OpenMed/multicare-articles huggingface dataset:
Case Report: Successful Mechanical Thrombectomy in a Newborn With Basilar Artery Occlusion
Authors: Christian Paul Stracke, Lukas Meyer, Wolfram Schwindt, Alexander Ranft, Ronald Straeter
Journal: Front Neurol (2022)
Keywords: basilar, neonatal stroke, newborn, pediatric, stroke, thrombectomy
MeSH terms: Case Reports

Background:
Neonatal stroke remains a rare condition that has not yet been assessed in the field of endovascular treatment.
Case:
We present the first case report of a successful mechanical thrombectomy in a newborn with a basilar occlusion the treatment was 14 hours after birth. Complete reperfusion of the basilar artery was achieved after the two thrombectomy maneuvers with stent retrievers. Imaging follow-up proved patency of the target vessel and at day 30, the patient showed no neurologic deficits.
Conclusions:
Mechanical thrombectomy appears to be technically feasible and can be an individual option in selected cases to treat stroke in neonates with proven persistent proximal cerebral artery occlusion.
Case Report: Leishmania and HIV Co-Diagnosis: How to Understand Medical History?
Authors: Arthur Dujardin, Arnaud de La Blanchardière, Julia Dina, Karl Stefic, Christophe Ravel, Julie Bonhomme, Renaud Verdon, Anna Lucie Fournier
Journal: Front Immunol (2021)
Keywords: hiv, bone marrow aspirate, hemophagocytic lymphohistiocytosis, pancytopenia, visceral leishmaniasis
MeSH terms: Coinfection, HIV Infections / diagnosis, HIV Testing, HIV-1 / pathogenicity, Leishmaniasis, Visceral / diagnosis, Lymphohistiocytosis, Hemophagocytic / diagnosis, Case Reports, Adult, Anti-HIV Agents / therapeutic use, Antiprotozoal Agents / therapeutic use, Bone Marrow Examination, CD4 Lymphocyte Count, HIV Infections / drug therapy, HIV Infections / virology, Humans, Leishmaniasis, Visceral / drug therapy, Leishmaniasis, Visceral / parasitology, Lymphohistiocytosis, Hemophagocytic / drug therapy, Lymphohistiocytosis, Hemophagocytic / parasitology, Male, Predictive Value of Tests, Serologic Tests, Severity of Illness Index, Treatment Outcome, Viral Load, Anti-HIV Agents, Antiprotozoal Agents

We report a case of a severe visceral leishmaniasis revealing an HIV-1 infection presenting as an acute primary infection. A young French man living in Paris with history of unprotected sex with a recent male partner and recent travel in Greece was admitted in our Infectious Diseases Department, presenting with acute febrile psychotic disorder, and positive HIV-1 serology with high viral load, very low CD4+ T-cells count and a western blot pattern suggesting an acute infection. The psychotic disorder was finally related to hemophagocytic lymphohistiocytosis diagnosed on bone marrow aspiration, supposedly secondary to HIV acute primary infection. The progressive worsening of pancytopenia despite antiretroviral treatment and the persistence of fever, chills and sweat led to the diagnosis of visceral leishmaniasis through bone marrow biopsy and leishmanial serology. He was treated with intravenous liposomal amphotericin B with quick improvement. We discuss the way HIV infection and visceral leishmaniasis may have interact to lead to the clinical presentation of our patient.
Uncommon cause of psychotic behavior in a 9-year-old girl: a case report
Authors: Willemina K Van Putten, Said Hachimi-Idrissi, Anna Jansen, Viola Van Gorp, Luc Huyghens
Journal: Case Rep Med (2012)

Anti-N-methyl-D-aspartate receptors encephalitis (ANMDARE) is a well-defined, life threatening, but treatable disorder that often occurs as a paraneoplastic manifestation of ovarian teratomas in adult women. We report a child with this disorder who displayed a subacute onset of delirium, seizures, and autonomic instability. Antibodies against NMDA receptor were detectable in the serum and in the cerebrospinal fluid. No teratoma or other tumour was detected. We speculate that the previous viral/mycoplasma infection may be the trigger of this encephalitis. This patient showed a reversal of the neurological symptoms after intravenous immunoglobulin. Prompt recognition of this disorder followed by immunotherapy results in full neurological recovery.
Cone beam computed topographic evaluation and endodontic management of a rare mandibular first molar with four distal canals
Authors: Nidhi Sinha, Bijay Singh, Akshay Langaliya, Nitin Mirdha, Irfanul Huda, Ashwin Jain
Journal: Case Rep Dent (2014)

