OpenMed/multicare-articles huggingface dataset:
Polycythemia with Renal Cell Carcinoma and Normal Erythropoietin Level
Authors: Jonathan Kopel, Pranav Sharma, Irfan Warriach, Sriman Swarup
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

A 61-year-old obese Caucasian male with past medical history of smoking, hypertension, chronic obstructive pulmonary disease (COPD), and sleep apnea presented to the hematology clinic with polycythemia. Despite the newly-diagnosed polycythemia, the patient denied any significant symptoms or history of blood clots. Further evaluation with computerized tomography (CT) and ultrasound showed a large renal mass suspicious for renal cell carcinoma of the right kidney. An incidental abdominal aortic aneurysm (AAA) measuring was also appreciated on imaging. Subsequent histological sections of the tumor showed cell renal cell carcinoma. Though previously reported, the concomitant finding of an AAA with renal cell carcinoma with a normal erythropoietin levels is surprising. Given the surgical complications associated with concomitant conditions with renal cell carcinoma, further investigation into paraneoplastic syndromes secondary to renal cell carcinoma remains open to investigation.
Successful Clearance of Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia with Daptomycin, Linezolid, and Meropenem Salvage Therapy
Authors: Grant Shaddix, Kalindi Patel, Matthew Simmons, Kelsie Burner
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Staphylococcus aureus is one of the most virulent Gram-positive organisms responsible for a multitude of infections, including bacteremia. Methicillin-resistant Staphylococcus aureus (MRSA) is of special concern in patients with bacteremia. Due to its associated poor clinical outcomes, morbidity, and mortality, the superlative salvage regimen for persistent MRSA bacteremia remains uncertain. An 85-year-old white female presented with persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Empiric antibiotic therapy with linezolid was initiated prior to blood culture results. Once MRSA bacteremia was confirmed, alternative antibiotic therapy with daptomycin was initiated. Blood cultures remained positive for MRSA despite three days of daptomycin therapy after which ceftaroline was added to the antibiotic regimen. Blood cultures remained positive for MRSA despite seven days of combination therapy with daptomycin and ceftaroline. Salvage therapy was then initiated with daptomycin, linezolid, and meropenem. One day following initiation of salvage therapy, blood cultures revealed no bacterial growth for the remainder of the length of stay. This report supports the effectiveness of salvage therapy consisting of daptomycin, linezolid, and meropenem in patients with persistent MRSA bacteremia.
Unexpected hair regrowth in a woman with longstanding Alopecia universalis
Authors: Fani Akritidou, Konstantina Misiou, Elina Tsanidou, Georgios N Katsaras, Theodora Papamitsou
Journal: GMS Ophthalmol Cases (2021)
MeSH terms: Case Reports

Alopecia areata (AA) is an autoimmune disorder leading to non-scarring hair loss. As long as hair follicles are not destroyed, the potential for hair regrowth remains. Alopecia universalis is a severe form of AA and the chance of full hair regrowth is below 10%. We present a case of a 55-year-old woman with longstanding AA, who presented to the Outpatient Clinic of our Hospital Unit with almost full eyelashes and hair regrowth after an emotional stressful event. She reported no hair regrowth for the last 35 years. There are few case reports which have exhibited that hair follicles are still alive and may be reactivated after many years.
Case Report: Neuropathic pain in a patient with congenital insensitivity to pain
Authors: Daniel W Wheeler, Michael C H Lee, E Katherine Harrison, David K Menon, C Geoffrey Woods
Journal: F1000Res (2014)
Keywords: channelopathy, congenital insensitivity to pain, neuropathic pain, pain

