OpenMed/multicare-articles huggingface dataset:
Rupture of an unsuspected ectopic pregnancy following a hysterosalpingography-A case report
Authors: P T Lim, Rohit, V Viardot-Foucault
Journal: Int J Surg Case Rep (2019)
Keywords: case report, ectopic pregnancy, hysterosalpingography, subfertility

Introduction:
Hysterosalpingography (HSG) is routinely performed in the mid-follicular phase of a woman's menstrual cycle for cavity and tubal patency assessment as a part of the infertility screening. A pre-procedural pregnancy test is not routinely required unless the patient reports abnormal menstrual bleeding or irregular menstrual pattern.
Presentation of case:
We present the case of a 29 year-old sub fertile woman who had a HSG performed on day 12 of her menstrual cycle. She developed abdominal pain shortly after and was diagnosed with a ruptured ectopic pregnancy, resulting in a right salpingectomy. The patient was discharged well 3 days later.
Discussion:
Based on available guidelines and the rare occurrence of such complication, we find insufficient evidence to perform universal pre-procedural pregnancy testing. However, we strongly recommend doing it for abnormal menstrual cycles (cycles shorter than 21 or longer than 35 days, unreliable menstrual history or unusual menstrual flow pattern). Furthermore, HSG should be scheduled during the follicular phase after practicing safe sex within the two weeks preceding the test.
Conclusion:
While pre-procedural pregnancy test should not be performed for all, a high index of suspicion for early pregnancy should be maintained as undetected ectopic and heterotopic pregnancies could lead to serious complications once the HSG is done.
Peritoneal tuberculosis in pregnancy: a case report
Authors: Fatima Zohra Fdili Alaoui, Myriem Rachad, Hikmat Chaara, Hakima Bouguern, Moulay Abdilah Melhouf
Journal: Pan Afr Med J (2012)
Keywords: peritoneal tuberculosis, diagnosis, pregnancy
MeSH terms: Antitubercular Agents / therapeutic use, Peritonitis, Tuberculous / complications, Pregnancy Complications, Infectious / drug therapy, Case Reports, Adult, Female, Humans, Peritonitis, Tuberculous / diagnosis, Peritonitis, Tuberculous / drug therapy, Pregnancy, Pregnancy Complications, Infectious / diagnosis, Pregnancy Complications, Infectious / microbiology, Pregnancy Outcome, Antitubercular Agents

Peritoneal tuberculosis in pregnancy is one of the least common forms of extrapulmonory tuberculosis in pregnancy. Early diagnosis is important to prevent obstetrical and neonatal morbidity. We report the case of a 37-year-old pregnant woman who presented with abdominal volume increase, night-sweat, anorexia, loss of weight and abdominal pain at 23 weeks. A peritoneal laparoscopic biopsy was performed and confirmed the diagnosis of tuberculous peritonitis. The patient received antituberculosis chemotherapy. The recovery was good as gave birth to a healthy infant of 3200Kg at 37th week's gestation by vaginal delivery.
Tuberculosis of the rare azygos lobe of the right lung
Authors: Abdelrhman Abo-Zed, Mohamed Yassin, Tung Phan
Journal: Respir Med Case Rep (2021)
Keywords: azygos lobe, biopsy, mycobacterium, right lung, tuberculosis
MeSH terms: Case Reports

