva, Marina Ryzhova, Olga Zheludkova, Margarita Belogurova, Yulia Dinikina
Journal: Front Pediatr (2023)
Keywords: cns tumors, dna methylation, sanger sequencing, children, molecular diagnostics, pediatric oncology, pilocytic astrocytoma
MeSH terms: Case Reports

Central nervous system (CNS) tumors in children comprise a highly heterogenous and complex group of diseases. Historically, diagnosis and confirmation of these tumors were routinely based on histological examination. However, recently obtained data demonstrate that such a diagnostic approach is not completely accurate and could lead to misdiagnosis. Also, in recent times, the quantity and quality of molecular diagnostic methods have greatly improved, which influences the current classification methods and treatment approach for pediatric CNS tumors. Nowadays, molecular methods, such as DNA methylation profiling, are an integral part of diagnosing brain and spinal tumors in children. In this paper, we present the case of an infant with a posterior fossa tumor who demonstrated a non-specific morphology and whose diagnosis was verified only after DNA methylation.
Appendicitis after endoscopic band ligation for massive ileocecal hemorrhage
Authors: Hiroto Sato, Yu Yamamoto, Akira Kaizuka, Yu Ohtaki, Makoto Toda, Shoichiro Fujishima, Nakao Shirahata, Ryusuke Ae, Takeshi Kanno
Journal: DEN Open (2024)
Keywords: appendicitis, complication, diverticular bleeding, endoscopic band ligation, ileocecal hemorrhage
MeSH terms: Case Reports

A 68-year-old man was admitted with hematochezia. Emergency computed tomography showed multiple diverticula throughout the colon. Initial colonoscopy on day 2 showed no active bleeding, but massive hematochezia on day 3 led to the performance of an emergency endoscopy. Substantial bleeding in the ileocecal area obscured the visual field, making it challenging to view the area around the bleeding site. Two endoscopic band ligations (EBLs) were applied at the suspected bleeding sites. Hemostasis was achieved without active bleeding after EBL. However, the patient developed lower right abdominal pain and fever (39.4°C) on day 6. Urgent computed tomography revealed appendiceal inflammation, necessitating emergency open ileocecal resection for acute appendicitis. Pathological examination confirmed acute phlegmonous appendicitis, with EBLs noted at the appendiceal orifice and on the anal side. This case illustrates the efficacy of EBL in managing colonic diverticular bleeding. However, it also highlights the risk of appendicitis due to EBL in cases of ileocecal hemorrhage exacerbated by poor visibility due to substantial bleeding. Endoscopists need to consider this rare but important complication when performing EBL in similar situations.
Case Report: Staged treatment of ankle deformity and first metatarsal deficiency after motorcycle spoke injury with Taylor external frame combined with fibular head grafting
Authors: Le Zhang, Yuxin Yan, Pengyu Ren, Yong Hou, Dan Liu, Caiwen Fan, Kehuan Cheng, Jun Zhang, Liangliang Shi
Journal: Front Surg (2024)
Keywords: tsf six-axis spatial fixation, free fibular head graft with epiphysis, medial column defects, multi-planar deformities, spoke injury
MeSH terms: Case Reports

The treatment of the sequelae of severe foot injuries caused by motorcycle spoke injury, especially in pediatric patients, allows for new options and surgical protocols. The tarsometatarsal joint and the first metatarsal were reconstructed by precise preoperative design using the TSF space external fixation technique in one stage to correct the foot deformity and restore the volume and length, and free grafting of the fibular head with epiphysis in the second stage. This method is the first of its kind reported. The patient's foot deformity was corrected, walking, walking up and down stairs, and running functions were achieved, and the bone quality could grow with age. The combination of TSF six-axis spatial external fixation technique and microscopic technique can maximize the patient's appearance and function and is worth promoting.
Case Report: Pleural effusion in Wilms tumor - always malignant?
Authors: Keta Vagha, Patel Zeeshan Jameel, Jayant Vagha, Ashish R Varma, Rupesh Rao
Journal: F1000Res (2023)
Keywords: wilms tumor, pleural effusion, pulmonary metastasis
MeSH terms: Kidney Neoplasms / complications, Kidney Neoplasms / pathology, Wilms Tumor / complications, Wilms Tumor / pathology, Case Reports, Child, Female, Humans, Pleural Effusion / etiology, Pleural Effusion / pathology, Pleural Effusion, Malignant / etiology, Pleural Effusion, Malignant / pathology