We report a unique case of a woman with Channelopathy-associated Insensitivity to Pain (CIP) Syndrome, who developed features of neuropathic pain after sustaining pelvic fractures and an epidural hematoma that impinged on the right fifth lumbar (L5) nerve root. Her pelvic injuries were sustained during painless labor, which culminated in a Cesarean section. She had been diagnosed with CIP as child, which was later confirmed when she was found to have null mutations of the SCN9A gene that encodes the voltage-gated sodium channel Nav1.7. She now complains of troubling continuous buzzing in both legs and a vice-like squeezing in the pelvis on walking. Quantitative sensory testing showed that sensory thresholds to mechanical stimulation of the dorsum of both feet had increased more than 10-fold on both sides compared with tests performed before her pregnancy. These findings fulfill the diagnostic criteria for neuropathic pain. Notably, she mostly only experiences the negative symptoms (such as numbness and tingling, but also electric shocks), and she has not reported sharp or burning sensations, although the value of verbal descriptors is somewhat limited in a person who has never felt pain before. However, her case strongly suggests that at least some of the symptoms of neuropathic pain can persist despite the absence of the Nav1.7 channel. Pain is a subjective experience and this case sheds light on the transmission of neuropathic pain in humans that cannot be learned from knockout mice.
Kidney biopsy for renal tubular acidosis: when tissue diagnosis makes a difference
Authors: Youshay Humayun, Patrick Sanchez, Lindsey T Norris, Divya Monga, Jack Lewin, Tibor Fülöp
Journal: Clin Nephrol Case Stud (2015)
Keywords: allergic interstitial nephritis, distal renal tubular acidosis, hypokalemia, metabolic acidosis, omeprazole, proton-pump inhibitor
MeSH terms: Case Reports

Renal tubular acidosis (RTA) is a disorder with variable presentations and oftentimes a nebulous underlying primary diagnosis. We describe a rare cause of RTA as an unusual complication of proton pump inhibitor (PPI) therapy. We report a case of a 33-year-old male with history of hypertension, acid reflux, allergic rhinitis, and low testosterone admitted with complaints of fatigue, weight loss, and unexplained acidosis for ~ 2 months. His medications prior to admission included losartan, omeprazole, potassium chloride, sildenafil, and testosterone propionate injections. His physical exam was unremarkable with a blood pressure of 120/80 mmHg. Initial lab work showed a nonanion gap metabolic acidosis with serum bicarbonate level of 16 mM/L and potassium 3 mM/L. Urine studies showed urine pH of 6.5 and a positive urine anion gap. The serum creatinine was within normal range(1.13 mg/dL). He required massive doses of bicarbonate and potassium supplementation with minimal improvement of serum chemistries achieved. The cause of apparent distal RTA remained elusive despite extensive blood, urine, and imaging testing. Ultimately a renal biopsy was obtained showing mild to moderate tubule-interstitial inflammation with 5% fibrosis. PPI therapy (omeprazole) was stopped, and he was started on prednisone 60 mg per day. Two weeks later, his RTA findings resolved, and he no longer required bicarbonate and potassium supplementation. Our case highlights the importance of recognizing a unique complication of RTA following PPI therapy. It also underscores the possible need for considering a kidney biopsy in the setting of nondiagnostic laboratory work up to uncover the underlying etiology of RTA and suspected allergic interstitial nephritis (AIN).
Disseminated hydatidosis with rare presentation as "cystovesical fistula"
Authors: Rashmeet Kaur, Simmi Garg, Navkiran Kaur, Paramdeep Singh
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Disseminated hydatidosis is a rare disease and may involve any organ of the human body. In this case, an elderly female got infected by Echinococcus and presented with disseminated disease. A fistulous communication developed between one of the hydatid cysts present in the retrovesical region and the bladder, because of which the patient presented with hydatiduria.
Primary antiphospholipid syndrome associated with pneumonia: a case report of a 16-year-old male patient
Authors: Süreyya Yilmaz, Fusun Topcu, Hadice Selimoglu Sen, Yasar Yildirim, Zülfükar Yilmaz, Ali Veysel Kara, Cihan Akgul Ozmen
Journal: Case Rep Pulmonol (2015)

Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterial and/or venous thrombosis and/or recurrent pregnancy loss in the presence of antiphospholipid (APL) antibodies. It is evaluated as APS when it develops associated with other systemic autoimmune diseases or primary APS if there is no concomitant disorder. In this study, we present a case of a 16-year-old male patient with primary APS. The patient was admitted with presumptive diagnosis of pneumonia, but multiple pulmonary thromboembolism (PTE) was observed on computerized tomography (CT) pulmonary angiography. APL antibodies positivity and thrombocytopenia developed in our patient. The patient was evaluated as primary APS since another etiology that could explain PTE was not found. Primary APS is a rare disease in children along with adolescents, compared with APS associated with other systemic autoimmune diseases. We present here a young male patient with primary APS and PTE to contribute to the literature. The patient initially had pneumonia but later developed PTE and thrombocytopenia.
Pericardiectomy for pleuropericardial effusion complicating bacterial pneumonia
Authors: Andrea Quarti, Fernando Maria de Benedictis, Elli Soura, Marco Pozzi
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Severe pericardial effusion is a rare complication of bacterial pneumonia and it usually disappears under medical treatment. Herein we report a case of a girl with a congenital immunodeficient syndrome and bacterial pneumonia, who developed recurrent and life-threatening pericardial effusion refractory to medical treatment. She was finally treated with pericardiectomy.
Massive Upper Body and Cervicofacial Subcutaneous Emphysema Following Robotic Myomectomy
Authors: Joseph Capone, Aladino De Ranieri, Nebojsa N Knezevic, Ivan K Lukić, Kenneth Candido, Vicko Gluncic
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

Subcutaneous emphysema is defined as the unintentional introduction of air or carbon dioxide in the subcutaneous tissues. The use of robotic surgical techniques has greatly expanded over the past decade specifically to treat intraperitoneal pathology. In general, advantages of these minimally invasive procedures are reported to decrease operating time, patient morbidity, and shorten hospital stay providing a safe alternative to traditional surgery. However, as with any surgery, potential complications may occur. We describe an unusual case of massive subcutaneous emphysema involving the upper body and cervicofacial region, with bilateral pneumothoraces following robotic intraperitoneal surgery. Written authorization was obtained from the patient.
Secondary Hyperparathyroidism Presenting as a Brown Tumor: A Case Report and Review of the Literature
Authors: Rui Flores, Joana Lopes, Sofia Caridade
Journal: Cureus (2023)
Keywords: brown tumor, chronic kidney disease (ckd), osteitis fibrosa cystica, renal osteodystrophy, secondary hyperparathyroidism
MeSH terms: Case Reports

Severe secondary hyperparathyroidism in advanced stages of chronic kidney disease (CKD) is associated with CKD-related mineral and bone disease (CKD-MBD). A 70-year-old woman was admitted at the Hospital for generalized bone pain and peripheral edema. Initial laboratory tests revealed normocytic anemia and severe renal dysfunction, and further tests evidenced severe secondary hyperparathyroidism. Full-body computerized tomography showed an osteolytic lesion in the right iliac wing. The iliac bone lesion was biopsied and histological examination was consistent with the diagnosis of a brown tumor of hyperparathyroidism. Brown tumors are a rare variant of osteitis fibrosa cystica that results from sustained high levels of parathyroid hormone in CKD. This case sheds light on rare complications that are experienced today in CKD. The clinical and biochemical setting, as well as the clinical suspicion, are essential to the diagnosis.
Case report: Teflon granuloma following microvascular decompression manifesting as light-triggered trigeminal neuralgia
Authors: Mustaqim Prasetya, Peter Adidharma, Takuro Inoue, Adi Sulistyanto, Fadhil, Selfy Oswari, Ryan Rhiveldi Keswani, Muhammad Kusdiansah, Yunus Kuntawi Aji, Abrar Arham
Journal: Front Surg (2022)
Keywords: teflon granuloma, light-triggered pain, microvascular decompression, recurrent trigeminal neuralgia, trigeminal neuralgia
MeSH terms: Case Reports

Trigeminal Neuralgia is commonly triggered by stimuli in the area of the trigeminal nerve innervation. We report an exceptionally rare case of a 61-year-old woman who complained of recurrent trigeminal neuralgia, which sole trigger was seeing a bright light. Teflon felt that was placed on the nerve root in the initial surgery was suspected of causing this rare type of trigeminal neuralgia. A reflex circuit linking luminance to trigeminal nerve activity may be implicated in activating a trigeminal nociceptive pathway by a bright light trigger.
Multiple Calcifying Hyperplastic Dental Follicle (MCHDF): A Case Report
Authors: Shokoofeh Jamshidi, Massoumeh Zargaran, Nooshin Mohtasham
Journal: J Dent Res Dent Clin Dent Prospects (2013)
Keywords: dental follicle, hyperplastic, teeth
MeSH terms: Case Reports

