OpenMed/multicare-articles huggingface dataset:
Case Report: Successful non-operative management of spontaneous splenic rupture in a patient with babesiosis
Authors: William D Tobler Jr, Deborah Cotton, Timothy Lepore, Suresh Agarwal, Eric J Mahoney
Journal: World J Emerg Surg (2011)

Background:
Babesiosis is a zoonotic disease transmitted by the Ixodes tick species. Infection often results in sub-clinical manifestations; however, patients with this disease can become critically ill. Splenic rupture has been a previously reported complication of babesiosis, but treatment has always led to splenectomy. Asplenia places a patient at greater risk for overwhelming post-splenectomy infection from encapsulated bacteria, Lyme disease, Ehrlichia as well as Babesia microti. Therefore, avoiding splenectomy in these patients must be considered by the physician; particularly, if the patient is at risk for re-infection by living in an endemic area.
Case presentation:
A 54 year-old male from the northeast United States presented with left upper quadrant abdominal pain associated with fever, chills, night sweats and nausea. A full evaluation revealed active infection with Babesia microti and multiple splenic lacerations. This patient was successfully treated with appropriate pharmacological therapy and non-operative observation for the splenic injury.
Conclusion:
Patients diagnosed with Babesia microti infection are becoming more common, especially in endemic areas. Although clinical manifestations are usually minimal, this infection can present with significant injuries leading to critical illness. We present the successful non-operative treatment of a patient with splenic rupture due to babesiosis infection.
Draining Fluids through a Peritoneal Catheter in Newborns after Cardiac Surgery Helps to Control Fluid Balance
Authors: Elisa Ruano Cea, Philippe Jouvet, Suzanne Vobecky, Aicha Merouani
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Dialysis can be used in severe cases, but may not be well tolerated. In such patients, peritoneal drainage could be an alternative option for fluid removal. We report the case of a newborn with a truncus arteriosus who developed postoperatively a complicated clinical course with right ventricular dysfunction, prerenal condition as well as fluid overload despite diuretic therapy. Dialysis was indicated for fluid removal. Peritoneal dialysis was started using a surgically placed Tenckhoff catheter and stopped due to inefficacy and leaks and no other modalities of dialysis were used. However, the catheter was left in place over a period of two months for fluid drainage and removed because of unexplained fever. In order to determine the effect of peritoneal drainage, we selected a period of one week before and one week after the removal of the drain to compare daily clinical data, urine electrolytes and renal function and found a positive effect on fluid balance control. We conclude that the fluid removal by continuous peritoneal drainage is a simple and safe alternative that can be used to control fluid balance in infants after cardiac surgery.
Extrapontine Myelinolysis following Extreme Hypernatremia and Hyperosmolarity
Authors: Jan-Niclas Schwade, Lior Haftel, Lars Rühe, Matthias Endmann
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

We present a case of a nearly 3-year-old girl who was admitted to hospital due to severe hypernatremia (196 mmol/l). Her medical history included central hypothyreosis and growth hormone deficiency. Rehydration and normalization of sodium was achieved according to guidelines. On the fourth day of hospitalization, the patient developed tremor, ataxia, and rigor. Cranial magnetic resonance imaging (cMRI) was performed and (mis)interpreted for meningoencephalitis, with corresponding diagnostic and therapeutic implications. The patient had extrapontine myelinolysis. The child recovered completely after hospitalization for nearly 2 weeks.
Cystitis Cystica as a Large Solitary Bladder Cyst
Authors: Stephanie Potts, John Calleary
Journal: J Endourol Case Rep (2017)
Keywords: bladder cyst, cystitis cystica, lower urinary tract symptoms, suprapubic pain
MeSH terms: Case Reports

Background: In this case we describe the rare and not previously documented presentation of cystitis cystica as a large solitary cystic lesion within the bladder wall. Case Presentation: We present a case of a 46-year-old Russian male with a history of lower urinary tract symptoms and suprapubic pain. CT urogram showed a 5.8 cm filling defect/cystic mass related to the base of the bladder and prostate with 8 mm thick wall. The patient underwent cystoscopy and contrast study of bladder lesion with urethral dilatation and transurethral deroofing of bladder wall cyst under general anesthesia. A histologic diagnosis of cystitis cystica was made. Conclusion: This case described the rare presentation of a large solitary bladder cyst arising from the anterior bladder wall, identified histologically as cystitis cystica. Cystitis cystica presenting as a large cystic lesion of the bladder wall is rare; however, a diagnosis of cystitis cystica should be considered in unexplained cystic defects of the bladder wall.
Irreducible Distal Tibia Physeal Injury with Tibialis Posterior Tendon Interposition
Authors: Chintan Doshi, Simran Dua, Shital N Parikh
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

