OpenMed/multicare-articles huggingface dataset:
PD-1 inhibitor therapy causes multisystem immune adverse reactions: a case report and literature review
Authors: Na Yin, Xiangliang Liu, Xiaojun Ye, Wei Song, Jin Lu, Xiao Chen
Journal: Front Oncol (2022)
Keywords: il-6, immune checkpoint inhibitor, immunotherapy, lung cancer, myocarditis, myositis, thrombocytopenia
MeSH terms: Case Reports

Immune checkpoint inhibitors(ICIs), including cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4), programmed cell death protein 1 and its ligand (PD-1/PD-L1) inhibitors, have been shown to have antitumor activity in various solid tumors. Their mechanism of action is to selectively restore and normalize the body's immune reponses by disrupting the immunosuppressive signals mediated by PD-1, PD-L1 and CTLA-4 in the tumor microenvironment. With the increase in clinical applications of ICIs, reports of immune-related adverse events (irAEs) have also increased. This article reports a case of a lung cancer patient who developed multisystemic adverse effects after PD-1 inhibitor application: myocarditis, myositis and thrombocytopenia, and analyzes the role of Interleukin 6(IL-6)in the management of irAEs. Despite the patient's eventual discontinuation of antitumor therapy due to severe irAEs, a significant and durable therapeutic response was observed.
May-Thurner Syndrome with Large Abdominal Varicosity, Treated Successfully Using Multiple Approaches
Authors: Lori Jia, Jason Alexander, Nedaa Skeik
Journal: Case Rep Vasc Med (2019)
MeSH terms: Case Reports

May-Thurner syndrome (MTS) is a venous outflow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic. Anatomic variations of MTS, while uncommon, have been described. Treatment usually involves endovascular management, including thrombolysis and/or thrombectomy with or without inferior vena cava filter placement, followed by angioplasty and stenting of the left common iliac vein. We report a unique case of a 31-year-old woman who presented with MTS-related deep vein thrombosis accompanied by symptomatic abdominal and pelvic varicosities. The varicosities were treated successfully using multiple procedures, resulting in complete resolution of all symptoms. Our case discusses a treatment approach for an unusual presentation of MTS-related postthrombotic syndrome, and provides a brief literature review of MTS complications and management.
Central and extrapontine myelinolysis affecting the brain and spinal cord. An unusual presentation of pancreatic encephalopathy
Authors: Alejandro Hornik, Federico J Rodriguez Porcel, Caroline Agha, Murray Flaster, Sarkis Morales Vidal, Michael J Schneck, John Lee, José Biller
Journal: Front Neurol (2012)
Keywords: extrapontine myelinolysis, leukoencephalopathy, osmotic myelinolysis, pancreatic encephalopathy, pontine myelinolysis

Pancreatic encephalopathy refers to a gamut of neuropsychiatric symptoms complicating acute pancreatitis. Osmotic myelinolysis is a known complication of pancreatic encephalopathy. We evaluated a 58-year-old woman with pancreatic encephalopathy associated to pontine and extrapontine myelinolysis involving the brain and spinal cord. To our knowledge, this is the first clinic pathological case report of pancreatic encephalopathy involving the spinal cord.
Singleton Merten Syndrome: A Rare Cause of Early Onset Aortic Stenosis
Authors: Harshavardhan Ghadiam, Sudhir Mungee
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Singleton Merten syndrome (SMS) is a rare autosomal dominant genetic disorder with variable expression. Its characteristic features include abnormal aortic calcification, abnormal ossification of extremities, and dental anomalies. We present a young man with dyspnea who was noted to have aortic stenosis in the background of glaucoma, psoriasis, dental anomalies, hand and foot deformities, Achilles tendinitis, osteopenia, and nephrolithiasis. The conglomeration of features led to the diagnosis of SMS. His mother had a very similar phenotype.
Pathological complete response after preoperative chemotherapy including FOLFOX plus bevacizumab for locally advanced rectal cancer: A case report and literature review
Authors: Ryoichi Miyamoto, Kazunori Kikuchi, Atsushi Uchida, Masayoshi Ozawa, Naoki Sano, Sosuke Tadano, Satoshi Inagawa, Tatsuya Oda, Nobuhiro Ohkohchi
Journal: Int J Surg Case Rep (2019)
Keywords: bevacizumab, neoadjuvant chemotherapy, pathological complete response, preoperative chemotherapy, rectal cancer