Evaluation of enlarged follicles with unerupted teeth is always important because some changes may occur. One of the ex-tremely rare conditions seen in dental follicles is multiple calcifying hyperplastic dental follicle. We report a case of multi-ple calcifying hyperplastic dental follicle. Radiographs showed that mandibular third molars had a pericoronal radiolucent zone delineated by a well-defined and sclerotic border. Microscopic examination revealed a combination of fibrous connec-tive and small calcifications. Multiple calcifying hyperplastic dental follicle is a rare condition and its correct diagnosis is necessary to apply appropriate treatment.
Bronchiolitis obliterans associated with toxic epidermal necrolysis induced by infection: A case report and literature review
Authors: Jingwei Liu, Haibo Yan, Chunfeng Yang, Yumei Li
Journal: Front Pediatr (2023)
Keywords: bronchiolitis obliterans, dyspnea, infection, stevens-johnson syndrome, toxic epidermal necrolysis
MeSH terms: Case Reports

Background:
Stevens-Johnson syndrome/toxic epidermal necrolysis has a severe impact on patients' eyes, genital mucosa, and many other organs. Bronchiolitis obliterans is a rare complication of Stevens-Johnson syndrome/toxic epidermal necrolysis.
Data sources:
We report a case of bronchiolitis obliterans associated with toxic epidermal necrolysis in our department. Furthermore, we examined the patients with bronchiolitis obliterans induced by Stevens-Johnson syndrome/toxic epidermal necrolysis and summarized the clinical characteristics, treatment, and prognosis. Databases available online in English including PubMed, Medline, and Web of Science were consulted.
Results:
We report one case and review 23 published case reports. Of the 24 patients, 13 were female, the oldest patient was 59 years old and the youngest was 5 years old. The time of bronchiolitis obliterans onset after Stevens-Johnson syndrome/toxic epidermal necrolysis varied from 5 days to 5 months. Bronchoscopy examination showed ulceration, exudative lesions, occlusion, and inflammation. The CT of lung manifestation included mosaic perfusion, bronchiectasis, consolidation, air trapping, pneumatocele, pleural thickening, lung collapse, larger central airway dilatation, lung overinflation, oligemia, and pneumomediastinum. Most cases indicated pulmonary function tests with obstructive ventilation dysfunction. The prognosis was poor; six of the patients died.
Conclusions:
Patients with Stevens-Johnson syndrome/toxic epidermal necrolysis may develop bronchitis obliterans at different stages, so all patients with Stevens-Johnson syndrome/toxic epidermal necrolysis should be followed up for possible respiratory complications.
Bearing-Foreign Material Deposition on Retrieved Co-Cr Femoral Heads: Composition and Morphology
Authors: Nishant M Tikekar, Anneliese D Heiner, Thomas E Baer, Karen M Kruger, John J Callaghan, Thomas D Brown, John J Lannutti
Journal: Biomed Res Int (2015)
MeSH terms: Arthroplasty, Replacement, Hip, Chromium Alloys, Foreign Bodies / diagnostic imaging, Hip Prosthesis, Case Reports, Research Support, N.I.H., Extramural, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Radiography, Surface Properties, Chromium Alloys