Mycobacterium tuberculosis is the etiological agent of tuberculosis in humans. Tuberculosis is not only a highly contagious infectious disease, but also one of the top causes of death globally, especially in developing countries. Tuberculosis generally affects the lungs, and tuberculosis of the azygos lobe of the lung is extremely rare. This case report presents such a unique finding.
Posterior Reversible Encephalopathy Syndrome with Stroke in Puerperal Woman with High Titer of Anti-Phospholipid IgM Antibody
Authors: Hiroto Hirashima, Masahiro Iwamoto, Tadashi Ozawa, Shigeyoshi Kijima, Shigeki Matsubara, Akihide Ohkuchi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Posterior reversible encephalopathy syndrome with stroke is very rare in puerperal women. A 36-year-old nulliparous woman with both rheumatoid arthritis and recurrent pregnancy loss, probably due to a high titer of anti-phospholipid IgM antibody, was referred at 10 weeks of gestation. Low-dose aspirin at 100 mg/day and heparin calcium subcutaneous injection at 10,000 units/day were started before pregnancy and stopped at 35+6 and 40+2 weeks, respectively. She transabdominally delivered a male infant weighing 3,344 g at 40+5 weeks. A tonic-clonic seizure abruptly occurred without either hypertension or proteinuria 5 days after delivery. Intracerebral hemorrhage involving an area of 2 cm in diameter in the right frontal lobe and subarachnoid hemorrhage with PRES were confirmed. Seizure recurred 2 days after the initial episode. She showed severe headache and mild disturbance of consciousness but no neurological findings. We suggested that a high titer of anti-phospholipid IgM antibody might be associated with stroke.
Functional Rabbit Syndrome: A Case Report
Authors: Maria Stella Aniello, Sergio Altomare, Pasquale Difazio, Maurizio Giorelli
Journal: Tremor Other Hyperkinet Mov (N Y) (2021)
Keywords: functional, hyperkinetic movement disorder, rabbit syndrome, tremor
MeSH terms: Antipsychotic Agents, Dyskinesias, Case Reports, Humans, Middle Aged, Psychomotor Agitation, Syndrome, Antipsychotic Agents

Rabbit Syndrome is a rare involuntary movement occurring in 1.5-4.4% of patients receiving antipsychotics and characterized by rapid, regular movements (4-6 Hz) of the oral and masticatory musculature resembling the chewing motions of a rabbit. Herein we describe a middle-aged woman who presented with a rabbit syndrome characterized by several clues of psychogenicity such as sudden onset, distractibility, variability and complete "miracolous" remission.
Biosafety level-2 laboratory diagnosis of Zaire Ebola virus disease imported from Liberia to Nigeria
Authors: Olumuyiwa B Salu, Ayorinde B James, Bamidele O Oke, Mercy R Orenolu, Roosevelt A Anyanwu, Maryam A Abdullah, Christian Happi, Jide Idris, Ismail A Abdus-Salam, Abdul-Salam Nasidi, Folashade T Ogunsola, Oyewale Tomori, Sunday A Omilabu
Journal: Afr J Lab Med (2016)

Introduction:
Global travel is an efficient route of transmission for highly infectious pathogens and increases the chances of such pathogens moving from high disease-endemic areas to new regions. We describe the rapid and safe identification of the first imported case of Ebola virus disease in a traveler to Lagos, Nigeria, using conventional reverse transcription polymerase chain reaction (RT-PCR) in a biosafety level (BSL)-2 facility.
Case presentation:
On 20 July 2014, a traveler arrived from Liberia at Lagos International Airport and was admitted to a private hospital in Lagos, with clinical suspicion of Ebola virus disease.
Methodology and outcome:
Blood and urine specimens were collected, transported to the Virology Unit Laboratory at the College of Medicine, University of Lagos, and processed under stringent biosafety conditions for viral RNA extraction. RT-PCR was set-up to query the Ebola, Lassa and Dengue fever viruses. Amplicons for pan-filoviruses were detected as 300 bp bands on a 1.5% agarose gel image; there were no detectable bands for Lassa and Dengue viral RNA. Nucleotide BLAST and phylogenetic analysis of sequence data of the RNA-dependent RNA polymerase (L) gene confirmed the sequence to be Zaire ebolavirus (EBOV/Hsap/NGA/2014/LIB-NIG 01072014; Genbank: KM251803.1).
Conclusion:
Our BSL-2 facility in Lagos, Nigeria, was able to safely detect Ebola virus disease using molecular techniques, supporting the reliability of molecular detection of highly infectious viral pathogens under stringent safety guidelines in BSL-2 laboratories. This is a significant lesson for the many under-facilitated laboratories in resource-limited settings, as is predominantly found in sub-Saharan Africa.
Coxiella burnetii vascular graft infection
Authors: Laurence Senn, Mario Franciolli, Didier Raoult, Alexandre Moulin, Ludwig Von Segesser, Thierry Calandra, Gilbert Greub
Journal: BMC Infect Dis (2005)
MeSH terms: Blood Vessel Prosthesis / microbiology, Coxiella burnetii / isolation & purification, Prosthesis-Related Infections / diagnosis, Q Fever / diagnosis, Case Reports, Antibodies, Bacterial / blood, Aorta, Abdominal / pathology, Aorta, Abdominal / surgery, Aortic Aneurysm, Abdominal / surgery, Chloroquine / administration & dosage, Coxiella burnetii / drug effects, Coxiella burnetii / immunology, Doxycycline / administration & dosage, Femoral Artery / surgery, Humans, Male, Middle Aged, Polymerase Chain Reaction, Prosthesis-Related Infections / drug therapy, Prosthesis-Related Infections / microbiology, Q Fever / drug therapy, RNA, Ribosomal, 16S, Treatment Outcome, Antibodies, Bacterial, RNA, Ribosomal, 16S, Chloroquine, Doxycycline