Wilms tumor (WT) is the most common renal malignancy seen in pediatric patients. Although lungs are the most common site of metastasis in Wilms tumor, non-malignant pleural effusion has been infrequently reported. Here, we report a case of an eleven-year-old female who presented with an abdominal mass and progressive breathlessness. On further evaluation, she was found to have a right-sided Wilms tumor with ipsilateral massive pleural effusion. The effusion resolved almost completely after four weeks of chemotherapy. We conclude that patients suffering from Wilms tumor presenting with pleural effusion need not be synonymous with metastatic disease and can have a favorable prognosis.
Interpretation of chest fluoroscopy: the risk of misdiagnosing atelectasis as pneumothorax due to greyscale inversion
Authors: C Y Lin, N B Cavanaugh, S Subramani, A K Singhal, S Hanada
Journal: Anaesth Rep (2024)
Keywords: x‐rays, atelectasis, fluoroscopy, pneumothorax, radiograph
MeSH terms: Case Reports

Anaesthetists may be required to work in hybrid theatres for procedures using fluoroscopic imaging. Adequate knowledge of fluoroscopic images allows prompt and effective emergency management of complications which arise during procedures. Here, we present a case of severe hypotension and hypoxia occurring shortly after induction of anaesthesia. Atelectasis was mistaken for a pneumothorax due to misinterpretation of fluoroscopic imaging, which demonstrated a dark pleural cavity peripheral to a partially collapsed left lung, leading to an incorrect diagnosis. This case highlights the importance of understanding greyscale inversion in fluoroscopy.
Histoplasmosis in a fingolimod-treated patient: case report and scoping review
Authors: Vítor Falcão de Oliveira, Guilherme Diogo da Silva, Larissa Teixeira Silva, Victor Lucas Gonçalves, Paula Emilia Rivas, Alexandre Coelho Marques, Mariane Taborda, Adriana Satie Gonçalves Kono Magri, Samira Luisa Apóstolos-Pereira, Dagoberto Callegaro, Marcello Mihailenko Chaves Magri
Journal: Rev Inst Med Trop Sao Paulo (2024)
MeSH terms: Fingolimod Hydrochloride / adverse effects, Histoplasmosis / diagnosis, Histoplasmosis / drug therapy, Multiple Sclerosis, Relapsing-Remitting / drug therapy, Case Reports, Review, Adult, Antifungal Agents / adverse effects, Antifungal Agents / therapeutic use, Female, Histoplasma, Humans, Immunosuppressive Agents / adverse effects, Fingolimod Hydrochloride, Antifungal Agents, Immunosuppressive Agents

Fingolimod is a sphingosine-1-phosphate receptor modulator used to treat multiple sclerosis. While fingolimod has been associated with an increased risk of cryptococcal meningitis, its correlation with other deep mycoses remains unclear. In this study, we conducted a scoping review of fingolimod associated with histoplasmosis, based on a case report, a literature review, and data from the FDA Adverse Events Reporting System (FAERS) as of January 24th, 2023. A 30-year-old Brazilian woman diagnosed with relapsing-remitting multiple sclerosis, receiving a daily dose of 0.5 mg of fingolimod, presented with a two-month history of fever and unintended weight loss, accompanied by lymphadenopathy, splenomegaly, and lung involvement was investigated. Biopsy of a lung nodule revealed fungal structures suggestive of Histoplasma sp. Additionally, serological testing yielded positive for Histoplasma capsulatum. Disseminated histoplasmosis should be considered in the differential diagnosis of febrile syndromes in patients undergoing fingolimod therapy for multiple sclerosis, particularly in the Americas, where this mycosis is endemic. Treatment with itraconazole and modification of immunotherapy can achieve excellent clinical outcomes.
Xeroderma Pigmentosum With Ocular Surface Squamous Neoplasia: A Case Report
Authors: Sravanthi Malikireddy
Journal: Cureus (2024)
Keywords: basal cell carcinoma (bcc), imiquimod, interferon therapy, ocular surface squamous neoplasia (ossn), xeroderma pigmentosum
MeSH terms: Case Reports

Xeroderma pigmentosum (XP) is a rare, autosomal recessive disorder characterized by defective DNA repair. Patients with this disorder are at increased risk of developing various oculocutaneous malignancies. We report a rare case of a child with XP with bilateral ocular surface squamous neoplasia (OSSN) and left eye (OS) medial canthal basal cell carcinoma (BCC). Ultrasound biomicroscopy and contrast-enhanced computed tomography (CECT) of the orbit showed intraocular extension with no orbital involvement. The patient was started on topical interferon therapy in both eyes for OSSN. Topical 5% imiquimod was started for BCC for eight hours a day and then washed off. During follow-up, there was no recurrence of tumors. Since ocular and cutaneous neoplasms tend to occur at an early age in XP with a high rate of recurrence and they tend to be more aggressive, multimodal therapy with long-term follow-up is more advantageous for these patients. Topical 5% imiquimod can be used as a treatment for periocular BCC as an alternative to excision.