OpenMed/multicare-articles huggingface dataset:
Ludwig's Angina-A Controversial Surgical Emergency: How We Do It
Authors: Wael Hasan, David Leonard, John Russell
Journal: Int J Otolaryngol (2011)
MeSH terms: Case Reports

Objectives. To review the current protocols used for management of Ludwig's angina and to assess the efficacy of conservative measures in these cases. Methods. A retrospective review of patients who were admitted to our institution for management of Ludwig's angina between 2003 and 2010. Results. Two patients were identified. Both were managed successfully with conservative measures and close airway observation. None needed an emergency intubation or surgical tracheostomy. There were no mortalities, and both had a short hospital stay. Conclusion. Recently, management of Ludwig's angina has evolved from aggressive airway management into a more conservative one. This is based on close airway observation on a specialised airway unit and a serial clinical airway assessment. Improved imaging modalities, antibiotic therapy, surgical skills, and clinical experience are the key factors behind this change in practice.
Methotrexate Treatment in Children with Febrile Ulceronecrotic Mucha-Habermann Disease: Case Report and Literature Review
Authors: Isil Bulur, Hilal Kaya Erdoğan, Zeynep Nurhan Saracoglu, Deniz Arık
Journal: Case Rep Dermatol Med (2015)

Febrile Ulceronecrotic Mucha-Habermann disease is a rare and potentially fatal variant of pityriasis lichenoides et varioliformis acuta and is characterized by high fever, constitutional symptoms, and acute oncet of ulceronecrotic lesions. We present an 11-year-old male with Febrile Ulceronecrotic Mucha-Habermann disease who was cured with methotrexate and review the use of methotrexate for this disorder in the pediatric age group with the relevant literature.
Case Report: Systemic treatment for breast and vulvar metastases from resected rectal signet ring cell carcinoma
Authors: Yihui Han, Wenming Yang, Qin Ma, Zhaolun Cai, Yun Yang, Junhe Gou, Tao Yuan, Mingming Zhang, Bo Zhang
Journal: Front Oncol (2023)
Keywords: breast metastasis, immunohistochemical staining, microsatellite stability, mismatch repair, rectal signet ring cell carcinoma, systemic treatment, vulvar metastasis
MeSH terms: Case Reports

Background:
Breast and vulvar metastases from rectal signet ring cell carcinoma (SRCC) represent a rare and obscure clinical entity associated with poor survival. Managing patients with metastatic rectal SRCC is extremely challenging due to the absence of high-quality evidence.
Case presentation:
A 26-year-old woman presented with progressively worsening anal pain, constipation, and hematochezia for approximately two years. Following the diagnosis of locally advanced rectal cancer (cT3N0-1M0), she received neoadjuvant chemotherapy with modified FOLFOX6 regimen and underwent laparoscopic abdominoperineal resection. Metastases to the breast and vulva developed during postoperative chemotherapy. Genetic testing revealed RAS/BRAF wild-type and microsatellite instability (MSI)-low status. Though sequential administration of irinotecan plus tegafur and tegafur plus raltitrexed-based chemotherapy in combination with bevacizumab, the disease progressed rapidly. Sadly, the patient passed away 15 months after initial diagnosis due to rapidly progressive disease.
Conclusion:
Rectal SRCC is associated with younger on-set, aggressive behaviors, and worse survival outcomes. Due to poor cohesiveness, SRCC tends to develop metastases. A patient's medical history and immunohistochemical staining (such as CK20, CK7, and CDX-2) can aid in identifying the tumor origin of breast and vulvar metastases. Mutations and signaling pathways predominant in the tumorigenesis of SRCC remains unveiled. There is poor effect of conventional chemotherapies, targeted and immunotherapies for colorectal adenocarcinoma on SRCC, so novel therapies are needed to treat this patient population.
Transafferent nodal embolization for lymphocele treatment: case report
Authors: Katia Pinheiro de Souza, Guilherme Moratti Gilberto, Guilherme Cayres Mariotti, Priscila Mina Falsarella, Francisco Leonardo Galastri, Fernando Korkes, Rodrigo Gobbo Garcia
Journal: Einstein (Sao Paulo) (2022)
MeSH terms: Embolization, Therapeutic / methods, Lymphocele / diagnostic imaging, Lymphocele / etiology, Lymphocele / therapy, Case Reports, Brazil, Drainage, Humans, Postoperative Complications