Background:
Coxiella burnetii, the causative agent of Q fever, may cause culture-negative vascular graft infections. Very few cases of C. burnetii infection of a vascular graft have been reported. All were diagnosed by serology.
Case presentation:
We report the first case of Coxiella burnetii vascular graft infection diagnosed by broad-range PCR and discuss the diagnostic approaches and treatment strategies of chronic C. burnetii infection.
Conclusion:
C. burnetii should be considered as etiological agent in patients with a vascular graft and fever, abdominal pain, and laboratory signs of inflammation, with or without exposure history. Broad-range PCR should be performed on culture-negative surgical samples in patients with suspected infection of vascular graft.
Fat embolism syndrome in a patient that sustained a femoral neck fracture: A case report
Authors: L A S den Otter, B Vermin, M Goeijenbier
Journal: Front Med (Lausanne) (2022)
Keywords: cerebral fat embolisms, fat embolism syndrome, fat embolisms, patent foramen ovale (pfo), “starfield” pattern
MeSH terms: Case Reports

Background:
We present a case of a patient with a femoral neck fracture that shows neurological impairment and respiratory distress 1 day after trauma, caused by the Fat Embolism Syndrome with the presence of Cerebral Fat Embolisms.
Case summary:
A 75 year old female remained unresponsive after a hemi arthroplasty was performed because of a 1 day old femoral neck fracture. She rapidly developed respiratory insufficiency and an obstructive shock with right ventricle dilatation on transthoracic echocardiography. The diffusion-weighted MRI brain images showed the "Starfield" pattern, a radiologic phenomenon typical for FES. During 3 weeks of ICU admission the neurologic state slowly ameliorated.
Conclusion:
The rare FES is a clinical diagnosis with mainly respiratory, neurologic and dermatologic symptoms in the setting of a trauma patient. Fat embolisms are able to reach the brain without the presence of a patent foramen ovale to cause neurological symptoms. Diagnosing FES remains challenging but the distinctive "Starfield" pattern on MRI scans is promising.
Recurrent spontaneous pneumothorax in pregnancy - a case report and review of literature
Authors: Noman Lateef, Mustafa Dawood, Karn Sharma, Abubakar Tauseef, Muhammad Asadullah Munir, Erin Godbout
Journal: J Community Hosp Intern Med Perspect (2018)
Keywords: pneumothorax, chest tubes, video-assisted thoracoscopic surgery
MeSH terms: Case Reports

