OpenMed/multicare-articles huggingface dataset:
Coccidioidomycosis Chorioretinitis
Authors: Brian Nordstrom, Namgyal Sherpa, Meagan Marshall, Anuj Chawla, Arash Heidari, Royce Johnson
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: chorioretinitis, choroiditis, coccidioidomycosis, endopthalmitis, retinitis
MeSH terms: Chorioretinitis / microbiology, Coccidioidomycosis / complications, Eye Infections, Fungal / microbiology, Case Reports, Adult, Chorioretinitis / diagnosis, Chorioretinitis / diagnostic imaging, Chorioretinitis / etiology, Coccidioides, Coccidioidomycosis / diagnosis, Coccidioidomycosis / diagnostic imaging, Eye Infections, Fungal / diagnosis, Eye Infections, Fungal / diagnostic imaging, Eye Infections, Fungal / etiology, Humans, Male, Tomography, Optical Coherence, Tomography, X-Ray Computed, Vitreous Body / microbiology

Coccidioidomycosis is an invasive fungus found primarily in the soil of Southwestern United States, Mexico, and Central America. Primary disease mostly presents as a pulmonary disease although multiple organ systems can be affected through lymphohematogenous dissemination, with ocular seeding extremely rare. When present, the anterior segment structures are most commonly affected. Isolated choroid and/or vitreal disease has been reported infrequently. This is a case of chorioretinitis with vitreal involvement.
Radiological manifestation of optic nerve infarction in a patient with invasive mucormycosis secondary to diabetic ketoacidosis in Pakistan
Authors: Shehroze Tabassum, Aroma Naeem, Afshan Shakir, Faiza Afzal, Laya Ohadi
Journal: Clin Case Rep (2023)
Keywords: diabetic ketoacidosis, mucormycosis, optic nerve infarction
MeSH terms: Case Reports

A 35 years old male patient presented in the hospital with complaints of left-sided facial swelling, blindness in the left eye, and left eye proptosis. He had a concomitant history of diabetic ketoacidosis. Magnetic resonance imaging was advised, which revealed infected tissue of the left cheek, optic nerve infarction, intracranial extension, and leptomeningeal involvement by the disease process.
Gradenigo's Syndrome and Labyrinthitis: Conservative versus Surgical Treatment
Authors: Ahmad Al-Juboori, Amira Nasser Al Hail
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Background:
Extracranial intratemporal complications of chronic suppurative otitis media (CSOM) are extremely rare. Gradenigo's syndrome is defined as a clinical triad of otitis media, severe pain originating from the trigeminal nerve, and ipsilateral sixth cranial nerve palsy.
Case report:
A 61-year-old man presented with chronic left ear discharge, left-sided headache, diplopia associated with vertigo, tinnitus, and hearing impairment. MRI with contrast showed asymmetrical signal changes in the bilateral petrous bone with reduced enhancement on the left with high suspicion of petrositis; in the context of chronic tympanomastoiditis, there was a 10 × 4 mm enhancing lesion in the left internal auditory meatus involving the 7th-8th nerve complex. The patient was treated conservatively with local and systemic antimicrobial agents, he had satisfactory response and improvement regarding symptoms of ear discharge, vertigo, and diplopia, but there is no remarkable response regarding hearing loss and tinnitus.
Conclusion:
Although there is little evidence to support the use of conservative treatment in the treatment of Gradenigo's syndrome resulting from chronic ear disease, we here demonstrate successful conservative treatment of Gradenigo's syndrome.
Case Report: Molecular Characterization of Aggressive Malignant Retroperitoneal Solitary Fibrous Tumor: A Case Study
Authors: Haruna Nonaka, Shuya Kandori, Satoshi Nitta, Masanobu Shiga, Yoshiyuki Nagumo, Tomokazu Kimura, Takashi Kawahara, Hiromitsu Negoro, Akio Hoshi, Takahiro Kojima, Koji Kawai, Bryan J Mathis, Takuro Tamura, Taka-Aki Sato, Mariko Yamato, Masayuki Noguchi, Hiroyuki Nishiyama
Journal: Front Oncol (2021)
Keywords: nab2-stat6 fusion gene, stat6 nuclear expression, tp53 mutation, malignant solitary fibrous tumor, target dna sequencing
MeSH terms: Case Reports

