OpenMed/multicare-articles huggingface dataset:
Tubercular sinus of labia majora: rare case report
Authors: Kela Manoj, Mukherjee Soma, Lunawat Ajay, Agrawal Ashish, Shishodiya Rakesh, R V Paliwal
Journal: Infect Dis Obstet Gynecol (2008)
MeSH terms: Tuberculosis, Urogenital / microbiology, Vulva / microbiology, Vulvar Diseases / microbiology, Case Reports, Female, Humans, Middle Aged, Tuberculosis, Urogenital / pathology, Tuberculosis, Urogenital / surgery, Vulva / pathology, Vulvar Diseases / pathology

Tuberculosis of the female external genitalia is unusual and primary infection is rare. We report a 50-year-old female patient admitted to Department to Surgery with swelling over left inguinal area with discharging sinus from labia majora to left inguinal crease which was found to be tubercular sinus on histopathology.
Human subcutaneous dirofilariasis: the 'migrating' skin tumor
Authors: Michelle Alexandra Mistry, Jens Hoejvig, Marie Helleberg, Christen Rune Stensvold, Pikka Jokelainen, Anders Noehr, Christian Bonde
Journal: Case Reports Plast Surg Hand Surg (2021)
Keywords: dirofilaria, northern europe, vector-borne diseases, dirofilariasis, subcutaneous nodules
MeSH terms: Case Reports

A 46-year-old woman presented with facial pain and discomfort. Diagnosis of subcutaneous dirofilariasis was reached after several months from symptom onset. Dirofilariasis should be suspected, also in non-endemic areas, in patients with a migrating subcutaneous nodule. Plastic surgery is preferred, as the face is often involved.
Intraoperative Treatment of Duct of Luschka during Laparoscopic Cholecystectomy: A Case Report and Revision of Literature
Authors: Luigi Masoni, Leandro Landi, Riccardo Maglio
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Background:
Bile leakage still remains a serious complication during cholecystectomies. In limited cases, this complication may occur from injury of the so-called ducts of Luschka. These rare ducts are usually discovered intraoperatively, and their presence poses the risk of bile injury and clinically significant bile leak.
Presentation case:
We present a unique case of a 59-year-old male patient with acute cholecystitis. After removal of the gallbladder, thorough inspection of the hepatic bed was made and a little bile leak was identified from a duct of Luschka 1 cm away from the gallbladder hilum. We report on the use of endoscopic QuickClip Pro® clips (Olympus Medical Systems Corp., Tokyo, Japan) to avoid further more invasive treatment.
Discussion:
Endoscopic retrograde cholangiopancreatography with sphincterotomy played a crucial role for diagnosis and treatment of bile leaks with success rate near 94%. Many authors have argued the role of relaparoscopy, Diagnosis may be intraoperatively but this option does not seem to occur very often; in fact, there is a lack of data in literature.
Conclusion:
This is the first case report of bile leak from duct of Luschka treated during the cholecystectomies with endoscopic clip.
Case Report: Re-Sensitization to Gefitinib in Lung Adenocarcinoma Harboring EGFR Mutation and High PD-L1 Expression After Immunotherapy Resistance, Which Finally Transform Into Small Cell Carcinoma
Authors: Xiaoqian Zhai, Jiewei Liu, Zuoyu Liang, Zhixi Li, Yanyang Liu, Lin Huang, Weiya Wang, Feng Luo
Journal: Front Oncol (2021)
Keywords: epidermal growth factor receptor mutation, high pd-l1 expression, immunotherapy resistance, lung adenocarcinoma, small cell cancer transformation, targeted therapy resistance, tyrosine kinase inhibitors
MeSH terms: Case Reports

