OpenMed/multicare-articles huggingface dataset:
Baclofen and catatonia: a case report
Authors: Jamir Pitton Rissardo, Sai Nikhil Konduru, Vinay Kumar Gadamidi, Ana Letícia Fornari Caprara
Journal: Pan Afr Med J (2022)
Keywords: baclofen, case report, catatonia, lioresal, psychosis
MeSH terms: Catatonia / chemically induced, Catatonia / diagnosis, Catatonia / drug therapy, Psychotic Disorders / drug therapy, Case Reports, Adult, Baclofen / adverse effects, Female, Humans, Lorazepam, Young Adult, Baclofen, Lorazepam

Baclofen was approved for medical use in the United States in 1977 by Food and Drug Administration. Serious adverse effects associated with this medication are uncommon at usually prescribed doses. Herein, we present a case of baclofen-induced catatonia in a young-adult female with back pain receiving oral baclofen. A 20-year-old female presented to the emergency department with possible seizure-like activity. It was reported that the patient was suffering from acute back pain and was prescribed baclofen three times a day by her general physician one day before her presentation. Upon further discussion, it was known that following an altercation with her family member, she had attempted suicide by consuming 200 mg of baclofen and then developed rapidly progressive symptoms of aphasia, mutism, and decreased oral intake. Laboratory tests, cerebrospinal fluid analysis, and neuroimaging were unremarkable. Electroencephalogram was normal. Bush-Francis Catatonia Rating Scale score was 27. She showed significant improvement following low-dose lorazepam administration. There are four reports in the literature of catatonia secondary to baclofen. The present report is the first to describe the occurrence of catatonia in a previously healthy individual. Analysis of these cases suggests a relationship between a history of psychotic symptoms and catatonia. All the reports were classified as probable by the Naranjo algorithm.
Finite Element Analysis of a New Pedicle Screw-Plate System for Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Jie Li, Jin Shang, Yue Zhou, Changqing Li, Huan Liu
Journal: PLoS One (2015)
MeSH terms: Finite Element Analysis, Intervertebral Disc Degeneration / surgery, Pedicle Screws, Spinal Fusion / instrumentation, Case Reports, Research Support, Non-U.S. Gov't, Biomechanical Phenomena, Bone Plates, Bone Screws, Decompression, Surgical, Humans, Lumbar Vertebrae / surgery, Lumbosacral Region / surgery, Range of Motion, Articular, Rotation

Purpose:
Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is increasingly popular for the surgical treatment of degenerative lumbar disc diseases. The constructs intended for segmental stability are varied in MI-TLIF. We adopted finite element (FE) analysis to compare the stability after different construct fixations using interbody cage with posterior pedicle screw-rod or pedicle screw-plate instrumentation system.
Methods:
A L3-S1 FE model was modified to simulate decompression and fusion at L4-L5 segment. Fixation modes included unilateral plate (UP), unilateral rod (UR), bilateral plate (BP), bilateral rod (BR) and UP+UR fixation. The inferior surface of the S1 vertebra remained immobilized throughout the load simulation, and a bending moment of 7.5 Nm with 400N pre-load was applied on the L3 vertebra to recreate flexion, extension, lateral bending, and axial rotation. Range of motion (ROM) and Von Mises stress were evaluated for intact and instrumentation models in all loading planes.
Results:
All reconstructive conditions displayed decreased motion at L4-L5. The pedicle screw-plate system offered equal ROM to pedicle screw-rod system in unilateral or bilateral fixation modes respectively. Pedicle screw stresses for plate system were 2.2 times greater than those for rod system in left lateral bending under unilateral fixation. Stresses for plate were 3.1 times greater than those for rod in right axial rotation under bilateral fixation. Stresses on intervertebral graft for plate system were similar to rod system in unilateral and bilateral fixation modes respectively. Increased ROM and posterior instrumentation stresses were observed in all loading modes with unilateral fixation compared with bilateral fixation in both systems.
Conclusions:
Transforaminal lumbar interbody fusion augmentation with pedicle screw-plate system fixation increases fusion construct stability equally to the pedicle screw-rod system. Increased posterior instrumentation stresses are observed in all loading modes with plate fixation, and bilateral fixation could reduce stress concentration.
Ileal Adenocarcinoma with Liver Metastasis in Patient with Crohn's Disease: A 9-Year Survival
Authors: Jiten P Kothadia, Deepa H Nagaraju, Seymour Katz, Howard Bruckner, Steven H Itzkowitz, Myron Schwartz
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Small bowel adenocarcinoma is a rare but well-known complication of Crohn's disease. The diagnosis of small bowel adenocarcinoma remains difficult since its presentation is highly variable and mimics active or obstructive Crohn's disease. The diagnosis is often delayed and typically detected only at surgery in an advanced stage with a poor prognosis. We report a case of metastatic ileal adenocarcinoma in a patient with Crohn's disease with prolonged survival. Our case describes serial promising treatment options of these advanced malignancies and raises a possible role for checkpoint immunotherapy.
Case Report: Near-Fatal Intestinal Hemorrhage and Acute Acalculous Cholecystitis due to Vi-Negative and Fluoroquinolone-Insensitive Salmonella enterica Serovar Typhi Infection: A Rare Entity
Authors: Yuehua Gong, Jianlin Li, Dongnan Zhu, Songsong Wang, Yingchun Xu, Yan Li, Yanqing Wang, Yan Song, Wenjuan Liu, Yunlong Tian
Journal: Front Med (Lausanne) (2021)
Keywords: salmonella, vi-negative, acute acalculous cholecystitis, antimicrobial resistant, intestinal hemorrhage
MeSH terms: Case Reports

