OpenMed/multicare-articles huggingface dataset:
Delayed Medical Care Following an Alligator Bite: A Case Report and Literature Review
Authors: Roksana Hesari, Thaddeus Chuchla, Angelica R Carnemolla, Nicholas Tyndall, Randy Scott
Journal: Cureus (2024)
Keywords: alligator bite, animal-inflicted injuries, case report, literature review, reptile bites, wildlife-related injuries
MeSH terms: Case Reports

Alligator bites in humans present a significant concern for public safety in the southern United States, especially in states like Florida with substantial alligator populations. Although these reptiles play a vital role in the local ecology, encounters with humans can lead to severe injuries and even fatalities. A case report is presented of a 58-year-old male who suffered an alligator bite while attempting to take a selfie with the reptile during a hunting trip in rural Florida. The patient's injuries included multiple lacerations on the dorsum of his right hand. Despite the incident, the patient hesitated in seeking medical attention due to a lack of insurance, emphasizing the need for public awareness of alligator bite management. The discussion highlights the potential complications of alligator bites, including hemorrhage and infection, as well as the importance of appropriate medical treatment, including wound irrigation, debridement, and antibiotic therapy. Moreover, preventive strategies are discussed, such as maintaining a safe distance from alligators and refraining from feeding them, to ensure coexistence between humans and these reptiles in their natural habitats. As knowledge of alligator bites remains limited, this case report contributes valuable information to promote public safety and guide future research in this area.
Overlap syndrome of seronegative primary biliary cholangitis and small duct primary sclerosing cholangitis: a first case report and literature review
Authors: Salma Souissi, Sarah Laabidi, Nadia Ben Mustpha, Ines Chelly, Meriem Serghini, Monia Fekih, Asma Laabidi, Jalel Boubaker
Journal: Future Sci OA (2024)
Keywords: overlap syndrome, primary biliary cholangitis, primary sclerosing cholangitis
MeSH terms: Case Reports

Primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH) are distinct liver diseases. Cases combining PBC and PSC, are extremely rare. Here, we present a case of a 39-year-old woman with a history of colonic Crohn's disease treated with azathioprine. Discontinuation of the medication was prompted by abnormal liver function tests, but subsequent evaluations revealed persistent liver injury. Extensive diagnostic investigations, including imaging, serological tests, and liver biopsy, were conducted leading to a diagnosis of PBC-PSC overlap syndrome based on the presence of concentric lamellar fibrosis and chronic non-suppurative destructive cholangitis. The patient responded well to ursodeoxycholic acid treatment. This case emphasizes the importance of recognizing and diagnosing rare overlap syndromes, particularly those involving PBC and PSC, to ensure appropriate management and improve patient outcomes.
Favorable response to surufatinib in a patient with necrolytic migratory erythema: A case report
Authors: Zhongan Liu, Feng Hu, Shuang Guo, Peng Zhang, Guiling Li, You Qin
Journal: Open Life Sci (2023)
Keywords: necrolytic migratory erythema, pancreatic neuroendocrine tumors, surufatinib
MeSH terms: Case Reports

Necrolytic migratory erythema (NME) is usually associated with paraneoplastic syndrome caused by functional pancreatic neuroendocrine tumor (PNET). Accurate diagnosis and effective treatment of NET-related NME is challenging due to its rarity and lack of typical clinical symptoms and specific pathological manifestations. Here we report a rare case of PNET with NME as the initial manifestation. 68Ga-DOTA-TATE PET/MR was used to detect the primary pancreatic and metastatic liver tumors. Finally, the patient was diagnosed as PNET via liver biopsy. After four cycles of standard capecitabine plus temozolomide chemotherapy combined with long-acting octreotide, the patient's skin lesions on both lower extremities improved only slightly, while tumors remained stable and unchanged in size. Then the patient was treated with surufatinib. Two months later, the skin lesions healed completely, and tumors responded significantly. This rare case suggests that surufatinib may be a promising therapy for patients with PNET-associated NME.
Paraganglioma of the Neck: A Rare Case With Spinal Metastasis
Authors: Sean McCormack, Eyad Hamad, Amar Hamad
Journal: Case Rep Oncol Med (2024)
Keywords: carotid body paraganglioma, diagnostic imaging, extra-adrenal paraganglioma, multidisciplinary approach, neuroendocrine tumor, nonfunctional paraganglioma, oncology, paraganglioma, radiology
MeSH terms: Case Reports