A 14-year-old basketball player presented with a displaced distal tibia physeal fracture which is typically treated with closed reduction with or without internal fixation. However, repeated attempts at closed reduction failed to align the fracture fragments. At open reduction, tibialis posterior tendon interposition was identified within the fracture site and bowstringing of the tendon prevented closed reduction. A tendon interposition should be suspected when repeated closed reduction attempts fail to achieve satisfactory fracture reduction. The features of tendon interposition should be differentiated from the more common periosteal interposition for physeal fractures of the tibia.
Case report: Surgical treatment of a primary giant epithelioid hemangioendothelioma of the spine with total en-bloc spondylectomy
Authors: Wanbao Ge, Yuan Qu, Tingting Hou, Jiayin Zhang, Qiuju Li, Lili Yang, Lanqing Cao, Jindong Li, Shanyong Zhang
Journal: Front Oncol (2023)
Keywords: epithelioid hemangioendothelioma, giant, total en-bloc spondylectomy, vascular neoplasm, vertebral lesion
MeSH terms: Case Reports

Background:
Epithelioid hemangioendothelioma (EHE) is an extremely uncommon malignant neoplasm that originates from vascular endothelial or pre-endothelial cells. In this report, we present the case of patient who was diagnosed with a primary giant EHE of the spine and underwent treatment with total en-bloc spondylectomy (TES).
Case presentation:
A 43-year-old male patient with a history of he presented to our hospital with chronic and progressive back pain. Physical examination revealed weakened sensation of acupuncture and touch on the left costal arch, while relatively normal neurological functions were preserved. Radiological examinations identified a giant destructive soft tissue lesion occupying the T8 vertebral region, with moderate destruction of the pedicle and lamina, as well as the 7th left rib. A preoperative biopsy of the 8th vertebra resulted in a diagnosis of epithelioid hemangioendothelioma(EHE). Postoperative immunohistochemical and pathological reports confirmed the presence of EHE in the left ribs and T8 ribs. The patient underwent resection of the 7th left rib and posterior pedicle screw fixation with 8 pairs of screws and a titanium mesh cage. Subsequently, thoracic en bloc spondylectomy was performed on the T8 vertebra. The patient did not receive radiation or chemotherapy following surgery. Over a period of 3 years, the patient remained free of disease and relapse.
Conclusion:
The use of transarterial embolization with spherical embolic agents (TES) has been demonstrated to be a safe, effective, and reliable treatment option for hepatic epithelioid hemangioendothelioma (EHE). Nevertheless, it is crucial to conduct long-term follow-up of this patient in order to assess their clinical outcome.
Laparoscopic-Assisted Recipient Nephrectomy and Recipient Kidney Procurement during Orthotopic Living-Related Kidney Transplantation
Authors: Dimitri Mikhalski, Karl Martin Wissing, Renaud Bollens, Daniel Abramowicz, Vincent Donckier, Anh-Dung Hoang
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

Advanced atherosclerosis or thrombosis of iliac vessels can constitute an absolute contraindication for heterotopic kidney transplantation. We report the case of a 42-year-old women with end-stage renal disease due to lupus nephritis and a history of bilateral thrombosis of iliac arteries caused by antiphospholipid antibodies. Occlusion had been treated by the bilateral placement of wall stents which precluded vascular anastomosis. The patient was transplanted with a right kidney procured by laparoscopic nephrectomy from her HLA semi-identical sister. The recipient had left nephrectomy after laparoscopical transperitoneal dissection. The donor kidney was orthotopically transplanted with end-to-end anastomosis of graft vessels to native renal vessels and of the graft and native ureter. Although, the patient received full anticoagulation because of a cardiac valve and antiphospholipid antibodies, she had no postoperative complication in spite of a short period of delayed graft function. Serum creatinine levels three months after transplantation were at 1.0 mg/dl. Our case documents that orthotopical transplantation of laparoscopically procured living donor kidneys at the site of recipient nephrectomy is a feasible procedure in patients with surgical contraindication of standard heterotopic kidney transplantation.
Musical hallucinations and forgotten tunes - case report and brief literature review
Authors: Danilo Vitorovic, José Biller
Journal: Front Neurol (2013)
Keywords: auditory processing, memory, musical hallucinations

