OpenMed/multicare-articles huggingface dataset:
Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma
Authors: Basheer Tashtoush, Jonathan Schroeder, Roya Memarpour, Eduardo Oliveira, Michael Medina, Anas Hadeh, Jose Ramirez, Laurence Smolley
Journal: Case Rep Emerg Med (2015)

The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT) scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis. Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population.
Laparoscopic diagnosis of incarcerated "spigelian hernia": report of a case and review of the literature
Authors: Sanoop Koshy Zachariah, Priya Jose
Journal: Case Rep Surg (2011)
MeSH terms: Case Reports

Spigelian hernias are rare hernias, representing only about 1-2% of all abdominal hernias. An accurate preoperative diagnosis of this condition is often difficult because the physical presence of these hernias is often not demonstrable owing to its peculiar anatomic location. Many patients with Spigelian hernias, therefore, may have no obvious findings on clinical examination. The diagnosis is even trickier in obese patients wherein the hernia sac may lie in an intraparietal plane, masked by the abdominal subcutaneous fat. Here we describe a case of incarcerated Spigelian hernia where clinical and radiological findings were inconsistent and the accurate diagnosis was made by laparoscopy and was followed by a laparoscopic-assisted repair using an open anterior approach with an onlay mesh. We therefore feel that laparoscopy can be a useful tool for confirming the diagnosis and also for performing a definitive repair in doubtful cases of Spigelian hernias.
Retroperitoneal Ectopic Location of an Intrauterine Device Revealed by Renal Colic: An Exceptional Case
Authors: Idriss Ziani, Imad Boualaoui, Ahmed Ibrahimi, Hachem El Sayegh, Lounis Benslimane, Yassine Nouini
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

The intrauterine device (IUD) is one of the most effective contraceptive methods. Its Pearl Index is less than 1 per 100 women. It is the most used method around the world: about 100 million users. However, its insertion can cause certain complications, such as infection, expulsion, or perforation essentially when the rules of use are poorly applied. Perforation remains exceptional but one of the most serious complications. Indeed, after a perforation, the IUD could be located in different neighboring organs. We report a new case of IUD ectopic location in the peritoneal cavity, which was diagnosed 7 years after the insertion and as part of the renal colic assessment. The surgery was performed to remove the IUD which was embedded in the peritoneum and compresses the ureter and causes dilation upstream. To our knowledge, this is the first case reported in the literature of an ectopic location in the retroperitoneal space of an intrauterine device.
Optimal Molecular Methods in Detecting p190 (BCR-ABL) Fusion Variants in Hematologic Malignancies: A Case Report and Review of the Literature
Authors: Rebecca J Sonu, Brian A Jonas, Denis M Dwyre, Jeffrey P Gregg, Hooman H Rashidi
Journal: Case Rep Hematol (2015)

Patients with BCR-ABL1 positive hematologic malignancies and Philadelphia-like B-lymphoblastic leukemia (B-ALL) are potential candidates for targeted therapy with tyrosine kinase inhibitors (TKI). Before TKIs, patients with B-ALL had a much worse prognosis and current treatments with targeted TKI therapy have improved outcomes. Thus, the detection of BCR-ABL1 is crucial and a false negative BCR-ABL1 result may adversely affect patient care. We report a case of a 76-year-old male with a new diagnosis of B-ALL who was initially found to be BCR-ABL1 negative by quantitative polymerase chain reaction (PCR). A concurrent qualitative PCR was performed which detected a positive BCR-ABL1 result that was confirmed by a next generation sequencing (NGS) based assay and identified as the rare fusion variant e1a3 of p190(BCR-ABL). Based on this result, the patient was placed on dasatinib as a targeted therapy. In the era of molecular diagnostic medicine and targeted therapy, it is essential to have an understanding of the limitations of molecular assays and to follow a comprehensive diagnostic approach in order to detect common abnormalities and rare variants. Incorporating NGS methods in an algorithmic manner into the standard diagnostic PCR-based approach for BCR-ABL1 will aid in minimizing false negative results.
Cocaine and COVID-19 in ST-Elevation Myocardial Infarction
Authors: Florian Appenzeller, Meinrad Gawaz, Iris Müller
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Both COVID-19 disease and cocaine consumption have prothrombotic and hypercoagulable effects and are associated with increased risk of cardiovascular events. We report the case of a patient with acute myocardial infarction in the setting of active COVID-19 disease and recent cocaine consumption. We hypothesize that COVID-19 and cocaine synergistically provoke cardiovascular events. Identifying COVID-19 disease and/or cocaine abuse as potential triggers of acute myocardial infarction can be crucial due to distinctive therapeutic consequences.
Case Report: Mature Plasmacytoid Dendritic Cell Proliferation Associated With a Lymphoid Neoplasm
Authors: Fei Fei, Michaela Liedtke, Oscar Silva
Journal: Front Oncol (2022)
Keywords: bpdcn, mpdcp, t-all, leukemia, lymphoid, mature, pdc proliferation
MeSH terms: Case Reports