Background:
In Japan, the significance and efficacy of preoperative chemotherapy alone for locally advanced rectal cancer remain controversial. This case report presents the apparent effectiveness of preoperative FOLFOX plus bevacizumab as shown by pathological complete response (pCR). Additionally, we review the relevant literature and discuss the clinical management of locally advanced rectal cancer with preoperative chemotherapy.
Case presentation:
A 59-year-old male presented with severe constipation, bloody stool and a loss of 10% of his body weight over 3 months. Preoperative examination revealed locally advanced rectal cancer with extensive invasion of the bladder wall and enlarged regional lymph nodes. Thus, this lesion was assigned a preoperative classification of T4bN2bM0 stage IIIC according to the 8th Union for International Cancer Control (UICC) guidelines. Therefore, the patient initially underwent an external loop colostomy of the transverse colon. Next, the patient received chemotherapy including FOLFOX plus bevacizumab. After 12 cycles of chemotherapy, the tumor size was markedly decreased, and all lymph node metastases had disappeared. Therefore, the patient underwent conventional resection of the rectum with D3 lymph node dissection and closure of the colostomy. Histopathological analysis of the resected specimen revealed that all lesions were fibrotic and devoid of any viable cancer cells. Thus, this lesion was assigned a final classification of ypT0N0M0 stage 0.
Conclusions:
We present the rare case of a patient with surgically resected locally advanced rectal cancer who demonstrated an impressive pCR with preoperative chemotherapy, which included FOLFOX plus bevacizumab.
Case Report: Successful Treatment of Acute Generalized Exanthematous Pustulosis With Secukinumab
Authors: Liangliang Zhang, Qiuyun Xu, Tingting Lin, Shifan Ruan, Mengting Lin, Chengbei Bao, Jing Zhang, Tao Liu, Ting Gong, Chao Ji
Journal: Front Med (Lausanne) (2021)
Keywords: agep, biologic, drug eruption, interleukin-17a inhibition, secukinumab
MeSH terms: Case Reports

Acute generalized exanthematous pustulosis is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base. Most cases of acute generalized exanthematous pustulosis (AGEP) clear quickly with a systemic corticosteroid, but severe or recalcitrant cases may need other systemic therapies. In this case, a man in his 40 s with a history of psoriasis consulted a physician about widespread erythema, pustules, target lesions, and fever after the administration of a quadruple antituberculosis drug. Routine laboratory testing revealed elevated white blood cell count and C-reactive protein. The histopathology showed subcorneal pustules, spongiosis as well as lymphocyte and eosinophils infiltration in the dermis. The patient was diagnosed with definitive AGEP according to the diagnostic score from the EuroSCAR study. Cutaneous lesions especially pustules and erythema multiforme-like lesions on the upper arms and palms are crucial for distinguishing AGEP from Generalized pustular psoriasis. The patient was treated with secukinumab as a result of his failure to respond to topical corticosteroids and constrain of systemic steroids. Remission with secukinumab therapy was safe without increased risks of infections. This case indicates that secukinumab is a potential therapy that can rapidly improve the clinical symptoms of AGEP.
Human pythiosis, Brazil
Authors: Sandra de Moraes Gimenes Bosco, Eduardo Bagagli, João Pessoa Araújo Jr, João Manuel Grisi Candeias, Marcello Fabiano de Franco, Mariangela Esther Alencar Marques, Leonel Mendoza, Rosangela Pires de Camargo, Silvio Alencar Marques
Journal: Emerg Infect Dis (2005)
MeSH terms: Infections / microbiology, Pythium / isolation & purification, Case Reports, Research Support, Non-U.S. Gov't, Brazil, Humans, Infections / diagnosis, Infections / pathology, Infections / therapy, Male, Middle Aged

Pythiosis, caused by Pythium insidiosum, occurs in humans and animals and is acquired from aquatic environments that harbor the emerging pathogen. Diagnosis is difficult because clinical and histopathologic features are not pathognomonic. We report the first human case of pythiosis from Brazil, diagnosed by using culture and rDNA sequencing.
A mural nodule of anaplastic carcinoma with sarcomatoid differentiation in a background of ovarian borderline mucinous cystadenoma
Authors: Kasiemobi Eberechukwu Uchime, Oludolapo Andrea Akinjo, Nicholas Awodele Awolola, Ephraim Ohazurike, Adekunbiola Aina Banjo, Igbokwe Uchechi
Journal: Ecancermedicalscience (2023)
Keywords: anaplastic carcinoma, case report, mucinous cystic neoplasms, mural nodules, ovarian tumour, sarcomatoid differentiation
MeSH terms: Case Reports