The treatment sequence of immunotherapy (IO) and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) is of great importance for the survival of non-small cell lung cancer (NSCLC) patients with EGFR sensitive mutation. Here, we reported an advanced lung adenocarcinoma case concurrent with EGFR sensitive mutation and high PD-L1 expression (>50%) that was administrated with gefitinib firstly, and then became resistant to EGFR-TKI. He received the strategy of immunity-combined chemo-radiotherapy and responded significantly. However, the disease re-progressed after 10 months. Surprisingly, the tumor re-sensitized to gefitinib for 13 months. At final, following the treatment pressure of TKI-IO combination therapy-TKI strategy, tumor clone eventually transformed into small cell lung carcinoma (SCLC). For one thing, our study provided novel approach and extended the treatment spectra of overcoming immunotherapy resistance after EGFR resistance in driver oncogene-mutated NSCLC. For another thing, our case is the first time to report that SCLC transformation can be achieved after gefitinib-pembrolizumab-gefitinib resistance in EGFR sensitive mutation NSCLC, providing a new condition for SCLC transformation.
Multifocal Pulmonary Granular Cell Tumor Presenting with Postobstructive Pneumonia
Authors: Samid M Farooqui, Muhammad S Khan, Laura Adhikari, Viral Doshi
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Granular cell tumor (GCT) is a neoplasm of Schwann cell origin. Its presence in the aerodigestive tract is uncommon and becomes a diagnostic challenge on initial presentation. Our case is of a 59-year-old woman who presented to the emergency department with a history of productive cough and dyspnea associated with fever and chest pain. An initial chest X-ray (CXR) showed a right middle lobe consolidation with follow-up Computed Tomography (CT) scan showing a mass in the right bronchus. Bronchoscopy revealed a polypoid, sessile granular mass in the right bronchus intermedius with multiple white lesions in trachea, left main bronchus, and right upper bronchi. Histology revealed a benign GCT. Bronchoalveolar lavage from the right middle lobe grew Streptococcus pneumoniae. Patient was treated with intravenous levofloxacin during hospital stay and discharged on a 7-day course of oral antibiotics to be followed as outpatient but was lost to follow-up. GCT can present as a polypoid tumor causing recurrent postobstructive pneumonia. Surgical resection is the most successful treatment option. The tumor is more common in third and fourth decade of life and our patient is the oldest patient, according to our knowledge, to have a GCT.
Secondary aorto-duodenal fistula successfully treated with a novel surgical method: A case report
Authors: Takao Tsuneki, Yasuhiro Yuasa, Mizuki Fukuta, Hidenori Maki, Yuta Matsuo, Osamu Mori, Shohei Eto, Satoshi Fujiwara, Atsusi Tomibayashi, Takashi Otani
Journal: Int J Surg Case Rep (2020)
Keywords: duodenectomy, endovascular aneurysmal repair, secondary aorto-duodenal fistula
MeSH terms: Case Reports

Introduction:
Secondary aorto-duodenal fistula (sADF) is a complication of abdominal aorta artificial blood vessel replacement that often leads to death. However, an optimal operative method has not yet been established. We describe a patient who underwent artificial blood vessel reimplantation and duodenectomy after endovascular aneurysmal repair (EVAR) with positive outcomes.
Presentation of case:
An 84-year-old man underwent artificial blood vessel replacement in 2015. In September 2016, he visited our emergency department and was diagnosed with sADF based on computed tomography. Urgent EVAR was performed, followed by duodenal segmental resection on the next day without opening the syringeal part to minimize the pollution of the operative field. Artificial blood vessel reimplantation and omental flap transposition were performed. As of 2020, about 3 years after surgery, there has been no relapse of the infection.
Discussion:
Using our novel operative method, we can minimize exposure of the artificial blood vessel and surrounding tissue to intestinal juice and pus. We believe that this reduces the risk of postoperative artificial blood vessel reinfection.
Conclusion:
Controlling bleeding by EVAR and resection of the duodenum and artificial blood vessels as a group without opening the syringeal part can contribute to positive long-term results as this method minimizes the pollution of the duodenectomy surgical field.
Extranodal MALT Lymphoma of the Right Triceps Muscle following Influenza Vaccine Injection: A Rare Case with an Interesting Presentation
Authors: S M Edwards-Bennett, D Straus, E A Athanasian, J Yahalom
Journal: ISRN Hematol (2011)
MeSH terms: Case Reports