Musical hallucinations represent a specific form of auditory hallucinations whereby patients experience formed music without an external source. We describe a 60-year-old woman with history of bilateral hearing impairment and tinnitus who experienced both recognizable and non-recognizable songs. Curiously, she was able to reproduce non-recognizable songs in a way that could be recognized by others. This phenomenon is in line with current understanding that musical hallucinations represent abnormal activity in the auditory associative cortices, raising intriguing questions regarding memory, forgetting, and access to lost memories.
Macroscopic Hematuria due to Placenta Percreta: Report of Two Cases and Short Review
Authors: Ourania Koukoura, George Lialios, Antonios Garas, George Sveronis, Asterios Nidimos, Irondiana Gkorezi, Zoi Alevra, Vassilios Tzortzis, Athanasios Oeconomou, Ioannis Zachos, Alexandros Daponte
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Herein we present two cases of pregnant women with placenta percreta and severe hematuria during the 24th and 35th weeks of pregnancy, respectively. A timely sonographic diagnosis was feasible in the first case and cesarean section was performed during the 29th week. During the operation, the placenta was invading the bladder wall and concomitant hysterectomy with cystotomy and bladder wall reconstruction was performed. The second case presented in our emergency department with vaginal bleeding during the 35th weeks of pregnancy. She underwent an emergency cesarean section with uterine preservation, cystotomy, and bladder reconstruction.
Complication with removal of a lumbar spinal locking plate
Authors: Brooke Crawford, Christopher Lenarz, J Tracy Watson, Dirk Alander
Journal: Case Rep Orthop (2015)