Spontaneous pneumothorax in pregnancy is a rare and life-threatening condition. In this report, a case of spontaneous pneumothorax occurring at 34 weeks' gestation in a healthy 34-year-old primigravida is described. She had typical complaints of chest pain and dyspnoea and diagnosis was made by chest X-ray which showed an extensive pneumothorax in the right side. Pneumothorax recurred twice over approximately three weeks. A caesarean section secondary to small pelvic parameters was scheduled with the chest tube in situ and a healthy 2.5 kg female infant was delivered. We discuss spontaneous pneumothorax during pregnancy and review the literature.
Portal Venous Stenting in Locally Advanced Pancreatic Cancer to Decrease Risk of Thrombosis Before Irreversible Electroporation: A Case Report and Review of the Literature
Authors: Justin F Monroe, Thor Johnson, Barish H Edil
Journal: J Pancreat Cancer (2017)
Keywords: irreversible electroporation, locally advanced pancreatic cancer, portal vein, portal vein thrombosis, venous stenting
MeSH terms: Case Reports

Background: For patients with locally advanced pancreatic cancer, irreversible electroporation (IRE) is a fairly novel treatment tool that has shown promise in improving survival. However, many patients being considered for IRE have tumors adjacent to and/or encasing portal vasculature, increasing risk of postoperative portal vein thrombosis and associated complications. This report describes a successful new approach of portal venous stenting preoperatively to decrease this risk. Case Presentation: A 64-year-old female with locally advanced pancreatic cancer, initially deemed too high risk for IRE therapy because of portal vein-superior mesenteric vein confluence encasement and compression, was offered and underwent venous stenting to decrease the chance of postoperative thrombosis and related complications. Stenting improved portal venous flow, decreased collateralization, and allowed for successful IRE. At 61 days post-IRE, there was no significant tumor growth and the stent remained patent. Conclusion: Preoperative portomesenteric stenting could expand the population eligible for IRE therapy, allowing for this treatment in patients without other options. To the authors' knowledge, this is the first reported case of portal venous stenting for this purpose.
Successful treatment of a blunt retrohepatic vena cava injury using an atriocaval shunt without sternotomy or thoracotomy: a case report
Authors: Donghwan Choi, Dongmin Seo, Hang Jun Choi, Jonghwan Moon
Journal: Front Surg (2023)
Keywords: atriocaval shunt, blunt liver injuries, retrohepatic vena cava injury (rhivc), total hepatic vascular isolation, transdiaphragmatic incision
MeSH terms: Case Reports

Retrohepatic vena cava (RHIVC) injury is often fatal and can be very difficult to manage. Total hepatic vascular isolation, a shunt, or bypass surgery is required for the surgical treatment of RHIVC injury in hemodynamically unstable patients; however, these are not easy procedures. Here, we present a case of RHIVC injury that was successfully treated by atriocaval shunt placement via a transdiaphragmatic incision without sternotomy or thoracotomy. In addition, we review the resuscitation and surgical procedures used for total hepatic vascular isolation in patients with RHIVC injury.
Herbal Medicine Containing Licorice May Be Contraindicated for a Patient with an HSD11B2 Mutation
Authors: Indra Sari Kusuma Harahap, Naoko Sasaki, Gunadi, Surini Yusoff, Myeong Jin Lee, Satoru Morikawa, Noriyuki Nishimura, Tomohiro Sasaki, Seiichiro Usuki, Midori Hirai, Mika Ohta, Yutaka Takaoka, Takashi Nishimoto, Hisahide Nishio
Journal: Evid Based Complement Alternat Med (2011)
MeSH terms: Case Reports