Lymphoceles are collections of lymphatic fluid, mainly caused by major surgical approaches. Most lymphoceles are asymptomatic and limited, but some cases may require a medical management. Among the different techniques, transafferent nodal embolization has emerged as a minimally invasive option, with low morbidity and high resolubility, although it is not widespread in the Brazilian scenario. In this study, we report a case of lymphocele drained percutaneously, with maintenance of high output and requiring transafferent nodal embolization.
An unusual case of intraorbital foreign body and its management
Authors: Bipasha Mukherjee, Shubhra Goel, Nirmala Subramanian
Journal: Indian J Ophthalmol (2011)
MeSH terms: Cosmetic Techniques, Foreign Bodies / diagnosis, Foreign Bodies / surgery, Orbit / diagnostic imaging, Orbit / pathology, Plastic Surgery Procedures, Case Reports, Adult, Blindness / etiology, Foreign Bodies / complications, Humans, Male, Plastics, Tomography, X-Ray Computed, Plastics

Intraorbital foreign bodies are usually the result of accidental trauma and can lead to considerable morbidity. We report an unusual case of an industrial injury in a plastic manufacturing unit wherein hot molten plastic splashed and solidified inside the orbit. The resultant increased intraorbital pressure led to loss of vision in that eye. The extreme temperature of the foreign body caused extensive thermal damage to the surrounding adnexal structures. Staged reconstructive surgery was undertaken to repair the damage, with an acceptable final cosmetic outcome. Employment of protective eye wear to prevent such accidents in high-risk occupations should be made mandatory.
Recompensation of heart and kidney function after treatment with peritoneal dialysis in a case of congestive heart failure
Authors: Lars P Kihm, Vinzent Hankel, Christian Zugck, Andrew Remppis, Vedat Schwenger
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions.
Acute Fulminant Myocarditis Successfully Bridged to Recovery with Left Ventricular Assist Device and Complicated by Flail Mitral Valve
Authors: Pınar Türker Duyuler, Serkan Duyuler, Ekrem Şahan, Şeref Alp Küçüker
Journal: J Tehran Heart Cent (2016)
Keywords: heart-assist devices, mitral valve, myocarditis
MeSH terms: Case Reports

Acute fulminant myocarditis is a life-threatening inflammatory disease of the myocardium characterized by the rapid deterioration of the hemodynamic status of the affected individual. With prompt recognition and appropriate management, complete recovery of ventricular function is likely within a few weeks. We introduce a 28-year-old man with acute fulminant myocarditis, who experienced circulatory collapse following acute angina and dyspnea. The patient had high troponin levels with low ejection fraction and normal coronary arteries. He was successfully bridged to recovery with a left ventricular assist device but was complicated by flail mitral valve. Perioperative myocardial biopsy was also compatible with myocarditis. At 4 months' follow-up, the patient was stable with functional capacity I according to the New York Heart Association's classification. A possible mechanism for this very rare complication is the rupture of the chordal structure secondary to the fragility of an inflamed subvalvular apparatus stretched by a recovered ventricle.
Next-Generation Sequencing Technology Combined With Multiplex Polymerase Chain Reaction as a Powerful Detection and Semiquantitative Method for Herpes Simplex Virus Type 1 in Adult Encephalitis: A Case Report
Authors: Weibi Chen, Yingfeng Wu, Yan Zhang
Journal: Front Med (Lausanne) (2022)
Keywords: encephalitis, herpes simplex virus type 1, metagenomic next-generation sequencing, multiplex pcr, sequencing
MeSH terms: Case Reports