Solitary fibrous tumors (SFT) are mesenchymal neoplasms with a favorable prognosis usually originating from the visceral pleura. Rarely, they may occur at various extrapleural sites and show malignant behavior coupled with dedifferentiation. NAB2-STAT6 fusion gene and STAT6 nuclear expression are biomarkers for diagnosis of SFT in addition to CD34, Bcl-2, and CD99. Furthermore, several reports have shown specific NAB2-STAT6 fusion variants and loss of STAT6 protein expression are associated with malignancy. We report a rare case of retroperitoneal SFT which rapidly progressed to death within 35 days after admission. Autopsy found a primary tumor containing both benign and malignant histologies, with multiple metastatic sites similar to the malignant, dedifferentiated tumor. STAT6 was detected in the primary differentiated tumor but not in the primary dedifferentiated tumor or lung/liver metastases. However, the NAB2-STAT6 fusion gene (NAB2ex6/STAT6ex16 variant) was detected in the primary tumor and lung/liver metastases. Intriguingly, fusion gene expression at the transcriptional level was downregulated in the dedifferentiated tumors compared to the differentiated tumor. We further performed target DNA sequencing and found gene mutations in TP53, FLT3, and AR in the dedifferentiated tumors, with TP53 mutations especially found among them. We demonstrate that downregulation of NAB2-STAT6 fusion gene at the transcriptional level is associated with malignant SFT for the first time. Moreover, the present study supports the idea that TP53 mutations promote malignancy in SFTs.
Guillain-Barré Syndrome Associated with COVID-19: Two Cases from a Public Hospital in Damascus, Syria
Authors: Tagrid Ahmad, Somar Hamdan, Imad Saadeh
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Objective:
To report two cases of COVID-19 complicated with Guillain-Barré syndrome (GBS) from a public hospital in Damascus, Syria.
Results:
Two unvaccinated patients, 49-year-old and 34-year-old men, presented with a history of paresthesia followed by ascending symmetric weakness with absent tendon reflexes. They were diagnosed with coronavirus disease 2019 (COVID-19) using chest CT and RT-PCR. Clinical status and lumbar puncture (LP) findings were consistent with GBS. They were treated with plasma exchange (PE). However, the first patient developed hallucinations and later deteriorated. He passed away after the second session of PE, while the second patient had four sessions of plasma exchange and was later discharged for home rehabilitation.
Conclusion:
It is important to consider GBS in COVID-19 patients who present with acute ascending weakness or cranial nerves involvement. More studies are needed to evaluate correlation between COVID-19, GBS, and development of psychiatric disturbances besides investigating the discrepancy between lung parameters and respiratory failure.
Malignant glomus tumor (glomangiosarcoma) of intestinal ileum: a rare case report
Authors: Ahmed Abu-Zaid, Ayman Azzam, Tarek Amin, Shamayel Mohammed
Journal: Case Rep Pathol (2013)

Glomus tumors are rare mesenchymal neoplastic lesions arising from glomus bodies that are involved in skin thermoregulation. They are mostly benign tumors, and malignant variants have been rarely reported. The subungual zones of fingers and toes are the most frequent sites of observation. Glomus tumors arising in visceral organs of the gastrointestinal tract are exceedingly rare. Stomach antrum and intestinal duodenum are the most frequent organs involved. No single case of glomus tumor involving intestinal ileum has been previously reported in the English medical literature. To the best of our knowledge, we report the first case of malignant glomus tumor (glomangiosarcoma) of intestinal ileum in a 29-year-old female patient who presented with a 1-month history of a tender pelvi-abdominal mass, constipation, vomiting, and melena. The intestinal ileum glomus tumor was resected, and histopathological diagnosis was consistent with glomangiosarcoma. A postoperative 6-month followup failed to show any evidence of tumor recurrence.
Delayed Diagnosis and Multi-TKI Intolerance: A Case Report of CML Concurrent With COVID-19
Authors: Chengxin Luan, Haixia Wang, Junjie Zhou, Xiaoyu Ma, Zhangbiao Long, Xin Cheng, Xiaowen Chen, Ruixiang Xia, Jian Ge
Journal: Front Oncol (2022)
Keywords: covid-19, case report, chronic myeloid leukemia, delayed diagnosis, tyrosine kinase inhibitors
MeSH terms: Case Reports