The study describes a case of a 67-year-old female who developed a Stage I E marginal zone lymphoma of the right triceps muscle 1 month after influenza vaccination at the same site. She was treated with single modality, involved field radiation therapy (IFRT) to 4000 cGy in 20 fractions with excellent response and no evidence of disease after one year followup.
Extraperitoneal bladder rupture with severe lacerations of the urogenital diaphragm: a case report
Authors: Akiyoshi Hagiwara, Koichiro Nishi, Keiichi Ito, Musasi Tobe, Tomohiko Asano, Masamichi Hayakawa
Journal: Cases J (2009)

Background:
A 65-year woman injured by automobile had an open-book type pelvic fracture and extraperitoneal bladder rupture.
Case presentation:
Non-surgical management was selected because of suspected minor leakage. A follow-up CT cystography on day 21 showed a large urinoma. In the sagittal reconstruction CT images, the bladder was displaced downwards. Surgery was performed. Surgical findings showed that the bladder neck and the urethra were not anchored because of a laceration in the urogenital diaphragm. The bladder base had descended to the inferior margin of the pubic bone and a laceration of about 3 cm was found in the anterior surface of the bladder neck. The laceration was sutured, and the wall of the urinoma was extensively resected. The postoperative course was uneventful.
Conclusion:
An extraperitoneal bladder rupture associated with a severe laceration in the urogenital diaphragm will be indicated for surgery when the bladder is not anchored and healing is prevented. Sagittal reconstruction CT cystography was effective for this diagnosis.
Implication of Topical Steroids in the Onset of Osteoporosis
Authors: Asmaa Adel Milyani, Abdulmoein Eid Al-Agha
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

The systemic bioavailability of steroids has long been implicated as a cause for osteoporosis (OP); however, much less is known about the effect of topical steroids on bone homeostasis. This is a case of an 11-year-old male who is a known case of generalised pustular psoriasis for 8-year duration with frequent exacerbations controlled with topical betamethasone dipropionate. He presented with generalised progressive bone pain and positive history of bone fracture. The diagnosis of OP was established on the results of DEXA, which were -2.7 SD and -2.4 SD for the lumbar spine and whole body, respectively. Although the cutoff value is the same (<-2 SD) in children, the definition of OP is more reliant on the densitometry Z score, as opposed to adults, who are approached using the T score. The element of psoriasis poses a risk for the development of OP due to the presence of a chronic inflammatory disease state that increases bone turnover. Furthermore, the compromised skin barrier and associated vasodilation seen in psoriasis enhance the absorption of topically applied agents and increase their bioavailability. Children are a targeted risk group as they are more vulnerable to the manifestation of systemic adverse affects of topically applied steroids as a result of their increased ratio of total surface area relative to their body weight and slower drug metabolism. We recommend that children undergoing long-term topical steroid therapy be screened for OP with the consideration of instituting prophylactic treatment especially in those suffering from chronic inflammatory disease states.
Case report: emergent endovascular treatment for carotid cavernous fistulas presenting as intracranial hemorrhage
Authors: Zhao-Liang Li, Ai-Lin Chen, Ying Chen, De-Hong Yang, Yu-Hui Wan, Yao Wu, Chun-Gang Dai, Qing Zhu
Journal: Front Neurol (2023)
Keywords: carotid cavernous fistula, case report, endovascular, intracranial hemorrhage, treatment
MeSH terms: Case Reports