Root canal system is complex to understand because of its unpredictable nature. It differs for different teeth and for the same teeth in different individuals. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these variations. A mandibular first molar with six root canals represents a rare anatomical variant, particularly when four canals are found in distal root. This case report discusses successful nonsurgical endodontic management of two-root mandibular first molar with four distal canals and two mesial canals reported for the first time in Indian population. Cone beam computed tomography was used as a diagnostic method to confirm the position and presence of 4 root canals in the distal root.
A rare cause of unilateral hypoglossal nerve palsy: case report of intraneural ganglion cyst of the hypoglossal nerve and review of the literature
Authors: Jeremie D Oliver, Antonio J Forte
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: ganglion cyst, cranial nerve palsy, hypoglossal nerve
MeSH terms: Case Reports

Benign lesions of the soft tissue arising in the periarticular space, such as a ganglion cyst, can cause compression of adjacent nerve fascicles passing in the nearby joint space. Intraneural ganglion cysts involving the cranial nerves are particularly rare, with only a few previous cases reported in the literature.
Mesenteric dermoid cyst in a child
Authors: Damien Punguyire, Kenneth Victor Iserson
Journal: Pan Afr Med J (2011)
Keywords: cyst, dermoid, mesentery, pediatrics, tumor
MeSH terms: Dermoid Cyst / diagnosis, Mesenteric Cyst / diagnosis, Poverty, Case Reports, Child, Preschool, Dermoid Cyst / surgery, Female, Ghana, Hospitals, Rural, Humans, Mesenteric Cyst / surgery, Treatment Outcome

If a pediatric abdominal mass is not organomegaly or colonic stool, narrowing the diagnostic possibilities may be difficult, especially in resource-poor areas where ancillary tests and treatment options may be limited. A 2-year-old girl was brought to the rural Kintampo Municipal Hospital in Ghana with a freely moveable, non-tender abdominal mass. A huge mesenteric dermoid cyst was surgically removed. Mesenteric cysts are rare intra-abdominal lesions, most commonly occurring in children <10 years old. Making a preoperative diagnosis is difficult. Dermoid cysts (mature cystic teratoma) rarely occur in the mesentery. Poverty, family circumstances and the rural location led to general physicians doing surgery. As in this case, due to economic, social and transportation issues common throughout Africa, children with abdominal masses may need at least initial surgery in hospitals without dedicated pediatric surgery or even a trained surgeon.
Fatal lactic acidosis in a kidney transplant recipient on combination antiretroviral therapy after initiation of tacrolimus therapy
Authors: Michael V Holmes, Ranjababu Kulasegaram, Sebastian B Lucas, Terry Wong, Rachel Hilton
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

In general, kidney transplantation is safe and efficacious in patients receiving treatment for HIV. Although multiple drug interactions between antiviral and immunosuppressive treatments exist, few patients experience serious adverse reactions. We report a case of fatal lactic acidosis in a healthy kidney transplant recipient with stable HIV infection who had previously received treatment for and cleared hepatitis C virus infection. Death occurred less than one month following the initiation of tacrolimus therapy. Based on predicted drug interactions, appropriate tacrolimus dosing was calculated prior to its commencement, yet plasma tacrolimus levels were initially unexpectedly high. The patient subsequently developed lactic acidosis and hepatic steatosis, presumably due to mitochondrial toxicity from the antiretroviral regimen on which he had previously been stable. We suspect CYP2C19*2 (poor metaboliser) genotype status and concomitant treatment with lansoprazole, tacrolimus, and antiretroviral (ARV) medications resulted in hepatic decompensation. This highlights the importance of careful interaction screening for all new drugs administered to patients with HIV who have complex treatment regimens as well as heightened clinical vigilance for unexpected toxicities.
Cardiovascular side effects of atomoxetine and its interactions with inhibitors of the cytochrome p450 system
Authors: Pashtoon Murtaza Kasi, Rawad Mounzer, George H Gleeson
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood and adolescence. Classically, stimulants have been used in the treatment of this condition. Atomoxetine (Strattera; Eli Lilly and Company) is a selective norepinephrine reuptake inhibitor (SNRI), one of the first medications in the nonstimulant class of medications that has been approved by the FDA for the treatment of ADHD. Atomoxetine is a phenoxypropylamine derivative and is structurally related to the antidepressant fluoxetine. The common side effects reported with the use of atomoxetine include mainly GI disturbances. Cardiovascular side effects are less commonly reported. The increase in the noradrenergic tone may explain some of the side effects noted with the use of this medication. Here, we present a case of a patient who presented with syncope, orthostatic hypotension, and tachycardia and discuss the various clinical implications based on the pharmacokinetics and pharmacodynamics of the drug.
Monteggia fracture with unreducable anterior dislocation of the radial head and a lesion of the external collateral ligament of the elbow
Authors: Aymen Saidi, Lassaad Hassini, Youcef Othmen, Aymen Fekih, Mohamed Allagui, Issam Aloui, Abderrazek Abid
Journal: Pan Afr Med J (2018)
Keywords: monteggia-fracture, anterior dislocation, unreducable
MeSH terms: Collateral Ligaments / surgery, Elbow Injuries, Fracture Fixation, Internal / methods, Monteggia's Fracture / diagnosis, Case Reports, Adult, Elbow Joint / surgery, Female, Humans, Joint Dislocations / surgery, Monteggia's Fracture / surgery, Range of Motion, Articular, Treatment Outcome