Ovarian mucinous cystic tumours with mural nodules are rare tumours of the ovary that are often missed out during diagnosis. They are classified under the ovarian mucinous surface epithelial-stromal tumours. These mural nodules can be sarcoma-like (benign), anaplastic carcinoma, sarcomas, or mixed malignant (carcinosarcoma). However, very few cases of anaplastic malignant mural nodules have been reported. Here, we present a case of a borderline ovarian mucinous cystadenoma with anaplastic mural nodule that has sarcomatoid differentiation, in a 39-year-old woman who presented with a 1-year history of progressive abdominal swelling and pain. There were intraoperative findings of huge right ovarian cystic tumour with omental and umbilical deposits. Differential diagnosis of possible germ cell tumours, vascular tumours, melanoma, sarcoma and sarcoma-like nodules were ruled out with routine histology (Haematoxylin & Eosin), histochemical (reticulin) and immunohistochemical stains (CK AE1/3+, CD30+, AFP-, HCG-, EMA-, S100 protein-, CD31-, and CD34-) and the final diagnosis of a mural nodule of anaplastic carcinoma with sarcomatoid differentiation in a borderline ovarian mucinous cystadenoma established. Unfortunately, due to the aggressive nature of the tumour and disease progression, the patient passed on a few months after the surgery. This rare tumour, especially the ones with anaplastic carcinoma or mixed tumours, usually has an aggressive clinical course with most patients presenting late when the disease is advanced with poor clinical outcomes as is seen with the index patient. A high index of suspicion of this tumour with early detection and a multidisciplinary approach to its management is advised.
Case report: Shock after percutaneous vertebroplasty of the 5th thoracic vertebra
Authors: Shenshen Hao, Xin Yu, Laihao Li, Shuai Liu, Hongke Li, Shengli Dong, Xinhao Cao
Journal: Front Surg (2023)
Keywords: case report, osteoporotic vertebral compression fracture, percutaneous vertebroplasty, shock, treatment
MeSH terms: Case Reports

Background:
Percutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fracture (OVCF). Perioperative bleeding is usually rare, so there are few reports of shock. However, we developed shock after treating a case of OVCF of the 5th thoracic vertebra with PVP.
Case presentation:
An 80 years old female patient received PVP due to OVCF of the 5th thoracic vertebra. The operation was successfully completed and the patient returned to the ward safely after the operation. At 90 min after operation, she developed shock, which was induced by subcutaneous hemorrhage up to 1500 ml at the puncture site. Before using vascular embolization, transfusion and blood transfusion were used to maintain blood pressure, and local ice bag compression was used to reduce swelling and stop bleeding, which achieved successful hemostasis. She recovered and discharged after 15 days, with the hematoma having absorbed. There was no recurrence during the 17-month follow-up.
Conclusion:
Although PVP is considered to be a safe and effective method to treat OVCF, the possible hemorrhagic shock still needs to arouse the vigilance of surgeons.
Case report: Low-grade myofibroblastic sarcoma resembling lymphoma on 18F-FDG PET/CT
Authors: Huan Zhang, Liu He, Bin Hu, Xiaoming Zhang, Lichun Zheng
Journal: Front Oncol (2023)
Keywords: fdg, pet/ct, cancer, metastasis, myofibroblastic sarcoma
MeSH terms: Case Reports

Low-grade myofibroblastic sarcoma is a rare malignant tumor that arises from mesenchymal tissue and affects the head (particularly the tongue and oral cavity) and neck. It is characterized by local recurrence, with metastases being uncommon. We present a 72-year-old man who initially complained of a painless and progressive mass in the right inguinal region and came for consultation, and a malignant tumor was suspected based on the clinical and pelvic MRI manifestations. The 18F-FDG PET/CT revealed that the multiple lesions were located in the mediastinum, retroperitoneum, pelvis, and inguinal lymph nodes; hence, lymphoma was considered to be a combination of the symptoms. However, the histology of the ultrasound-guided puncture indicated low-grade myofibroblastic sarcoma. The patient was next administered chemotherapy, but the lesions did not undergo remission.
Biofilm Analysis of Retrieved Dental Implants after Different Peri-Implantitis Treatments
Authors: Thaise C Geremias, Juan F D Montero, Ricardo de Souza Magini, Guenther Schuldt Filho, Edival Barreto de Magalhães Jr, Marco A Bianchini
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