Objectives:
This study aimed to discuss the clinical characteristics and emergent endovascular treatment of carotid cavernous fistulas presenting as intracranial hemorrhage.
Methods:
The clinical data of five patients with carotid cavernous fistulas, who presented with intracranial hemorrhage and who were admitted from January 2010 to April 2017, were analyzed retrospectively, and the diagnoses were confirmed by head computed tomography. Digital subtraction angiography was carried out in all the patients for the diagnosis and further emergent endovascular procedures. All patients were followed up to assess the clinical outcomes.
Results:
In total, five patients harbored five mono-lateral lesions; two of them were obliterated by detachable balloons, two by detachable coils, and one by detachable coils and Onyx glue. Only one patient was cured by another detachable balloon in the second session, and the other four patients were cured in the first session. At the 3- to 10-year follow-up, there was no intracranial re-hemorrhage in any of the patients; there was no recurrence of symptoms; and delayed occlusion of the parent artery was noted in one case.
Conclusion:
Emergent endovascular therapy is indicated for carotid cavernous fistulas presenting as intracranial hemorrhage. Individualized treatment according to the characteristics of different lesions is safe and effective.
Guillain-Barré Syndrome after H1N1 Shot in Pregnancy: Maternal and Fetal Care in the Third Trimester-Case Report
Authors: Felipe Favorette Campanharo, Eduardo Felix Martins Santana, Stephanno Gomes Pereira Sarmento, Rosiane Mattar, Sue Yazaki Sun, Antonio Fernandes Moron
Journal: Case Rep Obstet Gynecol (2012)

Guillain-Barré syndrome is a rare neurological disease of progressive installation, usually following a previous acute infectious state, has a rare incidence, especially in pregnancy, and can induce major complications and high mortality risk. Its occurrence, after immunization to influenza during the last trimester pregnancy, has not been reported before. We presented a case of a 36-year-old pregnant woman that was immunized to H1N1 in the last trimester; 10 days later she developed shoulder and lumbar spine's pain, limbs weakness and facial paralysis with unfavorable clinical evolution and was submitted to intensive therapy care. We described clinical and obstetrical approach, pointing out peculiarities involved in this pathology in pregnancy.
Intrathecal baclofen withdrawal syndrome- a life-threatening complication of baclofen pump: a case report
Authors: Imran Mohammed, Asif Hussain
Journal: BMC Clin Pharmacol (2004)
MeSH terms: Baclofen / administration & dosage, Infusion Pumps, Implantable / adverse effects, Substance Withdrawal Syndrome / etiology, Substance Withdrawal Syndrome / mortality, Case Reports, Adult, Equipment Failure, Humans, Male, Spine / metabolism, Baclofen

Background:
Intrathecal baclofen pump has been used effectively with increasing frequency in patients with severe spasticity, particularly for those patients who are unresponsive to conservative pharmacotherapy or develop intolerable side effects at therapeutic doses of oral baclofen. Drowsiness, nausea, headache, muscle weakness, light-headedness and return of pretreatment spasticity can be caused by intrathecal pump delivering an incorrect dose of baclofen. Intrathecal baclofen withdrawal syndrome is a very rare, potentially life-threatening complication of baclofen pump caused by an abrupt cessation of intrathecal baclofen.
Case presentation:
A 24-year-old man with a past medical history of cerebral palsy and spastic quadriparesis developed hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, acute renal failure and multisystem organ failure leading to a full-blown intrathecal baclofen withdrawal syndrome. Intrathecal baclofen pump analysis revealed that it was stopped due to some programming error. He was treated effectively with supportive care, high-dose benzodiazepines and reinstitution of baclofen pump.
Conclusion:
The episodes of intrathecal baclofen withdrawal syndrome are mostly caused by preventable human errors or pump malfunction. Educating patients and their caregivers about the syndrome, and regular check-up of baclofen pump may decrease the incidence of intrathecal baclofen withdrawal syndrome. Oral baclofen replacement may not be an effective method to treat or prevent intrathecal baclofen withdrawal syndrome. Management includes an early recognition of syndrome, proper intensive care management, high-dose benzodiazepines and prompt analysis of intrathecal pump with reinstitution of baclofen.
Simultaneous Esophageal and Tracheal Obstructions Caused by a Pair of Magnetic Beads in a Child: A Case Report
Authors: Huan Ren, Dong Shi, Zhaowei Gu, Zhiwei Cao
Journal: Front Pediatr (2021)
Keywords: case report, esophageal foreign body, magnetic foreign body, pediatric, tracheal foreign body
MeSH terms: Case Reports