Typhoid fever is usually a mild clinical disease. Typhoid fever with massive intestinal hemorrhage is rare in the antibiotic era. Acute acalculous cholecystitis (AAC) is also rare in adults. Here, we describe the first adult case of typhoid fever with both complications due to Vi-negative and fluoroquinolone-insensitive Salmonella enterica serovar Typhi (S. Typhi) infection. We aim to alert physicians to this rare condition.
Bacteraemia with Moryella indoligenes and Fastidiosipila sanguinis: a case report
Authors: Sanne Kjær Hansen, Sandra Valborg Løfberg, Dorte Kassentoft Nielsen, Hanne Kobberø, Ulrik Stenz Justesen
Journal: Access Microbiol (2020)
Keywords: fastidiosipila sanguinis, moryella indoligenes, bacteraemia
MeSH terms: Case Reports

Moryella indoligenes and Fastidiosipila sanguinis are obligate anaerobic Gram-positive bacteria that are rarely involved in human infections. We present the first case of bacteraemia with M. indoligenes , which was part of a co-infection with F. sanguinis . Both micro-organisms were identified by 16S rRNA gene sequencing and M. indoligenes was also identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Prostate cancer involving the bladder suggests that the urinary tract was the most likely primary site of infection.
Isolated Rupture of the Teres Major Muscle When Water Skiing: A Case Report and Literature Review
Authors: Julien Cousin, Vincent Crenn, Alban Fouasson-Chailloux, Marc Dauty, Philippe Fradin, Francois Gouin, Guillaume Venet
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Isolated lesions to the teres major muscle are rare. They generally occur in patients participating in sports such as baseball, tennis, or boxing. We report the case of a sports patient who suffered an isolated injury to the teres major while water skiing. The clinical presentation was confirmed by MRI. Conservative treatment was chosen and consisted of brief analgesic immobilization, followed by rehabilitative treatment. The rapid recovery of this patient with normal isokinetic strength evaluation at 6 months was interesting for objectifying full muscle recovery. Our results and the data from the literature suggest that functional rather than surgical treatment is preferable in isolated lesions to the teres major muscle.
Filgrastim as a rescue therapy for persistent neutropenia in a case of dengue hemorrhagic Fever with acute respiratory distress syndrome and myocarditis
Authors: Desh Deepak, Rakesh Garg, Mridula Pawar, Neerja Banerjee, Rakesh Solanki, Indubala Maurya
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