Paragangliomas are rare neuroendocrine tumors that arise from the paraganglia, which are clusters of neuroendocrine cells associated with the autonomic nervous system. These tumors are commonly found in the adrenal medulla but can also occur in other locations outside the adrenal gland. Here, we present a case report of a slow-growing paraganglioma in the left neck with spinal metastasis in a 60-year-old man. This case highlights the importance of considering paraganglion tumors in the differential diagnosis of neck masses and the need for early diagnosis and management to prevent potential complications. Importantly, both the clinical picture and anatomical location of these tumors is important when determining treatment plans.
Rosai-Dorfman disease of the oral cavity
Authors: Abir Charfeddine, Mounir Omami, Marwa Garma, Ahlem Bellalah, Sameh Sioud, Jamil Selmi
Journal: Autops Case Rep (2023)
Keywords: emperipolesis, histiocytosis, sinus, lymph nodes, maxilla
MeSH terms: Case Reports

First described by J Rosai and R F Dorfman in 1969, Rosai-Dorfman disease (RDD) is a benign, self-limiting histiocytosis of unknown etiology. It is usually seen in the first two decades of life. The most frequent clinical presentation is painless, bilateral cervical lymphadenopathy accompanied by fever, weight loss, and an elevated ESR. However, RDD without nodal involvement is extremely rare, and the most common extranodal location is the head and neck region, mainly affecting the nasal cavity, pharynx, and paranasal sinuses. Oral location of RDD is occasional; according to our knowledge, only 17 cases of oral Rosai-Dorfman disease without lymph node involvement have been found in the literature. Because of the rarity of these isolated oral presentations, the clinical and radiological aspects need to be more studied. This article aims to present a rare case of oral Rosai-Dorfman disease without nodal involvement, detail the clinical and radiological signs, and the treatment strategy used in our patient.
Case Report: Colon malignant tumor caused by retroperitoneal small round cell undifferentiated sarcoma
Authors: Yuqin Wei, Zhiyong Zhang, Chenyan Long, Xiaoliang Huang, Weizhong Tang, Xianwei Mo, Jungang Liu
Journal: Front Oncol (2023)
Keywords: case report, colon malignant tumor, diagnosis, retroperitoneal, small round cell undifferentiated sarcoma, therapy
MeSH terms: Case Reports

Small round cell undifferentiated sarcoma is a rare and highly invasive group of malignant bone and soft tissue tumors, often associated with a high misdiagnosis rate. The patient in this case was a 34-year-old male who presented with a two-month history of abdominal pain that worsened over the past two weeks. Elevated levels of tumor markers CA19-9 and CA72-4 were observed. Imaging revealed a substantial, well-vascularized mass in the lower left abdomen, located in the posterior abdominal cavity, invading the descending colon and the root of the small mesentery, and infiltrating the serous layer. The lesion was extensively resected without any postoperative complications. Microscopic examination indicated a combination of mucinous adenocarcinoma (approximately 30%) and small round cell undifferentiated sarcoma (approximately 70%). The patient was followed up for six months, and one month after surgery, a recurrence of the tumor was observed in the left paracolonic sulcus area, with metastases to the abdominal wall, peritoneum, and medial iliac muscles. Chemotherapy and targeted therapy were administered, and the patient currently survives with the presence of tumors. Small round cell undifferentiated sarcoma is an uncommon and highly invasive tumor, and clinical surgeons need to raise their awareness and realize to the maximum extent possible that this disease can be described through a multi-modal combination of immunohistochemistry and genetic test to improve diagnostic accuracy and reduce missed diagnoses. Further research in the field of biology is necessary to explore targeted drugs specifically suitable for this disease.
Anti-SRP immune-mediated necrotizing myopathy responsive to ofatumumab: a case report
Authors: Sihui Chen, Jing Yang, Du He, Jiajia Fu, Xiaohui Lai, Bi Zhao, Xueping Chen, Huifang Shang
Journal: Front Immunol (2023)
Keywords: ofa, anti-srp, case report, immune-mediated necrotizing myopathy, ofatumumab
MeSH terms: Autoimmune Diseases, Muscular Diseases / diagnosis, Myositis / diagnosis, Myositis / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Autoantibodies, Female, Humans, Middle Aged, Signal Recognition Particle, ofatumumab, Signal Recognition Particle, Autoantibodies