Introduction. The use of locking plate technology for anterior lumbar spinal fusion has increased stability of the vertebral fusion mass over traditional nonconstrained screw and plate systems. This case report outlines a complication due to the use of this construct. Case. A patient with a history of L2 corpectomy and anterior spinal fusion presented with discitis at the L4/5 level and underwent an anterior lumbar interbody fusion (ALIF) supplemented with a locking plate placed anterolaterally for stability. Fifteen months after the ALIF procedure, he returned with a hardware infection. He underwent debridement of the infection site and removal of hardware. Results. Once hardware was exposed, removal of the locking plate screws was only successful in one out of four screws using a reverse thread screw removal device. Three of the reverse thread screw removal devices broke in attempt to remove the subsequent screws. A metal cutting drill was then used to break hoop stresses associated with the locking device and the plate was removed. Conclusion. Anterior locking plates add significant stability to an anterior spinal fusion mass. However, removal of this hardware can be complicated by the inherent properties of the design with significant risk of major vascular injury.
ICD Pocket-Site Infection Secondary to Gonococcal Bacteremia: The First Reported Case
Authors: Sardar Hassan Ijaz, Ali Haider Jafry, Areeba Shahnawaz, Mark Allee
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Introduction:
Cardiovascular implantable electronic devices (CIEDs) are being increasingly used in the primary and secondary prevention of malignant ventricular arrhythmias and conduction system disorders. Infectious complications associated with CIEDs include infective endocarditis, lead infections, and pocket-site infections, primarily involving Staphylococcus species. Infective endocarditis is a rare but life-threatening complication of gonococcal bacteremia. We report the first case of a CIED pocket-site infection secondary to Neisseria gonorrhoeae (N. gonorrhoeae).
Case:
A 56-year-old male with a history of congestive heart failure status postimplantable cardioverter-defibrillator (ICD) insertion presented with a pocket-site swelling initially concerning for a hematoma which began to exhibit erythema and tenderness. The patient reported a history of high-risk sexual behavior. On presentation, he was afebrile and hemodynamically stable. Physical exam showed a 5 cm × 6 cm pocket-site swelling with overlying erythema. Labs revealed elevated ESR and CRP levels. Transthoracic and transesophageal echocardiography was concerning for infective endocarditis and lead vegetations. Blood cultures tested positive for N. gonorrhoeae. He underwent surgical debridement with complete ICD extraction and drainage of infected serosanguineous pocket fluid. Tissue cultures were negative, but isolation of N. gonorrhoeae in blood cultures confirmed it as the causative agent of the pocket-site infection in the absence of prior Gram-positive coverage. He was started on a prolonged course of ceftriaxone for 4 weeks with reimplantation of ICD at a different site after completion of treatment.
Conclusion:
In patients with high-risk sexual behavior, gonococcal bacteremia can potentially lead to CIED infection. These individuals should be prudently evaluated for infective endocarditis or pocket-site infections as presenting complaints can be subtle.
Clavicular Metastasis as an Initial Presentation of Papillary Thyroid Cancer
Authors: Russell Fung, Madeline Fasen, Firas Warda, Patrick Natter, Stacey Nedrud, Rui Fernandes, Ahmad Alkhasawneh, Gunjan Y Gandhi
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Objective:
We present the case of a 44-year-old man with a large neck mass to highlight the unique presentation of papillary thyroid carcinoma (PTC) metastatic to the clavicle.
Methods:
We reviewed the medical record for a detailed history and physical examination findings. Our radiology colleagues examined the diagnostic imaging studies performed. The pathology team reviewed the neck mass biopsy and the confirmatory surgical pathology after total resection of the mass.
Results:
A 44-year-old man presented with an enlarging neck mass. Initial X-rays revealed a large soft tissue density mass that extended to the midline of the right clavicle. A neck ultrasound established a 5.4 × 3.6 cm mass with increased vascularity and calcification extending from the thyroid. A CT scan noted the extension of the mass into the adjacent sternoclavicular junction with osteolysis of the middle third of the clavicle and the superior aspect of the sternal body. Fine-needle aspiration revealed a thyroid neoplasm with follicular features and positive immunostaining consistent with thyroid carcinoma. The patient underwent a composite resection of the tumor, including a segmental osteotomy of approximately two-thirds of the medial clavicle. The pathology report confirmed PTC with extrathyroidal extension and clavicle involvement (staged pT4a pN0), with further genomic findings showing positive KRAS mutation.
Conclusion:
Clavicular metastasis from differentiated thyroid cancer is rare. While the prognosis is generally favorable, various factors, including age greater than 45 years, poor differentiation, follicular thyroid carcinoma, Hurthle cell variant, and extrapulmonary metastasis, have typically been associated with poorer cancer-specific survival.
Pylephlebitis: a rare complication of an intra-abdominal infection
Authors: Katherine Wong, David S Weisman, Kelly-Ann Patrice
Journal: J Community Hosp Intern Med Perspect (2013)
Keywords: abdominal infection, appendicitis, bacteroides, diverticulitis, portal vein thrombosis, pylephlebitis, sepsis
MeSH terms: Case Reports

Pylephlebitis is defined as an inflamed thrombosis of the portal vein. It is a rare complication of an intra-abdominal infection, and the diagnosis is often missed due to its nonspecific clinical presentation. Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. It is important to consider this differential when a patient presents with signs of abdominal sepsis since it has a high mortality rate and is often diagnosed postmortem. Pylephlebitis can be diagnosed via abdominal ultrasound or CT demonstrating a thrombus in the portal vein, and it must be treated early and aggressively with broad-spectrum antibiotics. We are presenting a case of pylephlebitis as well as discussing the diagnosis and treatment of this potentially lethal condition.
Concurrent Afatinib and Whole-Brain Radiotherapy in Exon 19-del-EGFR Mutant Lung Adenocarcinoma: A Case Report and Mini Review of the Literature
Authors: Chukwuka Eze, Nina-Sophie Hegemann, Olarn Roengvoraphoj, Maurice Dantes, Farkhad Manapov
Journal: Front Oncol (2017)
Keywords: afatinib, brain and leptomeningeal metastases, non-small cell lung cancer, tyrosine-kinase inhibitor, whole-brain radiotherapy
MeSH terms: Case Reports