Introduction:
The hematological manifestations of corona virus disease 2019 (COVID-19) can confound the diagnosis and therapy of other diseases. In this paper, we firstly reported a case of chronic myeloid leukemia (CML) of delayed diagnosis and intolerance to tyrosine kinase inhibitors (TKIs) concurrent with COVID-19.
Case presentation:
A 56-year-old female was diagnosed as COVID-19 with no obvious leukocytosis [white blood cell (WBC), ≤17 × 109/L] or splenomegaly until ablation of the virus. Bone marrow aspiration was conducted to establish the diagnosis of CML. She accepted an adjusted dosage of imatinib initially and had to suspend it after myelosuppression (day 41). After hematopoietic therapy, imatinib was given again (day 62), but she was still non-tolerant, and nilotinib at 150 mg twice a day was prescribed from day 214. At just about 4 weeks later, nilotinib was discontinued due to myelosuppression. Then, it was reduced to 150 mg per day and was re-initiated (day 349), but she was still non-tolerant to it. Similarly, from day 398, flumatinib at 200 mg per day was tried, but she was non-tolerant. Her white blood cell or platelet count fluctuated markedly with poor therapeutic response. Considering that she was relatively tolerant and responsive to imatinib, the medication was re-initiated at 200 mg and reduced to 100 mg per day. Her follow-up revealed stable WBC and PLT counts. The latest BCR-ABL-210/ABL was decreased to 0.68% at about 6 months after imatinib was re-initiated, which means an improved response.
Conclusion:
The offset effect between CML and SARS-CoV-2 infection was supposed to be the underlying mechanism for the absence of leukocytosis or splenomegaly. The impact of immune network by SARS-CoV-2 preserved and disrupted the patient's response to TKIs despite the virus' ablation. We suggest that a continued elevation of basophils may be a useful indicator for CML concurrent with COVID-19, and individualized treatment with adjusted dosage and suitable type of TKIs should be considered to improve the patient's health outcome.
Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly
Authors: Yuya Kinoshita, Hiroe Ueno, Hirofumi Kurata, Chizuru Ikeda, Erika Hori, Takumi Okada, Tomoyuki Shimazu, Isao Fujii, Makoto Matsukura, Hoseki Imamura
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Perampanel is a noncompetitive, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid glutamate receptor antagonist. Herein, we report a case of increased perampanel plasma concentration and impaired consciousness triggered by an infection. The patient had refractory epilepsy associated with hemimegalencephaly. During adolescence, perampanel (maximum dose, 10 mg, oral), valproic acid, clobazam, and lacosamide were administered for seizure control. He was admitted to our hospital with high fever, impaired consciousness, and elevated perampanel plasma level (from 1,300 to 1,790 ng/mL), but with no increase in the concentration of other antiseizure medications. Further examinations (blood, cerebrospinal fluid, brain magnetic resonance images, and electroencephalogram) revealed no physical cause for impaired consciousness. After discontinuation of perampanel, his level of consciousness gradually improved. The pharmacokinetics of perampanel may be modified by both hemimegalencephaly and infection, resulting in an elevated plasma concentration of perampanel. This case underlines the importance of monitoring perampanel plasma concentration in patients with underlying brain disease who develop an infection.
Middle ear adenoma: case report and discussion
Authors: D Isenring, T F Pezier, B Vrugt, A M Huber
Journal: Case Rep Otolaryngol (2014)

Introduction. Despite modern radiological workup, surgeons can still be surprised by intraoperative findings or by the pathologist's report. Materials & Methods. We describe the case of a 52-year-old male who was referred to our clinic with a single sided conductive hearing loss. He ultimately underwent middle ear exploration and excision of a middle ear tumour followed by second look and ossiculoplasty a year later. Results. Though preoperative CT and MRI scanning were suggestive of a congenital cholesteatoma, the pathologist's report diagnosed a middle ear adenoma. Discussion. Middle ear glandular tumors are extremely rare and, despite numerous histological techniques, continue to defy satisfactory classification. Most surgeons advocate surgical excision though evidence of the tumour's natural course and risk of recurrence is lacking.
Placental Insertion into the Cervix with Cervical Shortening as a Clinical Sign to Suspect Cervico-Isthmic Pregnancy: A Case Report and Literature Review
Authors: Chisa Ito, Hirotada Suzuki, Yusuke Amano, Shigeyoshi Kijima, Akihide Ohkuchi, Hironori Takahashi, Hiroyuki Fujiwara
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