Pathogenesis of dengue involves suppression of immune system leading to development of characteristic presentation of haematological picture of thrombocytopenia and leucopenia. Sometimes, this suppression in immune response is responsible for deterioration in clinical status of the patient in spite of all specific and supportive therapy. Certain drugs like steroids are used for rescue therapy in conditions like sepsis. We present a novel use of filgrastim as a rescue therapy in a patient with dengue hemorrhagic fever (DHF) with acute respiratory distress syndrome (ARDS), myocarditis, and febrile neutropenia and not responding to standard management.
Camrelizumab-Related Myocarditis and Myositis With Myasthenia Gravis: A Case Report and Literature Review
Authors: Jing Bai, Dan Li, Peidan Yang, Kunyan Xu, Yingnan Wang, Qian Li, Jiang Liu, Wenli Du, Fengbin Zhang, Rui Feng
Journal: Front Oncol (2022)
Keywords: camrelizumab, immune-related adverse events, myasthenia gravis, myocarditis, myositis
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) have substantially changed the treatment of a variety of malignant tumors. With the increasing of their usage, the unique immune-mediated toxicity profile of ICIs has become apparent. We report a case of esophageal squamous cell carcinoma in a patient who received anti-programmed cell death protein 1 (PD-1) (camrelizumab) therapy and the occurrence of sequential immune-related adverse events (irAEs). Although many irAEs have been reported, severe myositis caused by camrelizumab with simultaneous involvement of multiple organs, including the myocardium, respiratory muscles, and skeletal muscles, has rarely been described in literature. This 69-year-old male patient developed a grade 4 camrelizumab-induced adverse reaction according to the Common Terminology Criteria for Adverse Events (CTCAE) and was successfully treated with methylprednisolone and immunoglobulins. The early identification of irAEs, immediate discontinuation of immunotherapy, use of steroids and/or immunosuppressants, and adjuvant supportive treatment are critical to the clinical prognosis of patients. It should be aware that autoimmune complications can occur even when ICI treatment is ceased.
Single-Stage BAHA and Mastoid Obliteration
Authors: Ajith George, Chris Coulson, Elizabeth Ross, Ranit De
Journal: Int J Otolaryngol (2012)

A single-stage fitting of a bone-anchored hearing aid (BAHA) implant and abutment with mastoid obliteration both obviates the need for two separate procedures and utilises the BAHA soft tissue reduction in the mastoid obliteration. Such a procedure has good outcomes in terms of osseointegration and achieving a dry ear. We present a 6-patient case series report highlighting the technique of combined BAHA insertion and mastoid obliteration in six patients. All patients at twelve-month followup have a good degree of sound localisation and hearing thresholds with their BAHA and are free from the social stigma associated with a foul smelling discharging ear.
Primary Carcinosarcoma of the Spleen: A Rare Case Report of Incidental Finding after Splenic Trauma
Authors: Hugues Ndasu Matendo, Raouf Fayisall Geraldo, Liviu Musteata, Joel Allan Green, Valeriu Krasovski, Valentin Nitu, Thierry Gastaud, Fabrice Cattan
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Primary carcinosarcoma of the spleen is a rare, aggressive splenic malignancy. To date, seven cases have been reported in the literature. We report a first case of primary carcinosarcoma of the spleen in France. A 75-year-old woman with a medical history of hysterectomy for uterine adenocarcinoma presented with left hypochondrium pain following blunt abdominal trauma. A splenic mass was noted on computed tomography (CT) scan. A splenectomy was performed by laparotomy. Histology revealed a malignant mixed Mullerian tumor. The PET scan allowed us to confirm that it was a primary lesion of the spleen. She is currently undergoing adjuvant chemotherapy despite the tumor progression. The interest of this case lies in the rarity of primary carcinosarcomas of the spleen and the circumstances of its diagnosis.
Masquerade syndrome of multicentre primary central nervous system lymphoma
Authors: Silvana Guerriero, Ermete Giancipoli, Lorenza Ciracì, Giuseppe Ingravallo, Marcella Prete, Elisabetta Di Leo, Antonietta Cimmino, Nicola Cardascia
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Purpose. In Italy we say that the most unlucky things can happen to physicians when they get sick, despite the attention of colleagues. To confirm this rumor, we report the sad story of a surgeon with bilateral vitreitis and glaucoma unresponsive to traditional therapies. Methods/Design. Case report. Results. After one year of steroidal and immunosuppressive therapy, a vitrectomy, and a trabeculectomy for unresponsive bilateral vitreitis and glaucoma, MRI showed a multicentre primary central nervous system lymphoma, which was the underlying cause of the masquerade syndrome. Conclusions. All ophthalmologists and clinicians must be aware of masquerade syndromes, in order to avoid delays in diagnosis.
Coarctation Stenting in a Rare Case with Congenitally Corrected Transposition of the Great Arteries and the Bicuspid Aortic Valve
Authors: Zahra Khajali, Majid Maleki, Bahram Mohebbi, Maryam Aliramezany
Journal: J Tehran Heart Cent (2020)
Keywords: aortic coarctation, bicuspid aortic valve, surgical procedures, operative, transposition of great vessels coarctation
MeSH terms: Case Reports