The aim of the current study was to analyse the planktonic growth of Streptococcus mutans on the surfaces of three implants retrieved after three different peri-implantitis treatments. Three implants from a male patient with high levels of bone loss were treated by mechanical debridement, chemical decontamination, and implantoplasty. After 4 months of follow-up, the implants were removed. The growth and biofilm formation were measured by spectrophotometry (OD630 nm) and scanning electron microscopy (SEM), after 48 hours of incubation. Results showed an average of Streptococcus mutans planktonic growth over the implants of 0.21 nm (mechanical debridement), 0.16 nm (chemical decontamination), and 0.15 nm (implantoplasty). Data were analysed by ANOVA and Tukey's test (p < 0.05 for chemical decontamination and implantoplasty). Implantoplasty and chemical decontamination showed the lowest levels of planktonic growth, indicating a possible influence of the modification procedures on the titanium surface on the initial biofilm attachment.
Burkholderia cepacia infection in a non-cystic fibrosis patient: an arcane presentation
Authors: Sufyan Ibrahim, Haritha Madigubba, Himanshu Y N, Kiran Chawla
Journal: Access Microbiol (2021)
Keywords: burkholderia cepacia, copd, acute exacerbation, antibiotic resistance, ceftazidime, cystic fibrosis
MeSH terms: Case Reports

Introduction:

Burkholderia cepacia is an aerobic, Gram-negative bacillus, which exhibits innate resistance to multiple antibiotics and disinfectants. Although it is a chronic colonizer of the respiratory tract, it may rarely present with fatal necrotizing pneumonia-like features in immunosuppressed individuals, as those with chronic granulomatous disease, or patients with significant pulmonary compromise, like cystic fibrosis.
Case presentation:
A 76-year-old male presented with complaints of breathlessness, cough with mucoid expectoration and fever for 3 days. He had a history of coronary artery disease, chronic obstructive pulmonary disease (COPD), diabetes mellitus and hypertension, under treatment. Pulmonary function tests were suggestive of very severe obstruction (FEV1/FVC was 55 %). So, clinical diagnosis of acute exacerbation of COPD was established. Sputum culture grew B. cepacia . The patient was treated with ceftazidime and meropenem along with inhalational bronchodilators and steroids, and showed symptomatic response to therapy.
Conclusion:
There is paucity of the literature describing B. cepacia as a potential cause for acute exacerbations in relatively common clinical conditions, such as COPD. This case report highlights the speculation of this rare possibility, thereby alerting a clinician dealing with such cases.
Cerebral microsporidiosis manifesting as progressive multifocal leukoencephalopathy in an HIV-infected individual - a case report
Authors: Maude Loignon, Louise-Geneviève Labrecque, Céline Bard, Yves Robitaille, Emil Toma
Journal: AIDS Res Ther (2014)
Keywords: cerebral lesions, hiv, microsporidiosis, progressive multifocal leukoencephalopathy

Microsporidia have become increasingly recognized as opportunistic pathogens since the genesis of the AIDS epidemic. The incidence of microsporidiosis has decreased with the advent of combination antiretroviral therapy but it is frequently reported in non-HIV immunosuppressed patients and as a latent infection in immunocompetent individuals. Herein, we describe an HIV-infected male (46 years) with suspected progressive multifocal leukoencephalopathy that has not responded to optimal antiretroviral therapy, steroids, or cidofovir. Post-mortem examination revealed cerebral microsporidiosis. No diagnostic clue however, was found when the patient was alive. This report underscores the need for physicians to consider microsporidiosis (potentially affecting the brain) when no other etiology is established both in HIV, non-HIV immunosuppressed patients and in immunocompetent individuals.
Miliary Tuberculosis Presenting with ARDS and Shock: A Case Report and Challenges in Current Management and Diagnosis
Authors: Keevan Singh, Saara Hyatali, Stanley Giddings, Kevin Singh, Neal Bhagwandass, Neil Bhagwandass
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Miliary tuberculosis, complicated by ARDS and septic shock, is a rare and lethal presentation of this disease. Here we present a case of such a patient, following which we discuss the management of tuberculosis in the ICU and some of the challenges that may be faced. A young HIV negative female presented to us with an acute history of worsening shortness of breath on a background of weight loss, nonproductive cough, and fever. CXR and CT scan showed bilateral miliary type opacities and the patient was admitted to the hospital. Within forty-eight hours of admission she became hypoxemic and was intubated and transferred to the ICU. There she experienced worsening organ dysfunction and developed circulatory shock. Despite escalating doses of noradrenaline, she continued to decline and died before specific anti-TB treatment could be started. Timely diagnosis and treatment initiation are the keys to improving outcomes in critically ill TB patients. However there are many challenges in doing so, especially in a general ICU located in a country with a low TB incidence.
Oral melanoacanthoma of a rare intraoral site: case report and review of literature
Authors: Kshitiz Rohilla, V Ramesh, Pd Balamurali, Namrata Singh
Journal: Int J Clin Pediatr Dent (2013)
Keywords: melanoacanthoma, melanocytes, oral pigmented lesion
MeSH terms: Case Reports