Licorice ingestion, as well as mutations in the HSD11B2 gene, inhibits 11β-hydroxysteroid dehydrogenase type 2 (11βHSD2) enzyme activity, causing the syndrome of apparent mineral corticoid excess (AME). However, the combined effect of licorice ingestion and an HSD11B2 mutation has never been reported, until now. In this study, we demonstrated that licorice ingestion can produce overt hypertension in an individual without medical history of hypertension who is heterozygous for wild-type and mutant HSD11B2 genes. Our patient was a 51-year-old female with serious hypertension who had been taking herbal medicine containing licorice for more than one year. She was clinically diagnosed as having licorice intoxication, because she did not present with hypertension after ceasing the herbal medicine. Molecular analysis showed that she carried a missense mutation, c.40C>T, in HSD11B2. In conclusion, licorice ingestion is an environmental risk factor for hypertension or AME state in patients with a mutation in HSD11B2. Carrying a mutation in HSD11B2 is, conversely, a genetic risk factor for licorice-induced hypertension or AME state. Herbal medicine containing licorice may, therefore, be contraindicated in patients with an HSD11B2 mutation.
An Atypical Anomalous Aortic Origin of the Left Coronary Artery With Intra-Arterial Wall Course Pretending a Normal Migration on Imaging Screening: A Case Report
Authors: Fan Hu, Xinyue Wang, Jiaojiao Wan, Yifei Li, Tao Wang, Kaiyu Zhou, Xiaoqing Shi, Zhongqiang Liu, Jie Fang, Yimin Hua
Journal: Front Cardiovasc Med (2022)
Keywords: anomalous aortic origin of a coronary artery, case report, intra-arterial wall course, non-coronary sinus of valsalva, syncope
MeSH terms: Case Reports

Background:
An anomalous aortic origin of a coronary artery (AAOCA) has been considered as a dominant cause of sudden cardiac death (SCD) among young age children. Therefore, it is critical to identify AAOCA timely to avoid lethal events. Recently, accumulating cases of right or left coronary arteries originating from inappropriate locations at the sinus of Valsalva have been identified. Here, we report a rare case of AAOCA with an intra-arterial wall course pretending normal migration on imaging screening in a patient who suffered from syncope.
Case summary:
A 7-year-old male without a previous history of cardiovascular and cerebrovascular diseases suddenly suffered from sharp chest pain and syncope after intensive exercise. The electrocardiogram showed that the ST segment of multiple leads was depressed by more than 0.05 mV, and biomarkers indicated severe myocardial injuries. The left ventricular ejection fraction (LVEF) decreased dramatically to 23%. Fulminant myocarditis and cardiomyopathy were therefore excluded. However, a relatively normal coronary artery origin, which arose from the left coronary sinus, presented on echocardiography and cardiac CT angiography (CTA). It is difficult to draw an association between severe clinical manifestations and slight malformations on echocardiography and CTA. Furthermore, selective coronary angiography revealed that an anomalous left coronary artery arose from the superior margin of the inappropriate sinus, developed an intramural wall course and finally exits the left sinus of Valsalva and migrated between the aorta and the pulmonary artery, which induced severe myocardial infarction during exercise. Then, the patient received surgical correction with a modified unroofing procedure. After 2 months of intensive treatment, the patient was discharged and remained asymptomatic through 18 months of follow-up.
Conclusion:
AAOCA, especially anomalous left coronary artery (ALCA), represents a major potential risk of SCD. We reported an atypical manifestation of ALCA arising from the inappropriate sinus of Valsalva and merging into the intra-arterial wall to develop a strange course and then sprout between the aorta and the pulmonary artery. The diversity of AAOCA might present as a relatively normal course under non-invasive radiological imaging scanning.
Durable Response and Good Tolerance to the Triple Combination of Toripalimab, Gemcitabine, and Nab-Paclitaxel in a Patient With Metastatic Pancreatic Ductal Adenocarcinoma
Authors: Lin Shui, Ke Cheng, Xiaofen Li, Pixian Shui, Shuangshuang Li, Yang Peng, Jian Li, Fengzhu Guo, Cheng Yi, Dan Cao
Journal: Front Immunol (2020)
Keywords: pd-1 inhibitor, case report, chemotherapy, combination therapy, durable response, good tolerance, metastatic pancreatic ductal adenocarcinoma
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / administration & dosage, Carcinoma, Pancreatic Ductal / drug therapy, Pancreatic Neoplasms / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Albumins / administration & dosage, Antibodies, Monoclonal, Humanized / administration & dosage, B7-H1 Antigen / metabolism, Carcinoma, Pancreatic Ductal / metabolism, Carcinoma, Pancreatic Ductal / secondary, Deoxycytidine / administration & dosage, Deoxycytidine / analogs & derivatives, Gemcitabine, Humans, Immune Checkpoint Inhibitors / administration & dosage, Immunohistochemistry, Male, Middle Aged, Paclitaxel / administration & dosage, Pancreatic Neoplasms / metabolism, Pancreatic Neoplasms / pathology, Tomography, X-Ray Computed, Treatment Outcome, 130-nm albumin-bound paclitaxel, Albumins, Antibodies, Monoclonal, Humanized, B7-H1 Antigen, CD274 protein, human, Immune Checkpoint Inhibitors, Deoxycytidine, toripalimab, Paclitaxel, Gemcitabine