Leptomeningeal metastases (LM) are found in approximately 3.8% of non-small cell lung cancer cases with an increased incidence in adenocarcinoma, and approximately one-third of patients will present with concomitant brain metastases. We report the case of a 50-year-old male patient with stage IV exon 19-del-EGFR mutant lung adenocarcinoma who progressed on second-generation TKI therapy with manifestation of symptomatic simultaneous diffuse brain and LM. Whole-brain radiotherapy with concurrent afatinib resulted in an almost complete regression of neurological symptoms as well as good, durable radiological response. Furthermore, treatment was well tolerated with no relevant adverse effects.
A Novel Splicing Mutation in the CSF1R Gene in a Family With Hereditary Diffuse Leukoencephalopathy With Axonal Spheroids
Authors: Xiaodong Yang, Pei Huang, Yuyan Tan, Qin Xiao
Journal: Front Genet (2019)
Keywords: csf1r, hereditary diffuse leukoencephalopathy with axonal spheroids, neuroimages, splicing mutation, whole-exome sequencing
MeSH terms: Case Reports

Hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) is a rare autosomal dominant disorder that typically presents with early-onset cognitive decline or personality change. The disease is associated with heterozygous mutations in the colony stimulating factor-1 receptor (CSF1R) gene. CSF1R activation regulates microglial survival, proliferation, and differentiation. The different gene mutations may be related to the various clinical phenotypes. Here, we described comprehensive clinical, neuroimaging, neuropathological, and genetic analyses of a family with HDLS. A novel splicing mutation in intron 13 (c.1858+1G>T) of CSF1R was found in this family. It is located at the splice site of intron 13, resulting in a splice donor site leading to exon 13 skipping from the CSF1R mRNA. The mother and two elderly siblings of the proband had the same CSF1R mutation as the proband but showed very mild neuroimaging abnormalities and mild memory loss, which did not affect daily life, indicating very uneven penetrance and distinctly different disease progression among family members. This report provides diverse neuroimaging and clinical characteristics of a novel CSF1R mutation with different disease penetrance. The large clinical heterogeneity in the same family who all had the same mutation indicates that modifying genes and environmental factors may play a role in the pathogenesis of HDLS.
Stage IAE Follicular Lymphoma of the Breast: Case Report and Review of the Literature
Authors: Raymon Patron, Edward F Miles
Journal: Case Rep Oncol Med (2013)

Primary lymphoma of the breast is a rare entity in the field of oncological medicine and represents <0.5% of all breast malignancies. A definitive diagnosis is obtained by excisional biopsy as the clinical and radiographical presentation is similar to the more common primary breast carcinoma. Unlike primary breast carcinoma, localized radiation therapy is the mainstay of treatment. We report on a case of primary follicular lymphoma of the breast in a 67-year-old Caucasian woman treated with localized radiation as well as coinciding literature review regarding outcomes of different treatment modalities.
Behavior Modification Maintenance with Long-Term Blood Glucose and Weight Management in Prader-Willi Syndrome Complicated with Diabetes: Team Management Approach Combined with Pharmacological Treatment
Authors: Eri Kato, Moritsugu Kimura, Tomoyuki Okuda, Masao Toyoda, Masafumi Fukagawa
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

The patient was a 40-year-old woman, who had been diagnosed with Prader-Willi syndrome (PWS) at 1 year of age and type 2 diabetes at 27 years of age. At 34 years of age, she was hospitalized to start insulin therapy and receive guidance on treatment. During the next 6 months and through regular once-monthly outpatient clinic visits, the blood glucose level was relatively stabilized although body weight gradually increased. Two years following discharge, the blood glucose level became unstable, and she was hospitalized again to receive guidance on treatment. A team medicine-based approach was established upon hospitalization. The basic treatment was unchanged (insulin, diet, and exercise). The approach taken by the team included understanding the characteristics of PWS by all team members, clear definition of treatment goals, positive evaluation of the patient, and maintenance of the patient's motivation for treatment. Anxiety and stress related to mother's illness dampened motivation and adherence to treatment, but the addition of appropriate pharmacological treatment helped in rapid recovery of motivation to adhere to the treatment protocol. At 3 years after discharge, HbA1c is maintained at around 6%, and body weight continues to fall. Our protocol of the combination of a team medicine approach with appropriately timed pharmacological intervention could probably be applied to not only type 2 diabetes in PWS but also the management of patients with poorly controlled type 2 diabetes.