Oral melanoacanthoma is rare pigmented mucosal lesion that presents most commonly on the buccal mucosa, characterized by sudden appearance and rapid radial growth, thus clinically mimicking malignant melanoma. It was originally described as a mixed tumor of melanocytes and keratinocytes, but appears to be a reactive process; formed in areas prone to trauma, and regressing after the removal of trauma or incomplete excision. The clinical appearance of oral melanoacanthoma is nondiagnostic, and biopsy is mandatory to rule out malignancy. We report a case of melanoacanthoma of a rarer oral mucosal site in a 12-year-old Asian male. A brief review of the current literature is also presented. How to cite this article: Rohilla K, Ramesh V, Balamurali PD, Singh N. Oral Melanoacanthoma of a Rare Intraoral Site: Case Report and Review of Literature. Int J Clin Pediatr Dent 2013;6(1):40-43.
Ground-level geriatric falls: a not-so-minor mechanism of injury
Authors: Simon Parker, Arash Afsharpad
Journal: Case Rep Orthop (2014)

Introduction. Ground-level falls are typically regarded as a minor mechanism of injury that do not necessitate trauma team activation; however, they represent a significant proportion of hospitalised trauma and can result in multisystem injury. Case Presentation. A 79-year-old nursing home resident was brought to the emergency department following an unwitnessed fall. She suffered dementia and had a seizure in the department resulting in a reduced GCS, making history and examination difficult. She was diagnosed with a right proximal humerus fracture and admitted under joint orthopedic and medical care. Following orthopedic review, further X-rays were requested which showed bilateral neck of femur fractures. The following day she had bilateral hip hemiarthroplasties and K-wire stabilisation of the right shoulder. Several days later, when cognition had improved, she was noted to be avoiding use of the left arm and was found to also have a left proximal humerus fracture which was managed conservatively. Conclusion. Trauma patients with reduced cognitive function should undergo full ATLS assessment, and a prospective trial is required to see if age should be incorporated as a criteria for trauma team activation. More liberal use of advanced imaging such as a full body CT-scan may be beneficial.
First Schistosomal Cholecystitis Complicated by Cholangitis and Liver Abscess: Case Report and Review of Literature
Authors: Ali Toffaha, Samir Al Hyassat, Walid Elmoghazy, Hatem Khalaf, Ahmed Elaffandi
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Schistosomiasis is one of the most prevalent parasitic infections in the developing world. When it affects the gastrointestinal system specifically the liver, it causes periportal fibrosis followed by cirrhosis. Cholecystitis however is a rare presentation, and associated liver abscess has certainly never been reported to date. We report a case of acute cholecystitis complicated by cholangitis and liver abscess in a 46-year-old man. After complex course of treatment, he had laparoscopic cholecystectomy, and the histology report confirmed schistosomiasis. Gallbladder schistosomiasis is an uncommon disease that is associated with dense fibrotic changes that strongly mimics xanthogranulomatous cholecystitis. Liver abscess may occur during the disease evolution especially in patient originating from endemic backgrounds. We present the case and a comprehensive literature review.
Familial discoid medial meniscus tear in three members of a family: a case report and review of literature
Authors: Raheel Ahmed Ali, Scott McKay
Journal: Case Rep Orthop (2014)

Background. A discoid meniscus is a thickened variant of the normal C-shaped meniscus prone to injury. Discoid medial meniscal tears have rarely been reported within families and may suggest familial or developmental origins. Methods. We report the cases of two Caucasian brothers with symptomatic discoid medial meniscus tears. A literature review was conducted addressing discoid medial meniscus and cases of familial meniscus tears. Case Presentation. Physically active brothers presented with progressively worsening knee pain. MRI revealed medial meniscus tears in both brothers. The family history of medial meniscus tears in their mother and the discoid medial meniscus injuries found on arthroscopy suggested evidence for familial discoid medial meniscus tears. Conclusions. Discoid medial meniscus tears within a family have not been previously reported. Two cases of families with discoid lateral meniscus tears have been reported. Discoid medial meniscus is rare relative to the discoid lateral meniscus and predisposes children to symptomatic tears.