Esophageal and tracheal foreign body ingestion trigger common pediatric emergencies. In this case report, we describe a pediatric patient with simultaneous tracheal and esophageal obstruction caused by foreign bodies. A child aged 2 years and 1 month swallowed a pair of metallic magnetic beads at the same time; one bead entered the trachea and the other bead entered the esophagus. We suspected that the two magnetic beads were mutually attracted and thus became trapped in their respective lumina. The tracheal foreign body was uneventfully removed; this dislodged the esophageal foreign body, which was then excreted. There were no serious complications in the present case, but parents and medical personnel should be mindful of the potential hazards associated with ingestion of multiple magnetic foreign bodies. A high index of suspicion is appropriate. Investigations must be carefully planned. Treatment should not be delayed; the consequences of delay may be serious.
Glioblastoma Following Treated Medulloblastoma After 29 Years in the Posterior Fossa: Case Report and Review of Literature
Authors: Tarek Mesbahi, Hind Zaine, Ismaël Mahazou Abdou, Tarik Chekrine, Souha Sahraoui, Mehdi Karkouri, Abdelhakim Lakhdar
Journal: Front Oncol (2022)
Keywords: cerebellar neoplasm, glioblastoma, high-grade glioma, long-term effect of radiotherapy, medulloblastoma, meningioma
MeSH terms: Case Reports

Glioblastoma multiforme (GBM) is a high-grade glioma that may be a rare complication of radiotherapy. We report a case of a patient who was treated for medulloblastoma (MB) of the posterior fossa at the age of 27 years. Twenty-nine years later, at the age of 56 years, he presented with a double-location tumor: supratentorial and in the posterior fossa. Imaging features of the supratentorial location were very suggestive of a meningioma. We operated on the posterior fossa location, which revealed a glioblastoma. Histologically, the tumor cells exhibited characteristics of both GBM and rhabdoid tumor cells. Literature reports of cases of GBM following MB at the same place are very rare, and presenting rhabdoid characteristics is even rarer. This is the first case of MB and GBM at ages 27 and 56 years, respectively. The double-location supratentorial probable meningioma and GBM of the posterior fossa 32 years after MB is the only case reported in the literature. What to do in this case remains a topic of debate, and there are no clear recommendations in the literature.
Case Report: Traumatic Stress and Developmental Regression: An Unintended Consequence of Complex Cardiac Care
Authors: Claire M Dahl, Maria Kroupina, Sameh M Said, Arif Somani
Journal: Front Pediatr (2021)
Keywords: case report, critical care, mental health, pediatric development, pediatric intensive care unit
MeSH terms: Case Reports

This brief case report outlines a novel approach to supporting the development of a pediatric complex cardiac care patient. Patient X is a 19-month old patient who spent 5.5 months in hospital and underwent multiple surgeries including heart transplantation. This case report explores the impacts of his condition and care on his development and family functioning within the framework of an integrated care model. This case report is uniquely complimented by outpatient neurodevelopmental follow up, dyadic trauma-informed intervention and use of telemedicine allowing for a deeper understanding of the family adaptation that provide novel insight into long-term trajectory beyond discharge. Throughout care Patient X met criteria for both a traumatic stress disorder and global developmental delay. This case study highlights the threat complex care poses to neurodevelopment, pediatric mental health and family dynamics as well as opportunities for intervention.
Distribution and transmission of medicinal plant knowledge in the andean highlands: a case study from peru and bolivia
Authors: Sarah-Lan Mathez-Stiefel, Ina Vandebroek
Journal: Evid Based Complement Alternat Med (2012)

This paper presents a study of patterns in the distribution and transmission of medicinal plant knowledge in rural Andean communities in Peru and Bolivia. Interviews and freelisting exercises were conducted with 18 households at each study site. The amount of medicinal plant knowledge of households was compared in relation to their socioeconomic characteristics. Cluster analysis was applied to identify households that possessed similar knowledge. The different modes of knowledge transmission were also assessed. Our study shows that while the amount of plant knowledge is determined by individual motivation and experience, the type of knowledge is influenced by the community of residence, age, migratory activity, and market integration. Plant knowledge was equally transmitted vertically and horizontally, which indicates that it is first acquired within the family but then undergoes transformations as a result of subsequent contacts with other knowledge sources, including age peers.