Mature plasmacytoid dendritic cell proliferations (MPDCPs) are clonal, non-malignant pDC proliferations that have been reported to occur in association with myeloid neoplasms such as CMML, AML (pDC-AML), and, rarely, MDS or MPNs. Here we report the first case of a MPDCP associated with T-lymphoblastic leukemia (T-ALL), a lymphoid neoplasm. The MPDCP in this case involved ~50% of the bone marrow, was found in nodular aggregates, expressed CD123, CD4, and CD303, and lacked CD56 and TCL1 expression. In addition, the MPDCP lacked CD34 and TdT but showed aberrant expression of CD7, CD5, CD10, and CD13, markers expressed by the abnormal T-lymphoblastic cells. Mutational analysis demonstrated mutations in JAK3, NOTCH1, NRAS, KRAS, DNMT3A, and SH2B3 but no mutations in TET2, ASLX1 or ZRSR2. Analysis of the pDC frequency in a separate cohort of T-ALL and control patients demonstrated that bone marrow pDCs are often decreased in patients with T-ALL compared to controls. This is the first report of a MPDCP associated with a lymphoid neoplasm and provides further support that MPDCP can arise from a multipotent hematopoietic progenitor with lymphoid and dendritic cell potential.
Spinal Non-Hodgkin Lymphoma Mimicking Epidural Hematoma
Authors: Lorenz Vangeel, Joris Bleyen, Laurens De Cocker
Journal: J Belg Soc Radiol (2022)
Keywords: mri, epidural, hematoma, lymphoma, spine
MeSH terms: Case Reports

A patient, recently diagnosed with non-Hodgkin lymphoma, presented with acute tetraplegia after surgical cervical lymph node biopsy. MRI of the cervical spine demonstrated an epidural space-occupying lesion with compressive myelopathy. While epidural hematoma was the tentative diagnosis, intra-operatively non-Hodgkin lymphoma was found. Several factors may have accounted for the inaccurate interpretation of the MRI: the acute clinical presentation appearing shortly after surgery, the non-specific signal intensities of (hyper-) acute hematomas, the lack of contrast-enhanced images, and the absence of the FDG-avid spinal mass in the PET/CT-report. Without radiological features of invasiveness and contrast-enhanced images, careful interpretation is mandatory for space-occupying epidural lesions.
Teaching point:
Caution is needed when interpreting an epidural space-occupying lesion in the absence of contrast-enhanced images.
Are SARS-CoV-2 reinfection and Covid-19 recurrence possible? a case report from Brazil
Authors: Lívia Pimenta Bonifácio, Ana Paula Sulino Pereira, Daniel Cardoso de Almeida E Araújo, Viviane da Mata Pasti Balbão, Benedito Antônio Lopes da Fonseca, Afonso Dinis Costa Passos, Fernando Bellissimo-Rodrigues
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Coronavirus Infections / diagnosis, Pneumonia, Viral / diagnosis, Recurrence, Case Reports, Antibodies, Viral / blood, Betacoronavirus, Brazil, COVID-19, Female, Humans, Pandemics, RNA, Viral / isolation & purification, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Young Adult, Antibodies, Viral, RNA, Viral