Monteggia described a fracture of the proximal third of the ulna with anterior dislocation of the radial head from both the proximal radioulnar and radiocapitellar joints. The key treatment principle in Monteggia fractures is stable anatomic alignment of the ulna. We present an uncommon case of a Monteggia fracture-dislocation with an unreducable anterior dislocation of the radial head and associated with a lesion of the lateral collateral ligament of the elbow. The patient in our report had a successful clinical outcome and functional range of motion after rigid fixation of the ulnar shaft fracture and exploration of the elbow joint, reduction of the radial head and repair of the lateral collateral ligament. This case is unusual because of the association of a complete tear of the external collateral ligament of the elbow.
Acute Suppurative Thyroiditis in an Intravenous Drug User with a Preexisting Goiter
Authors: Nikhil Yegya-Raman, Tabitha Copeland, Payal Parikh
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Acute suppurative thyroiditis (AST) is an uncommon, potentially life-threatening cause of a rapidly enlarging neck mass. It may present similarly to subacute thyroiditis, a relatively benign and self-limiting condition. We report a case of AST in an adult intravenous (IV) drug user with a preexisting goiter who presented with a left forearm abscess that grew methicillin-sensitive Staphylococcus aureus. In this particular case, clinical suspicion for AST was high. As a result, early IV antibiotic therapy was initiated, and this led to rapid clinical improvement furthermore preventing airway compromise. To our knowledge, this is the first case of AST in the literature resulting from likely hematogenous spread in the setting of IV drug use and a preexisting goiter. Overall, this case highlights the importance of assessing risk factors for AST in patients whose presentations may seem more typical of subacute thyroiditis. Such an approach will lead to timely diagnosis and treatment to avoid potentially devastating consequences.
Cerebral venous sinus thrombosis following ChAdOx1 nCoV-19 AstraZeneca COVID-19 vaccine
Authors: Shyam S Sharma, Giosue Gulli, Pankaj Sharma
Journal: JRSM Cardiovasc Dis (2023)
Keywords: acute stroke syndromes, covid-19, cerebral venous thrombosis, vaccination
MeSH terms: Case Reports

A woman in her mid-twenties was admitted with headache, ultimately leading to a diagnosis of cerebral venous sinus thrombosis 10 days after receiving a first dose of the AstraZeneca ChAdOx1 nCoV-19 vaccine (Vaxzevria). We report this case from clinical investigations to outcomes and discuss the issues raised by it regarding the ChAdOx1 nCoV-19 vaccine.
Burkholderia cenocepacia vaginal infection in patient with smoldering myeloma and chronic hepatitis C
Authors: Andrea Petrucca, Paola Cipriani, Rosa Sessa, Antonella Teggi, Rosalia Pustorino, Daniela Santapaola, Mauro Nicoletti
Journal: Emerg Infect Dis (2004)
MeSH terms: Burkholderia Infections / microbiology, Burkholderia cepacia complex / isolation & purification, Hepatitis C, Chronic / complications, Multiple Myeloma / complications, Vaginosis, Bacterial / microbiology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Anti-Bacterial Agents / therapeutic use, Burkholderia Infections / drug therapy, Burkholderia Infections / etiology, Drug Resistance, Multiple, Bacterial, Female, Humans, Penicillanic Acid / analogs & derivatives, Penicillanic Acid / therapeutic use, Piperacillin / therapeutic use, Piperacillin, Tazobactam Drug Combination, Vaginosis, Bacterial / drug therapy, Anti-Bacterial Agents, Piperacillin, Tazobactam Drug Combination, Penicillanic Acid, Piperacillin