The clinical signs of cervico-isthmic pregnancy during pregnancy remain unknown. We herein report a case of cervico-isthmic pregnancy showing placental insertion into the cervix with cervical shortening, with a final diagnosis of placenta increta at the uterine body and cervix. A 33-year-old multiparous woman with a history of cesarean section was referred to our hospital at 7 weeks of gestation with suspected cesarean scar pregnancy. Cervical shortening with a cervical length of 14 mm was noted at 13 weeks of gestation. The placenta is gradually inserted into the cervix. An ultrasonographic examination and magnetic resonance imaging strongly suggested placenta accreta. We planned elective cesarean hysterectomy at 34 weeks of gestation. The pathological diagnosis was cervico-isthmic pregnancy with placenta increta at the uterine body and cervix. In conclusion, placental insertion into the cervix with cervical shortening in the early pregnancy period may be a clinical sign to suspect cervico-isthmic pregnancy.
Dasatinib-Induced Rhabdomyolysis in a 33-Year-Old Patient with Chronic Myeloid Leukemia
Authors: Andrew Stevenson Joel Chandranesan, Samip Master, Olivia Antosz, Breanne PeytonThomas, Nebu Koshy
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Rhabdomyolysis is a life-threatening syndrome due to breakdown of the skeletal muscle. It can be caused by massive trauma and crush injuries or occur as a side effect of medications. Here, we describe a case of a 33-year-old male with human immunodeficiency virus (HIV) and newly diagnosed chronic myeloid leukemia (CML) with severe life-threatening rhabdomyolysis due to a rare offending agent.
Delayed Diagnosis of Non-ST Segment Elevation Myocardial Infarction in a Young Patient with Multivessel Disease and Familial Hypercholesterolemia Complicated by Cardiogenic Shock Finally Treated with Intra-Aortic Balloon Pump as a Bridge to Extra Corporeal Membrane Oxygenation
Authors: Rafał Januszek, Magdalena Jędrychowska, Piotr Jankowski, Dariusz Dudek, Stanisław Bartuś
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Delayed diagnosis of coronary artery disease in young patients after cardiac arrest of unknown origin could increase the risk of death in further diagnostic and therapeutic process. Familial history of premature coronary atherosclerosis and hypercholesterolemia could help in proper diagnosis and treatment. We present a case of a 29-year-old female admitted to the catheterization laboratory with cardiogenic shock and multivessel coronary artery disease treated successfully with multivessel percutaneous coronary intervention and intra-aortic balloon counterpulsation as a bridge to extracorporeal membrane oxygenation.
Ischaemic stroke induced by neurocysticerosis, presenting as a clinical and radiological dilemma
Authors: Rabia Hasan, Alberto Iaia, Carlos Flores
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Neurocysticercosis (NCC) is a central nervous system parasitic infection with various clinical presentations, rarely manifesting as an acute stroke. The radiological appearance of this disease entity may be non-specific, at times mimicking an intracranial neoplasm. Early diagnosis requires a high index of suspicion. Serological testing is helpful and, if utilized early, can reduce the morbidity associated with invasive diagnostic techniques. We describe a case of a 32-year-old previously healthy male who presented with neurological deficits. A cystic lesion in the right sylvian cistern was noted, initially identified as a benign arachnoid cyst. The patient's symptoms rapidly progressed to an acute stroke. Follow-up imaging including an MRI of the brain demonstrated a right middle cerebral artery territory infarct adjacent to the cystic lesion, which had been diagnosed as an arachnoid cyst on an initial CT scan. Appearance of the cystic lesion on MRI, however, was concerning for a brain neoplasm or an abscess. Given the contiguity of the cystic mass to the right middle cerebral artery, it was suggested that the mass was the likely aetiology of the patient's symptoms. A stereotactic biopsy of the cystic lesion was performed and revealed it to be NCC. The hospital course was complicated by intracranial hypertension and cerebral oedema requiring craniectomy. Our case highlights the importance of considering NCC in the differential diagnosis of stroke in patients coming from endemic regions, especially in younger patients lacking the usual risk factors for cerebrovascular disease.
Childhood-Onset COPA Syndrome Recognized Retrospectively in the Context of Polyarticular Juvenile Idiopathic Arthritis and Rheumatoid Arthritis
Authors: Roko P A Nikolic, Cristina Moran Toro
Journal: Case Rep Rheumatol (2023)
MeSH terms: Case Reports

COPA syndrome is a very rare autoinflammatory disorder manifesting with childhood-onset arthritis and pulmonary and renal disease, of which awareness may remain lacking. We present the case of a twenty-year-old male patient seen in the Young Adults with Rheumatic Disease clinic. Initially diagnosed with seropositive polyarticular juvenile idiopathic arthritis, the patient's early childhood complaints of fatiguability, paroxysmal dyspnea, and pneumonia-like episodes were long to be felt unrelated to his arthritis. Upon transition to adult rheumatology care, a thorough review of the patient's history prompted imaging which revealed interstitial lung disease. Restrictive spirometry and genetic testing confirmed the retrospective diagnosis of COPA syndrome.
Two squamous cell carcinomas of the skin in a patient with Lynch syndrome
Authors: Oshan Basnayake, Umesh Jayarajah, Duminda Subasinghe, Kavinda Rajapakse, Thushan Beneragama, Sivasuriya Sivaganesh
Journal: Int J Surg Case Rep (2023)
Keywords: case report, lynch syndrome, squamous cell carcinoma
MeSH terms: Case Reports