Congenitally corrected transposition of the great arteries (cc-TGA) is a rare congenital abnormality that occurs in 1 per 33000 live births. This abnormality comprises nearly 0.05% of all congenital heart defects, with at least 90% of cc-TGA patients having associated cardiac defects; some of these associated defects are, however, very rare. In this case report, we describe a 22-year-old man who referred to our hospital for the evaluation of hypertension and cardiac murmurs. Via echocardiography and catheterization, the patient was finally diagnosed with cc-TGA, bicuspid aortic valve, and coarctation of the aorta. He underwent successful percutaneous transarterial coarctoplasty without any complications at early and 6 months' follow-up visits.
Well Leg Compartment Syndrome after Contralateral Femoral Neck ORIF
Authors: Christopher Shultz, Kristen Baca, Michael Decker
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

The authors present a case of WLCS after femoral neck fracture fixation. While this is a rare complication, a high index of suspicion should exist. Surgeons should use well leg holders with caution and limit utilization time. Alternative methods of positioning to allow for fluoroscopic imaging exist. WLCS remains a clinical diagnosis; intracompartmental measurements can be used but should be cautiously interpreted. When the diagnosis of WLCS is made, emergent fasciotomies of the affected compartments should be performed. Surgeons should be aware of this complication when using a well leg holder and the potential catastrophic consequences if left ignored.
Interstitial pneumonitis during rituximab-containing chemotherapy for primary central nervous system lymphomas: a case report and review of literature
Authors: Yuchen Wu, Xuefei Sun, Jing Liu, Jun Qian, Xueyan Bai, Yuedan Chen, Yuanbo Liu
Journal: Chin Neurosurg J (2018)
Keywords: central nervous system neoplasm, chemotherapy, immunotherapy, interstitial pneumonitis, lymphoma, r-mad regimen, rituximab, rituximab induced lung disease
MeSH terms: Case Reports

Background:
Primary central nervous system lymphoma(PCNSL) is a rare kind of non-Hodgkin lymphoma. Rituximab combined with high-dose methotrexate, cytarabine and dexamethasone (R-MAD regimen) were reported effective for PCNSL patients. Rituximab can cause several side effects, including fever, chills and rigors.
Case presentation:
In this case report, we demonstrate rituximab-induced interstitial pneumonitis in a PCNSL patient who has been treated with R-MAD regimen. The patient recovered after treatment and she remains complete remission after following consolidation chemotherapy.
Conclusions:
Here is no report of potential fatal complications of Rituximab like interstitial pneumonitis nowadays in PCNSL patients. As Rituximab is widely used, physicians should raise their awareness of this rare complication and detect RTX-ILD in early stage.
Endolumenal Vacuum Therapy and Fistulojejunostomy in the Management of Sleeve Gastrectomy Staple Line Leaks
Authors: Kyle Szymanski, Estrellita Ontiveros, James S Burdick, Daniel Davis, Steven G Leeds
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery performed for morbid obesity. Leaks of the vertical staple line can occur in up to 7% of cases and are difficult to manage. Endolumenal vacuum (EVAC) therapy and fistulojejunostomy (FJ) have separate documented uses to heal these complicated leaks. We aim to show the benefit of using EVAC with FJ in the treatment of LSG staple line leaks. The patient presented with an LSG chronic leak. EVAC therapy was initiated but failed to close the fistula after 101 days. EVAC therapy was abandoned, and FJ was performed to resolve the leak. Postoperatively, no leak was encountered requiring any additional procedures. Based on our findings, we conclude that EVAC therapy facilitates in resolving leaks that restore gastrointestinal continuity and maintain source control. It promotes healing and causes reperfusion of ischemic tissue and fistula cavity debridement.
A case of scrofuloderma of the axilla presenting as hidradenitis suppurativa: A case report
Authors: Laurence Garon, Ashley Hill
Journal: SAGE Open Med Case Rep (2022)
Keywords: dermatology, infectious disease
MeSH terms: Case Reports