With the large number of individuals infected and recovered from Covid-19, there is intense discussion about the quality and duration of the immunity elicited by SARS-CoV-2 infection, including the possibility of disease recurrence. Here we report a case with strong clinical, epidemiological and laboratorial evidence of, not only reinfection by SARS-CoV-2, but also clinical recurrence of Covid-19.
Case report: A rare multidrug-resistant Escherichia coli causes fatal neonatal meningoencephalitis
Authors: Qingyun Zhou, Zhifei Zhan, Furong Huang, Menghua Zhao, Daosheng Huang, Jun Xu, Li Huang, Liangyi Xie, Aimin Zhang
Journal: Front Public Health (2023)
Keywords: escherichia coli, encephalopathy, infant, infectious disease, metagenomic next-generation sequencing (mngs), neonatal meningitis
MeSH terms: Anti-Bacterial Agents / therapeutic use, Meningoencephalitis / diagnosis, Meningoencephalitis / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Cefoperazone / therapeutic use, Escherichia coli, Humans, Infant, Infant, Newborn, Sulbactam / therapeutic use, Anti-Bacterial Agents, Cefoperazone, Sulbactam

Neonatal meningitis is rare but devastating disease. Multidrug-resistant (MDR, multi-drug resistant) bacteria are a major global health risk. We report an Escherichia coli meningitis isolate with multiple resistance patterns and unusual serotype (O75) that caused sudden neonatal death. The isolate was resistant to antibiotics other than cefoperazone/sulbactam and imipenem, challenging the combination of antibiotics commonly used in the empirical treatment of neonatal sepsis. Despite aggressive symptomatic and supportive treatment of the infant based on laboratory tests and clinical practice, the infant eventually died. This is the first case of meningoencephalitis due to serotype O75 reported in China. The presence of highly pathogenic multidrug-resistant microorganisms isolated in neonates underscores the need to implement rapid resistance diagnostic methods and should prompt consideration of alternatives to empiric treatment of neonatal bacterial meningitis.
Third Trimester Lower Extremity Lymphorrhea
Authors: Kaori Morimoto, Luke O'Rourke
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Introduction:
Lower extremity edema is one of the most common complaints among pregnant patients. However, there is no literature mentioning weeping edema (i.e., lymphorrhea) in a pregnant woman who has no concordant underlying renal and/or cardiac pathology. There is also a lack of evidence and recommendations regarding the therapeutic benefit and safety profile of diuretic use to treat profound pregnancy-associated edema. Herein, we present the case of 32-year-old female who presented with a significant lymphorrhea during the third trimester without cardiac or renal comorbidity and was successfully treated with torsemide. Case Report. We report a case of a 32-year-old multigravida patient pregnant with her third child and has two living full-term children (G3P2003). Her pregnancy was complicated by obesity, smoking (vape), and previous history of fetal growth restriction. The patient presented for routine prenatal care at 9-week gestation. She was diagnosed with chronic hypertension at 19 weeks of pregnancy based upon systolic blood pressure > 140. Lifestyle modifications were recommended, but the patient did not comply. At her 31-week office visit, the patient presented with anasarca and clear, slightly viscous fluid seeping through the atraumatic skin of her lower extremities. Preeclampsia, renal, cardiac, vascular, and infectious complications were all ruled out. The patient responded positively to loop diuretic therapy. Torsemide was found to be far more beneficial than furosemide. The patient was induced at 37 weeks secondary to chronic hypertension requiring antihypertensive therapy. Delivery was uncomplicated. The patient gave birth to a healthy male with birth weight of 2,920 g via spontaneous vaginal delivery. Discussion. Pitting edema of lower limbs frequently occurs as a result of fluid overload and chronic venous insufficiency, and pregnancy is one of the known risk factors. Additionally, the blockage of lymphatic channel with the gravida uterus likely was the main contributing factor for her lymphorrhea. In this patient, the capillary hydrostatic pressure was likely accentuated due to hypertension, obesity, and vaping. Furosemide was minimally effective to alleviate her symptoms. Torsemide provided much more effective diuresis and symptom control. However, her symptoms persisted until delivery.