We report a case of a vaginal infection caused by a strain of Burkholderia cenocepacia. The strain was isolated from vaginal swab specimens from a 68-year-old woman with smoldering myeloma and chronic hepatitis C virus infection who was hospitalized for abdominal abscess. Treatment with piperacillin/tazobactam eliminated B. cenocepacia infection and vaginal symptoms.
Myasthenia gravis and stroke in the setting of giant cell arteritis
Authors: Elli-Sophia Tripodaki, Sotirios Kakavas, Ioanna Skrapari, Dimitrios Michas, Giorgios Katsikas, Charikleia Kouvidou, Theodoros Gounaris, Euaggelia Sioula
Journal: Case Rep Rheumatol (2013)

This case report concerns the diagnosis of two independent chronic diseases in a patient hospitalized for stroke, myasthenia gravis (MG) and giant cell arteritis (GCA). MG has been found to be associated with several diseases, but there are very few cases documenting its coexistence with GCA. We report the case of a 79-year-old woman initially hospitalized for stroke. Patient's concurrent symptoms of blepharoptosis, dysphagia, and proximal muscle weakness were strongly suggestive of myasthenia gravis. The persistent low-grade fever and elevated inflammatory markers in combination with the visual deterioration that developed also raised the suspicion of GCA. Histological examination confirmed GCA, while muscle acetylcholine receptor antibodies were also present. Even though in medicine one strives to interpret a patient's symptoms with one diagnosis, when one entity cannot fully interpret the clinical and laboratory findings, clinicians must consider the possibility of a second coexisting illness.
Rapidly Progressive Bladder Cancer Diagnosed because of Spontaneous Bladder Rupture
Authors: Hiroki Hagimoto, Takeshi Sano, Soki Kashima, Takayuki Yoshino, Takayuki Goto, Atsuro Sawada, Shusuke Akamatsu, Toshinari Yamasaki, Masakazu Fujimoto, Yoichiro Kajita, Takashi Kobayashi, Osamu Ogawa
Journal: Case Rep Urol (2022)
MeSH terms: Case Reports

Background:
Spontaneous bladder rupture (SBR) is very rare and can be associated with advanced bladder cancer. Because of its rarity, the optimal management of bladder cancer with SBR has not been established. Herein, we report a case of SBR due to locally advanced bladder cancer, which rapidly invaded the ileum and caused peritoneal dissemination. Case Presentation. An 86-year-old man presented with sudden-onset lower abdominal pain and distension. The patient was diagnosed with bladder perforation and bladder tumor on contrast-enhanced computed tomography (CECT). Transurethral resection of the bladder tumor revealed an invasive urothelial carcinoma with squamous differentiation. Although radical cystectomy with lymph node dissection was planned, preoperative CECT and magnetic resonance imaging revealed enlargement of the bilateral iliac regional lymph nodes, multiple peritoneal nodules, and invasion of the bladder tumor to the ileocecum. Therefore, cystectomy and resection of ileocecum with palliative intent and bilateral cutaneous ureterostomy were performed. However, the patient's general condition rapidly worsened after surgery, and he died 74 days after the initial diagnosis.
Conclusions:
We encountered a case of SBR accompanied by bladder cancer with extremely rapid progression, which suggested the importance of short-interval repeat imaging examinations. Emergency surgery should be considered when bladder cancer is suspected in patients with SBR so as not to miss the window period of a possible cure.
Reviewing the Emergence of Lactococcus garvieae: A Case of Catheter Associated Urinary Tract Infection Caused by Lactococcus garvieae and Escherichia coli Coinfection
Authors: Tatvam T Choksi, Farhan Dadani
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Lactococcus garvieae is considered a low virulence organism which is rarely associated with human infections. Most of the reported cases have been associated with bacteremia with or without endocarditis. We report a rare case of catheter associated urinary tract infection (CAUTI) caused by Lactococcus garvieae and Escherichia coli coinfection without any bacteremia in a patient with indwelling urinary catheter placed for benign prostatic hyperplasia (BPH). The patient also had a history of gastroesophageal reflux disease (GERD) with long standing famotidine treatment. In our case, Lactococcus garvieae was initially misidentified as Enterococcus species but was later detected by automated microbial identification system VITEK-2 (BioMerieux, Marcy-l'Étoile, France) and was confirmed with API 32 Strep system (BioMerieux, Marcy-l'Étoile, France). The patient responded well to a two-week course of cephalosporin. Interestingly, apart from the acid suppressive treatment, no other risk factors were identified.
Using d-dimer to diagnose painless acute aortic dissection: a case report
Authors: Caroline Barniol, Baptiste Vallé, Emilie Dehours, Sandrine Charpentier, Vincent Bounes, Dominique Lauque
Journal: Case Rep Emerg Med (2011)
MeSH terms: Case Reports