Background: The performance of immune checkpoint inhibitor (ICI) monotherapy was proved to be disappointing in pancreatic ductal adenocarcinoma (PDAC). Increasing evidence has shown the promising efficacy of ICIs combined with systemic therapy in the first-line treatment in solid tumors. Case presentation: We reported a case of a metastatic PDAC patient who had a long-term partial response and good tolerance to the combined approach of toripalimab (a novel PD-1 inhibitor) and gemcitabine plus nab-paclitaxel (GA). PD-L1 positive expression was detected in his liver metastases. Besides, we described a phenomenon of pseudo-progression of this patient during the course of therapy. Conclusion: As the first-line treatment of metastatic PDAC patients, GA plus toripalimab may provide a novel combined approach with favorable response and manageable toxicity. Further clinical trials are needed to confirm the results. Pseudo-progression requires special attention and to be differentiated with true progression in patients undergoing immunotherapy.
Gastric inflammatory pseudotumour secondary to Actinomyces hordeovulneris infection in a cat
Authors: Marco Pietra, Renato Giulio Zanoni, Angelo Peli, Barbara Brunetti, Nikolina Linta, Ombretta Capitani, Giuseppe Spinella
Journal: Ir Vet J (2016)
Keywords: actinomyces hordeovulneris, cat, gastritis, pseudotumour

Background:
The authors report the first case of feline gastric actinomycosis associated with infection by Actinomyces hordeovulneris.
Case presentation:
A 4-year-old, neutered male, semi-feral European cat, with a 1 year history of chronic vomiting, was referred to the clinic. Abdominal ultrasound examination identified a hypoechoic focal transmural thickening with loss of normal wall layering and hyperechoic speckles at the gastric body. Initial gastroscopic examination showed a tumour-like gastric mass with an ulcerated depression at the level of the greater curvature. Histologic examination of endoscopic biopsy specimens was consistent with a severe lymphoplasmacytic gastritis. After 2 months, due to persistence of abdominal discomfort, surgical exploration and intraoperative sampling of gross abnormalities was recommended. Full thickness gastric wall biopsies, and fine needle aspiration of the gastric thickening and gastric lymph node, were performed. Histopathological examination identified a transmural pyogranulomatous gastritis. Aspirate samples of the gastric wall cultured positive, with colony morphology, biochemical testing and PCR of the 16 s rRNA gene compatible with Actinomyces hordeovulneris. After 4 months of treatment with cefovecin (8 mg/kg subcutaneously every 14 days), the vomiting completely resolved, as well as the ultrasonographic gastric alteration.
Conclusion:
This case report of feline gastric actinomycosis, caused by Actinomyces hordeovulneris, suggests that gastric bacterial infection should be considered in cases of focal gastric wall thickening associated with chronic vomiting in the cat, which may otherwise closely resemble neoplastic disease. Once a diagnosis of actinomycosis was obtained, a correct treatment with antibiotic therapy can resolve it.