Background:
Traditional testing for specific microbes or categories of central nervous system (CNS) infectious diseases is often limited in sensitivity and timeliness. However, failure to initiate a timely etiological diagnosis and corresponding treatment in patients with neurologic infections contribute to poor outcomes.
Case summary:
A 58 year-old male presented acutely with fever, abnormal mental behavior, seizures and decreased consciousness. Brain magnetic resonance imaging (MRI) showed an abnormal FLAIR/T2 signal mainly in the left thalamus, temporal lobe, insular lobe, and bilateral hippocampus. To identify the pathogen, the cerebrospinal fluid (CSF) sample of the patient was used for metagenomic next-generation sequencing (mNGS) analysis and multiplex polymerase chain reaction (mPCR). The results showed 188 herpes simplex virus (HSV-1)-specific sequences. After acyclovir and foscarnet sodium treatment, the ratio of HSV-1/internal reference reads decreased from 813/493 to 695/1961, which coincided with clinical remission.
Conclusion:
This study indicates that mNGS combined with mPCR may be an effective method for etiological diagnostic and dynamic clinical surveillance for HSV-1 encephalitis.
Adult Still's disease and squamous cell carcinoma in a 69-year-old woman
Authors: Sameh Marzouk, Olfa Frikha, Mouna Guermazi, Mouna Snoussi, Moez Jallouli, Zouhir Bahloul
Journal: Pan Afr Med J (2019)
Keywords: adult-onset still’s disease, paraneoplastic syndrome, squamous cell carcinoma
MeSH terms: Carcinoma, Squamous Cell / diagnosis, Still's Disease, Adult-Onset / diagnosis, Case Reports, Aged, Carcinoma, Squamous Cell / therapy, Combined Modality Therapy, Diagnosis, Differential, Drug Therapy, Combination, Female, Humans, Methotrexate / administration & dosage, Prednisone / administration & dosage, Prednisone, Methotrexate

Adult-onset Still's disease (AOSD) has been recognized as a cause of fevers of unknown origin. Malignancies are the most important differential diagnoses of AOSD which has been rarely reported in association with cancer. The present paper undertakes the study of a 69-year-old Tunisian woman with AOSD according to the diagnostic criteria of Yamaguchi. She was treated by prednisone, then associated with methotrexate. 18 months later, she developed a squamous cell carcinoma treated with chemotherapy and radiotherapy.
Gallbladder osteoma in a 66-year-old female; Case report and review of literature
Authors: Alberto Valdes Castañeda, Raul Alexander Cuevas Bustos, Moises Brener Chaoul, Marcos Jafif Cojab, Juan Pablo Arribas Martin, Carlos Mancera Steiner, Diego L Jorge, Maria Veronica Velasco Vales, Oscar Cervantes Gutierrez, Angel Flores-Huidobro Martinez, Felix Alejandro Perez Tristan
Journal: Int J Surg Case Rep (2020)
Keywords: gallbladder, incidental lesions, mesenchymal tumors, osteoma, rare case
MeSH terms: Case Reports

Introduction:
Gallbladder mesenchymal tumours are rare. The more common include fibroma, lipoma or haemangioma. A gallbladder osteoma is very rare indeed there is only one other case reported in medical literature). We report a new case.
Presentation of case:
A 66-year-old female presented to the emergency department complaining of colicky epigastric pain and generalised abdominal discomfort for 1 month. The pain was scored 5/10 but there were no associated symptoms of fever, nausea or vomiting. Vital signs were normal as were all laboratory parameters. An abdominal ultrasound revealed a thin walled gallbladder with a solitary 3 mm polyp. Motility studies confirmed gallbladder dyskinesia. Laboratory studies were ordered reporting normal findings. Abdominal ultrasound was ordered reporting an image suggesting a gallbladder polyp and gallbladder dyskinesia. Cholecystectomy was done without any incidents and the gallbladder was sent to pathology. Pathology reported mature bone tissue in the stromal gallbladder tissue. Due to the rareness of the presence of mature bone tissue in the gallbladder we decided to report the case for the medical community.
Discussion:
Osteomas are mesenchymal cell tumors derived from the mesoderm; the gallbladder may be the primary site of numerous types of mesenchymal tumors, although these tumors are common the location is not.
Conclusions:
We report only the second case of gallbladder osteoma. These mesenchymal tumours are common but this location is not. This case report will serve to remind readers of both benign osteomas and unusual conditions causing gallbladder disease.
Opioid Drug-Drug-Drug Interactions and Unintentional Traumatic Injury: Screening to Detect Three-Way Drug Interaction Signals
Authors: Emily K Acton, Sean Hennessy, Colleen M Brensinger, Warren B Bilker, Todd A Miano, Sascha Dublin, John R Horn, Sophie Chung, Douglas J Wiebe, Allison W Willis, Charles E Leonard
Journal: Front Pharmacol (2022)
Keywords: drug interactions, injury, opioid analgesics, pharmacoepidemiology, population health, self-controlled case series