Bearing-foreign material deposition onto a femoral head can occur from contact with an acetabular shell due to dislocation, reduction, or subluxation. The purpose of this study was to comprehensively characterize deposit regions on retrieved cobalt-chrome femoral heads from metal-on-polyethylene total hip arthroplasties that had experienced such adverse events. The morphology, topography, and composition of deposition regions were characterized using macrophotography, optical profilometry, scanning electron microscopy, energy dispersive spectroscopy, and X-ray photoelectron spectroscopy. The deposit areas were relatively large, they were much rougher than the surrounding undamaged clean areas, and they displayed several distinct morphologies. Titanium alloy elements were the predominant constituents. Calcium and phosphorous were also detected within the deposit areas, in a composition that could nucleate abrasive hydroxyapatite. In addition, tungsten-rich particles, likely present as tungsten carbide, were observed on top of the titanium deposits. The increased roughness associated with these deposition features would be expected to accelerate damage and wear of the opposing liner and hence accelerate the development of osteolysis.
Utilization of Rituximab for Refractory Rowell Syndrome
Authors: Sukhraj Singh, Sandra Sheffield, Nisha Chowdhury, Swetha Nuthulaganti, Zareen Vaghaiwalla, Karishma Ramsubeik
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Rowell syndrome describes the occurrence of erythema multiforme-like lesions in patients with cutaneous lesions of lupus erythematosus. The clinical picture of atypical erythema multiforme-like lesions, presence of chilblains, speckled ANA pattern, anti-Ro/SSA, or anti-La/SSB antibodies, and absence of infectious or pharmacologic triggers in a patient with systemic lupus erythematosus are some of the classic clinical and serologic features. Histopathologic and serologic findings can help differentiate this process from erythema multiforme. We present a case of young woman with systemic lupus erythematosus, end-stage renal disease due to lupus nephritis, and a remote history of Steven-Johnson syndrome due to sulfa allergy who presented to the hospital with a recurrent, progressive, targetoid erythematous rash involving more than 60% of her body surface area. Our patient had several hospitalizations in the recent past for this erythematous rash and had failed oral therapy with prednisone 1 mg/kg and hydroxychloroquine. In view of the minimal improvement and increasing severity and patient exhibiting early features of mast cell activation syndrome, the patient was treated with pulse intravenous glucocorticoids followed by rituximab with an excellent response. We highlight a unique case report of progressive Rowell syndrome refractory to standard of care with an excellent response to rituximab.
Five-Year Follow-Up of Distal Tibia Bone and Foot and Ankle Trauma Treated with a 3D-Printed Titanium Cage
Authors: Eugene C Nwankwo, Fangyu Chen, Dana L Nettles, Samuel B Adams
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Large bone defects from trauma or cancer are difficult to treat. Current treatment options include the use of external fixation with bone transport, bone grafting, or amputation. These modes of therapy continue to pose challenges as they are associated with high cost, failure, and complication rates. In this study, we report a successful case of bone defect treatment using personalized 3D-printed implant. This is the longest known follow-up using a 3D-printed custom implant for this specific application. Ultimately, this report adds to existing literature as it demonstrates successful and maintained incorporation of bone into the titanium implant. The use of patient-specific 3D-printed implants adds to the available arsenal to treat complex pathologies of the foot and ankle. Moreover, the technology's flexibility and ease of customization makes it conducive to tailor to specific patient needs.
Case report: The clinical utility of metagenomic next-generation sequencing in mucormycosis diagnosis caused by fatal Lichtheimia ramosa infection in pediatric neuroblastoma
Authors: Huili Shen, Xiaodi Cai, Jing Liu, Gangfeng Yan, Ying Ye, Rui Dong, Jufang Wu, Li Li, Quanli Shen, Yutong Ma, Qiuxiang Ou, Meili Shen, Weiming Chen, Guoping Lu
Journal: Front Pediatr (2023)
Keywords: lichtheimia ramosa, mngs (metagenomic next-generation sequencing), mucormycosis, neuroblastoma, pediatric
MeSH terms: Case Reports

Lichtheimia ramosa (L. ramosa) is an opportunistic fungal pathogen of the order Mucorales that may result in a rare but serious mucormycosis infection. Mucormycosis could be angioinvasive, causing thrombosis and necrosis in the nose, brain, digestive tract, and respiratory tract. The infection is highly lethal, especially in immunocompromised hosts, and the incidence has been on the rise. However, due to its relatively low incidence in pediatric population and the challenges with diagnosis, the awareness and management experience for pediatric mucormycosis are extremely limited, which might lead to poor outcomes. In this study, we comprehensively reviewed the course of a fatal rhinocerebral mucormycosis case in a pediatric neuroblastoma patient receiving chemotherapy. Due to a lack of awareness of the infection, the standard care of amphotericin B treatment was delayed and not administered until the identification of L. ramosa by metagenomic next-generation sequencing (mNGS)-based pan-pathogen detection of the patient's peripheral blood sample. We also reviewed the literature on L. ramosa infection cases reported worldwide between 2010 and 2022, with an analysis of clinical manifestation, prognosis, and epidemiological data. Our study not only highlighted the clinical value of comprehensive mNGS in rapid pathogen detection but also raised awareness of recognizing lethal fungal infection early in immunocompromised hosts including pediatric cancer patients.