Introduction and importance:
Although synchronous and metachronous tumours of the bowel are well known associations of Lynch syndrome, the association of skin malignancies in such patients are extremely rare.
Case presentation:
A 40-year-old Sri Lankan man with a strong family history of colorectal cancer had an extended right hemicolectomy for a moderately differentiated adenocarcinoma. Two months after surgery, he developed two discrete ulcerative skin lesions in the chin and occipital region which excision biopsy confirmed to be squamous cell carcinoma. After more than two years of follow-up, patient remains disease free.
Clinical discussion:
The Muir Torre variant of Lynch syndrome is characteristically associated with sebaceous adenomas and carcinomas, though occurence of squamous cell carcinomas are rare. In reported cases, defective mismatch repair genes associated with Lynch syndrome may suggest an increased predisposition for squamous cell carcinomas.
Conclusion:
Patients with Lynch syndrome should be educated on the importance of seeking an early medical consult for new skin lesions and raising awareness of this rare phenomenon for physicians involved in follow up is important.
A Case of Bilateral Anesthesia Mumps after Cesarean Section under Spinal Anesthesia: A Rare Case and Literature Review
Authors: Narges Montazeri, Mohammad Hassan Darabi, Kamran Hessami, Ramin Shekouhi, Maryam Sohooli, Tahereh Shamsi, Fateme Bagheri, Mohammad Amin Shahrbaf
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

A 30-year-old pregnant female presented to the emergency department with labor pain in her 39th week of pregnancy. Cesarean section under spinal anesthesia was the chosen route of delivery for this patient due to previous cesarean section in her first pregnancy. The delivery itself was uneventful but seven hours after the surgery, bilateral swelling of parotid glands were noted. Rehydration therapy and a single dose of hydrocortisone (100 mg IV route) were administered, and swellings were completely resolved on postoperative day 2. This is one of the rare cases of anesthesia mumps after spinal anesthesia, and we think rehydration therapy and the single dose corticosteroid may prove useful in these cases.
Reactive infectious mucocutaneous eruption - repeat etanercept after intravenous immunoglobulin: A case report
Authors: Rochelle Tonkin, Malika Ladha, Nicole Johnson, William F Astle, Ami Britton, Neil H Shear, Luis Murguía-Favela, Michele Ramien
Journal: SAGE Open Med Case Rep (2022)
Keywords: coronavirus disease 2019, etanercept, intravenous immunoglobulin, mycoplasma-induced rash and mucositis, reactive infectious mucocutaneous eruption
MeSH terms: Case Reports

Reactive infectious mucocutaneous eruption is a recently distinguished mucosal-predominant blistering eruption triggered by respiratory infections. We describe a previously healthy 11-year-old Black female with rapidly progressive mucocutaneous blistering after prodromal respiratory infection symptoms. Reactive infectious mucocutaneous eruption was suspected and treated with systemic corticosteroids followed by etanercept. Twenty-four hours after etanercept, the diagnosis of multisystem inflammatory syndrome in children was raised and intravenous immunoglobulin was given. Rapidly worsening mucocutaneous disease ensued but was controlled by a second dose of etanercept. Our case highlights the following: (1) the novel observation of possible interaction/neutralization of etanercept by intravenous immunoglobulin, (2) the challenging differential diagnosis of multisystem inflammatory syndrome in children for reactive infectious mucocutaneous eruption patients in the Coronavirus disease 2019 (COVID-19) pandemic, and (3) the role of early treatment to prevent dyspigmentation.
An Uncommon Case of Bilateral Breast Enlargement Diagnosed as Tumoral Pseudoangiomatous Stromal Hyperplasia: Imaging and Pathological Findings
Authors: Isabel Sollozo-Dupont, Héctor Alejandro Domínguez-Hernández, Cecilia Pavón-Hernández, Yolanda Villaseñor-Navarro, Robin Shaw-Dulin, Victor Manuel Pérez-Sánchez, Alejandro Javier España-Ferrufino, Laura Marysol Álvarez-Guadarrama, Fany Iris Porras-Reyes, M Patricia Pérez-Badillo
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

The incidence of reported pseudoangiomatous stromal hyperplasia (PASH), as well as the variability and severity of clinical presentations, is increasing in the literature. In parallel, several authors posit the need for an improved classification of PASH to avoid possible variables associated with this diagnosis. Here, we present a 25-year-old woman with PASH accompanied by severe bilateral and symmetrical breasts enlargement, highlighting an uncommon clinical presentation of PASH as much as the careful interdisciplinary review and correlation of histology and all available imaging studies to confirm the definitive diagnosis.