Growing evidence suggests that drug interactions may be responsible for much of the known association between opioid use and unintentional traumatic injury. While prior research has focused on pairwise drug interactions, the role of higher-order (i.e., drug-drug-drug) interactions (3DIs) has not been examined. We aimed to identify signals of opioid 3DIs with commonly co-dispensed medications leading to unintentional traumatic injury, using semi-automated high-throughput screening of US commercial health insurance data. We conducted bi-directional, self-controlled case series studies using 2000-2015 Optum Data Mart database. Rates of unintentional traumatic injury were examined in individuals dispensed opioid-precipitant base pairs during time exposed vs unexposed to a candidate interacting precipitant. Underlying cohorts consisted of 16-90-year-olds with new use of opioid-precipitant base pairs and ≥1 injury during observation periods. We used conditional Poisson regression to estimate rate ratios adjusted for time-varying confounders, and semi-Bayes shrinkage to address multiple estimation. For hydrocodone, tramadol, and oxycodone (the most commonly used opioids), we examined 16,024, 8185, and 9330 drug triplets, respectively. Among these, 75 (0.5%; hydrocodone), 57 (0.7%; tramadol), and 42 (0.5%; oxycodone) were significantly positively associated with unintentional traumatic injury (50 unique base precipitants, 34 unique candidate precipitants) and therefore deemed potential 3DI signals. The signals found in this study provide valuable foundations for future research into opioid 3DIs, generating hypotheses to motivate crucially needed etiologic investigations. Further, this study applies a novel approach for 3DI signal detection using pharmacoepidemiologic screening of health insurance data, which could have broad applicability across drug classes and databases.
Case Report: Coronary artery stent infection with mycotic aneurysm secondary to tricuspid valve infective endocarditis
Authors: Mejdi Ben Messaoud, Nidhal Bouchahda, Marouane Mahjoub, Badii Hmida, Zohra Dridi, Habib Gamra
Journal: F1000Res (2019)
Keywords: acute coronary syndrome, coronary aneurysm, endocarditis, infection, stents
MeSH terms: Aneurysm, Infected / etiology, Endocarditis / complications, Tricuspid Valve / microbiology, Case Reports, Aged, Coronary Vessels, Humans, Male, Stents

Coronary artery stent infection with mycotic aneurysm is a rare life-threatening complication following coronary angioplasty, usually requiring surgical intervention. Reaching and confirming the diagnosis remains the most challenging aspect of this complication. We describe an unusual case of bare metal stent infection and coronary artery aneurysm in the setting of tricuspid valve infective endocarditis, resulting in ST elevation myocardial infarction, with a favorable outcome after primary angioplasty and antibiotic therapy. In the current era of growth of coronary stent implantation, it's important for clinicians to consider and to prevent such potentially fatal events. The diagnosis process remains difficult and requires the association of multiple clinical, biological and imaging parameters. Although treatment modalities tend to favor surgery, we showed that coronary angioplasty could be a successful alternative solution.
A case report of Kaposiform haemangioendothelioma; response with propranolol and steroids
Authors: Saurav Verma, Ekta Dhamija, Adarsh Barwad, Venkatesan S Kumar, Sameer Rastogi
Journal: Clin Sarcoma Res (2020)
Keywords: kaposiform hemangioendothelioma, propranolol, steroids
MeSH terms: Case Reports