Scrofuloderma is an uncommon cutaneous presentation of tuberculosis. It can be difficult to diagnose, as it can mimic various skin conditions, including hidradenitis suppurativa. We report a case of a 46-year-old female refugee patient with a history of nodules and sinus tracts in the left axilla treated for many years as hidradenitis suppurativa in her home country who was later found to have scrofuloderma. The diagnosis was based on a positive Mycobacterium tuberculosis polymerase chain reaction from an ultrasound-guided aspiration. Further investigation excluded pulmonary tuberculosis. In cases with an atypical presentation of hidradenitis suppurativa, imaging, along with histological and microbiologic examination are warranted to exclude scrofuloderma.
Metastatic renal clear cell carcinoma mimicking a gallbladder polyp: Case report and literature review
Authors: Skander Zouari, Mouna Ben Othmen, Nihed Abdessayed, Nadia Larbi Mama, Mohamed Salah Jarrar, Badreddine Sriha, Moncef Mokni, Mehdi Jaidane, Wissem Hmida
Journal: Int J Surg Case Rep (2019)
Keywords: cancer, case report, gallbladder, metastasis, polyp, renal cell carcinoma

Introduction:
Metastatic tumors to the gallbladder are uncommon. Metastases from renal cell carcinoma (RCC) to the gallbladder are exceptional. Frequencies of less than 0.6% reported in large autopsy reviews and few cases have been reported in the literature.
Presentation of case:
Herein we present a case of a 50-year-old man that developed four years after radical nephrectomy for RCC, a gallbladder metastasis, discovered incidentally on Computed Tomography (CT) scan. It was described as an intraluminal gallbladder polyp. Radiological features were very suggestive of primary gallbladder carcinoma, thus the patient had a laparoscopic cholecystectomy. The pathological examination of the surgical specimen concluded to a RCC metastasis. Immunochemistry with vimentin and pancytokeratin were supportive of this diagnosis. The clinical course was uneventful after 18 months period of follow up.
Discussion:
At the time of presentation, almost one-third of the patients with RCC are metastatic. Metastases to the gallbladder are extremely rare. Clinical presentation and physical examination are unspecific. Radiological findings can raise information and orient the diagnosis although the difference between both diagnoses remains difficult. Usually, it is a pedunculated and not associated with gallstones with enhancement on CT scan. The treatment remains surgical with R0 cholecystectomy, and prognosis is mainly related to disease free interval and single site metastasis.
Conclusion:
We highlight here the challenge to make the difference between a primary gallbladder carcinoma and metastasis from RCC. Diagnosis is made on pathological examination and immunochemistry.
Ultrasound-Proven Severe Synovitis Induced by PD-1 Inhibitor Therapy in a Patient Predisposed to Seronegative Inflammatory Arthritis
Authors: Shin-Ya Kawashiri, Naoki Iwamoto, Kojiro Ohba, Atsushi Kawakami
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

A 71-year-old Japanese woman was treated with programmed cell death protein-1 (PD-1) inhibitor, nivolumab, for renal cell carcinoma with lung metastasis. Although she had been treated with antirheumatic drugs from 40 to 60 years old by the diagnosis of seronegative inflammatory arthritis, treatment was discontinued based on her achievement of remission. She developed severe polyarthralgia after the administration of nivolumab. Severe synovitis with remarkable power Doppler signals was detected by ultrasound in multiple joints and tendons, and her serum levels of proinflammatory cytokine were remarkably elevated. Nevertheless, her arthritis disappeared after the discontinuation of nivolumab and treatment with a glucocorticoid without antirheumatic drugs. The use of PD-1 inhibitor may be restricted in patients predisposed to arthritis. Alternatively, a close monitoring of these patients by rheumatologists is necessary to identify predictable flares.