Conclusion:
Torsemide provided significant therapeutic benefit over furosemide in this patient without adverse maternal, fetal, or neonatal outcomes. Further study is needed to assess the safe use of loop diuretics in the pregnant population who suffers from significant lower extremity edema.
Severe Thyrotoxicosis Secondary to Povidone-Iodine from Peritoneal Dialysis
Authors: Kirstie Lithgow, Christopher Symonds
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically. Possible iodine sources were again reviewed, and it was determined that povidone-iodine solution was used with each PD cycle. Methimazole 25 mg daily was initiated; however, he had difficulty tolerating the medication and continued to clinically deteriorate. He was readmitted to hospital where methimazole was restarted at 20 mg bid with high dose prednisone 25 mg and daily plasma exchange (PLEX) therapy. Biochemical improvement was observed with FT4 dropping to 48.5 pmol/L by day 10, but FT4 rebounded to 67.8 pmol/L after PLEX was discontinued. PLEX was restarted and thyroidectomy was performed. Pathology revealed nodular hyperplasia with no evidence of thyroiditis. Preoperative plasma iodine levels were greater than 5 times the upper limit of normal range. We hypothesize that the patient had underlying autonomous thyroid hormone production exacerbated by exogenous iodine exposure from a previously unreported PD-related source.
Metastatic Basal Cell Carcinoma: A Rare Manifestation of a Common Disease
Authors: Paola Piva de Freitas, César Galusni Senna, Mayara Tabai, Carlos Takahiro Chone, Albina Altemani
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Introduction:
Basal cell carcinoma (BCC) is considered the most common malignancy in Caucasians. It constituted about 80% of all nonmelanoma skin tumors and, despite its high prevalence, is an extremely rare occurrence of metastases, with incidence rates varying from 0.0028% to 0.55%.
Case report:
A 58-year-old male patient with BCC on the left nasolabial sulcus for 17 years, reporting 3 previous excisions, evolved with local recurrence. A new procedure was performed, and anatomopathological study confirmed sclerosing BCC. Seven months later, he presented with a mass in the left submandibular region. Combined positron-emission tomography and computed tomography (PET-CT) showed cervical hypercaptation in the left cervical level I and vertebral body of L5. Excision of the cervical lesion was performed with diagnosis of sclerosing BCC compromising the submandibular gland. Biopsy of the lumbar lesion was found to be compatible with bone metastasis.
Conclusion:
BCC represents a very common entity, and the presence of metastasis, although infrequent, must be proposed because of the greater morbidity and mortality of this complication. This case shows the importance of early diagnosis and intervention in BCC as a way to avoid unfavorable outcomes.
An Uncommon Case of Incessant Tachycardia-induced Cardiomyopathy in a Child
Authors: Hermine R Poghosyan, Arman B Danoyan, Tatevik B Hovakimyan, Zara Ed Kartoyan, Karapet V Davtyan
Journal: J Innov Card Rhythm Manag (2018)
Keywords: ablation, child, incessant supraventricular tachycardia, uncommon concealed slow accessory pathway
MeSH terms: Case Reports

The case of a pediatric patient with a history of incessant narrow complex tachycardia is presented. The patient underwent successful catheter ablation for an uncommon concealed slow accessory pathway. The mechanism and ablation location are discussed.
Sclerosing epithelioid fibrosarcoma: rare and serious
Authors: Mounir Yahyaoui, Mohammed Benhammou, Soufiane Aharram, Jawad Amghar, Mohammed Sadougui, Omar Agoumi, Abdelkrim Daoudi
Journal: Pan Afr Med J (2020)
Keywords: sclerosing epithelioid fibrosarcoma, adjuvant treatment, metastases, recurrences, surgery
MeSH terms: Fibrosarcoma / diagnosis, Case Reports, Chemotherapy, Adjuvant, Combined Modality Therapy, Female, Fibrosarcoma / pathology, Fibrosarcoma / surgery, Follow-Up Studies, Humans, Neoplasm Recurrence, Local, Radiotherapy, Adjuvant