Introduction. Aortic dissection is a cardiovascular emergency; the most frequent symptom is chest pain, but clinical presentation can be varied and atypical. Case Presentation. We report the case of a 66-year-old Caucasian male who presented a syncope immediately followed by a left-arm weakness while driving his car. Clinical examination was normal, but bilateral jugular vein distension was noted. Electrocardiogram and chest radiography were unremarkable. Among blood tests performed, troponin I test result was negative, and D-dimer test concentration was >4000 ng/mL. Since D-dimer test result was positive, chest computer tomography angiogram was performed and found a thoracic aortic dissection. Conclusion. Our case report shows that acute aortic dissection diagnosis is difficult and must be associated with the interpretation of various clinical signs and D-dimer measurement. It could be helpful for the emergency physician to have a pretest probability D-dimer like in pulmonary embolism diagnosis.
Gastric and Rectal Metastases from Malignant Melanoma Presenting with Hypochromic Anemia and Treated with Immunotherapy
Authors: Pietro Genova, Maria Sorce, Daniela Cabibi, Gaspare Genova, Vittorio Gebbia, Daniele Galanti, Daniela Galanti, Chiara Ancona, Maria Rosaria Valerio
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

The authors present a case of an 80-year-old Caucasian male with multiple gastric and rectal metastases from malignant melanoma presenting with hypochromic anemia as the sole symptom of disease without evidence of cutaneous and ocular tumor localization. The patient had a medical history positive for malignant lentigo melanoma of the occipital region of the scalp and early stage laryngeal squamous cell carcinoma and prostatic carcinoma treated with radiation therapy. The authors make some considerations on intestinal involvement by metastatic melanoma and discuss the choice of not treating with endoscopic procedures the gastric metastatic lesions most likely responsible for the clinical sign present at diagnosis. The patient was referred to clinical oncologists and received immunotherapy with ipilimumab and pembrolizumab.
Runaway Train: A Leaky Radiosensitive SCID with Skin Lesions and Multiple Lymphomas
Authors: Børre Fevang, Unn Merete Fagerli, Hanne Sorte, Harald Aarset, Håkon Hov, Marit Langmyr, Thomas Morten Keil, Ellen Bjørge, Pål Aukrust, Asbjørg Stray-Pedersen, Tobias Gedde-Dahl
Journal: Case Reports Immunol (2018)
MeSH terms: Case Reports

The nuclease Artemis is essential for the development of T-cell and B-cell receptors and repair of DNA double-strand breaks, and a loss of expression or function will lead to a radiosensitive severe combined immunodeficiency with no functional T-cells or B-cells (T-B-SCID). Hypomorphic mutations in the Artemis gene can lead to a functional, but reduced, T-cell and B-cell repertoire with a more indolent clinical course called "leaky" SCID. Here, we present the case of a young man who had increasingly aggressive lymphoproliferative skin lesions from 2 years of age which developed into multiple EBV+ B-cell lymphomas, where a hypomorphic mutation in the Artemis gene was found in a diagnostic race against time using whole exome sequencing. The patient was given a haploidentical stem cell transplant while in remission for his lymphomas and although the initial course was successful, he succumbed to a serious Pneumocystis jirovecii pneumonia 5 months after the transplant. The case underscores the importance of next-generation sequencing in the diagnosis of patients with suspected severe immunodeficiency.