Background:
Kaposiform haemangioendothelioma is a rare vascular tumor and may involve skin, deep soft tissue or bone. It is a locally aggressive tumor usually seen in infants. Here we report a case of kaposiform hemagioendothelioma in a child who responded to propranolol and steroids.
Case presentation:
A 3-year-old male child presented with a swelling below his right knee with characteristic violet skin lesion. There was no evidence of Kasabach-Merritt phenomenon. After no improvement with several attempts at debridement and anti-tubercular treatment; a diagnosis of Kaposiform Haemangioendothelioma was reached on the basis of overall clinical picture and histology. The child was treated with propranolol and steroids and had an excellent clinical response and a near complete resolution on imaging at 5 months.
Conclusions:
These cases are often misdiagnosed and despite a delay in diagnosis have good outcomes with appropriate multimodality management. This case highlights the unique and typical characteristics of kaposiform haemangioendothelioma.
Kluyvera intermedia bacteremia with septic shock: A case report
Authors: Tomohiro Inoue, Yoshiro Hadano, Hitoshi Koga, Kazuhito Tamehiro, Syuichirou Sagara, Yuuji Tokuda, Syougo Urabe, Kohta Mukasa, Kouhei Onitsuka, Masahiro Higuchi, Toshiki Sudo, Takaaki Mabe, Kiyosiro Toyama, Aoi Ichikawa, Syunsuke Hisaka, Tomoka Moriya, Miki Yamamoto
Journal: IDCases (2023)
Keywords: bacteremia, kluyvera intermedia, septic shock
MeSH terms: Case Reports

Background:
Kluyvera intermedia is a bacterium indigenous to humans. But Kluyvera intermedia bacteremia has been not reported thus far. We report a case of Kluyvera intermedia bacteremia with septic shock due to left obstructive pyelonephritis as a result of urolithiasis.
Case presentation:
A 66-year-old woman with septic shock due to left obstructive pyelonephritis was transferred to our hospital. Tazobactam/Piperacillin 4.5 g was administered every 8 h for 5 days. The patient's condition improved, and she was transferred back to the previous hospital. Kluyvera intermedia was obtained by blood cultures. The patient was successfully treated with a two-week course of antibiotics.
Conclusions:
We describe the first case of bacteremia with septic shock caused by Kluyvera intermedia. Kluyvera intermedia can be a causative pathogen of septic shock. Since this bacterium has not been reported in the past, we expect further reports and the accumulation of cases in the future.
Whole genome sequencing of "Faecalibaculum rodentium" ALO17, isolated from C57BL/6J laboratory mouse feces
Authors: Sooyeon Lim, Dong-Ho Chang, Sharon Ahn, Byoung-Chan Kim
Journal: Gut Pathog (2016)
Keywords: comparative genomics, phylogeny, whole genome sequencing, “faecalibaculum rodentium” alo17
MeSH terms: Case Reports

Background:
Intestinal microorganisms affect host physiology, including ageing. Given the difficulty in controlling for human studies of the gut microbiome, mouse models provide an alternative avenue to study such relationships. In this study, we report on the complete genome of "Faecalibaculum rodentium" ALO17, a bacterium that was isolated from the faeces of a 9-month-old female C57BL/6J mouse. This strain will be utilized in future in vivo studies detailing the relationships between the gut microbiome and ageing.
Results:
The whole genome sequence of "F. rodentium" ALO17 was obtained using single-molecule, real-time (SMRT) technique on a PacBio instrument. The assembled genome consisted of 2,542,486 base pairs of double-stranded DNA with a GC content of 54.0 % and no plasmids. The genome was predicted to contain 2794 open reading frames, 55 tRNA genes, and 38 rRNA genes. The 16S rRNA gene of ALO17 was 86.9 % similar to that of Allobaculum stercoricanis DSM 13633(T), and the average overall nucleotide identity between strains ALO17 and DSM 13633(T) was 66.8 %. After confirming the phylogenetic relationship between "F. rodentium" ALO17 and A. stercoricanis DSM 13633(T), their whole genome sequences were compared, revealing that "F. rodentium" ALO17 contains more fermentation-related genes than A. stercoricanis DSM 13633(T). Furthermore, "F. rodentium" ALO17 produces higher levels of lactic acid than A. stercoricanis DSM 13633(T) as determined by high-performance liquid chromatography.
Conclusion:
The availability of the "F. rodentium" ALO17 whole genome sequence will enhance studies concerning the gut microbiota and host physiology, especially when investigating the molecular relationships between gut microbiota and ageing.