Sclerosing Epithelioid Fibrosarcoma (SEF) is a rare form of soft tissue sarcoma. It is characterized by a slow evolution, with local recurrences and late metastases that are mainly pulmonary and pleural in about 50% of cases. The treatment is based on the surgery which must be as wide as possible. The efficacy of adjuvant therapy in the control of SEF is not yet demonstrated. Chemotherapy is used in recurrences, some have also proposed radiotherapy. Long-term follow-up of patients with SEF is therefore essential.
Small Cell Neuroendocrine Carcinoma of the Cervix in Pregnancy: A Case Report and Review
Authors: Linglan Pan, Renyan Liu, Xiujie Sheng, Dunjin Chen
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Small cell neuroendocrine carcinoma of the cervix is a rare subtype of cervical cancer. Here we report a case in which a 27-year-old female patient presented at 34-week gestation with abnormal vaginal bleeding, underwent normal labor, and gave birth to a healthy neonate. Her pregnancy was complicated with a cervical tumor which turned out to be small cell neuroendocrine cervical carcinoma. We reviewed and discussed the features, diagnosis, and prognosis of small cell neuroendocrine carcinoma of the cervix.
A Case of "Late" Postsurgical Hypoparathyroidism
Authors: Cesar Augusto Simões, M K Costa, L B Comerlato, A A Ogusco, V Araújo Filho, R A Dedivitis, C R Cernea
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Introduction:
Postsurgical hypoparathyroidism normally occurs a short time after thyroid surgery in form of two clinical syndromes of different etiology and prognosis. The first is transitory and might spontaneously recover within a few weeks or months. The second is permanent and needs a definitive treatment. Only few cases of hypoparathyroidism clinically evident after many years from surgery have been reported.
Case report:
A case of hypoparathyroidism clinically evident only three and a half years after surgery is reported. Our findings and review of a few cases reported by medical literature suggest the existence of a third form of postsurgical hypoparathyroidism, characterized by a late beginning.
Rate and rhythm control strategies for apraxia of speech in nonfluent primary progressive aphasia
Authors: Bárbara Costa Beber, Monalise Costa Batista Berbert, Ruth Siqueira Grawer, Maria Cristina de Almeida Freitas Cardoso
Journal: Dement Neuropsychol (2018)
Keywords: apraxia of speech, primary progressive aphasia, rehabilitation, speech and language therapy
MeSH terms: Case Reports

The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.
Case Report: Tachycardia, Hypoxemia and Shock in a Severely Burned Pediatric Patient
Authors: Jianshe Shi, Chuheng Huang, Jialong Zheng, Yeqing Ai, Hiufang Liu, Zhiqiang Pan, Jiahai Chen, Runze Shang, Xinya Zhang, Shaoliang Dong, Rongkai Lin, Shurun Huang, Jianlong Huang, Chenghua Zhang
Journal: Front Cardiovasc Med (2022)
Keywords: abdominal compartment syndrome, continuous renal replacement therapy, hypoxemia, pediatric, severe burns, shock, tachycardia
MeSH terms: Case Reports

Background:
Severely burned children are at high risk of secondary intraabdominal hypertension and abdominal compartment syndrome (ACS). ACS is a life-threatening condition with high mortality and requires an effective, minimally invasive treatment to improve the prognosis when the condition is refractory to conventional therapy.
Case presentation:
A 4.5-year-old girl was admitted to our hospital 30 h after a severe burn injury. Her symptoms of burn shock were relieved after fluid resuscitation. However, her bloating was aggravated, and ACS developed on Day 5, manifesting as tachycardia, hypoxemia, shock, and oliguria. Invasive mechanical ventilation, vasopressors, and percutaneous catheter drainage were applied in addition to medical treatments (such as gastrointestinal decompression, diuresis, sedation, and neuromuscular blockade). These treatments did not improve the patient's condition until she received continuous renal replacement therapy. Subsequently, her vital signs and laboratory data improved, which were accompanied by decreased intra-abdominal pressure, and she was discharged after nutrition support, antibiotic therapy, and skin grafting.
Conclusion:
ACS can occur in severely burned children, leading to rapid deterioration of cardiopulmonary function. Patients who fail to respond to conventional medical management should be considered for continuous renal replacement therapy.