Background:
Immune-mediated necrotizing myopathies (IMNM) is a rare disease that was first described in 2004. Due to the lack of large case series, there are no formal treatment recommendations for IMNM.
Methods:
We presented a case of a 47-year-old woman who experienced progressive limb weakness, starting from the lower limbs and gradually affecting the upper limbs. She also reported experiencing dyspnea after engaging in daily activities. When she was admitted to the hospital, her upper limbs were almost unable to move and she could not stand even with support. Her Creatine kinase (CK) level significantly increased (> 3500 u/l). Electromyography showed myogenic damage, anti-Signal recognition particle (anti-SRP) and anti-Ro52 antibodies were highly positive. Pathological biopsy of the right biceps muscle showed necrotizing myopathy in the skeletal muscle. She was ultimately diagnosed with anti-SRP IMNN, and was given monotherapy with methylprednisolone and combination therapy with immunoglobulin, but her symptoms continued to worsen. The patient refused to bear the possible further liver dysfunction and blood system damage caused by Cyclophosphamide and Rituximab, and she chose to try to use Ofatumumab (OFA).
Results:
After receiving three doses of OFA treatment without any adverse reactions, she reported that her muscle strength had basically recovered and she was able to walk independently. The B cells in the circulatory system have been depleted, and blood markers such as liver function have consistently remained within normal range. During the follow up, her activity tolerance continued to improve.
Discussion:
We have presented a severe case of SRP-IMNM in which the patient showed poor response to conventional immunotherapy. However, rapid symptom relief was achieved with early sequential use of OFA treatment. This provides a new option for the treatment of SRP-IMNM, and more large-scale studies will be needed in the future to verify our results.
Adrenaline, Takotsubo, Anaphylaxis, and Kounis Syndrome (ATAK) Complex Unveiled: Integrating Takotsubo and Kounis Syndromes in the Context of Chemotherapy-Related Anaphylaxis
Authors: Piyush Puri, Meet Popatbhai Kachhadia, Princy Sardana, Ridhi Bhagat, Sammir S Dekowski, Emmanuel Fohle
Journal: Cureus (2024)
Keywords: allergic angina, allergy, atak syndrome, coronary hypersensitivity disorder, kounis case study, st elevation mi
MeSH terms: Case Reports

The convergence of takotsubo and Kounis syndromes, collectively referred to as the "ATAK complex" (short for adrenaline, takotsubo, anaphylaxis, and Kounis syndrome), poses a unique and challenging clinical scenario, especially in the context of chemotherapy-related anaphylaxis. We present a case report involving a 63-year-old woman undergoing chemotherapy for endometrial adenocarcinoma who experienced anaphylactic symptoms during treatment. Immediate administration of epinephrine was followed by the emergence of ST elevation, a reduced left ventricular ejection fraction, and wall motion abnormalities indicative of stress-induced cardiomyopathy. Detailed investigations revealed normal coronary arteries, prompting further exploration into the intricacies of the ATAK complex. Notably, the administration of intravenous rather than intramuscular epinephrine was identified as a contributing factor. This case underscores the critical importance of recognizing and managing the ATAK complex promptly, emphasizing the need for refined diagnostic and treatment guidelines. The interplay between adrenaline, takotsubo, anaphylaxis, and Kounis syndrome necessitates a nuanced approach, urging healthcare professionals to exercise caution and adhere to recommended administration routes. Increased awareness of the ATAK complex is imperative for optimizing patient outcomes and guiding therapeutic interventions in similar clinical scenarios. Further research is warranted to elucidate the underlying mechanisms and refine strategies for the effective management of this intricate syndrome.
Expansive Central Ossifying Fibroma of the Right Mandible
Authors: Kelsey Carey, Robert Koenigsberg, Riya Kuklani, Paul Deitrick
Journal: Cureus (2024)
Keywords: benign bone neoplasm, facial mass, neoplasm, ossifying fibroma, periodontal membrane
MeSH terms: Case Reports

This case report discusses a 28-year-old patient who presented with a large expansile lesion of the right mandible. A maxillofacial CT showed a 6.7 x 9.1 x 7.6 cm right mandibular cystic mass containing an internal matrix of ground glass bone, representing a huge odontogenic keratocyte. Upon biopsy of the lesion, the specimen consisted of non-decalcified irregular fragments of cemento-osseous material, embedded in a minimally hemorrhagic, cellular fibrous tissue stroma, suggestive of central ossifying fibroma. This case presents an ossifying fibroma that far exceeds the average size of these masses, which typically range from 1.0 to 2.5 cm at its greatest dimension. The immense size of the lesion seen in this case is rarely encountered. This case also helps to emphasize the importance of timely diagnosis and complete resection of the lesion to prevent mass recurrence and possible malignant transformation.
A Rare Case of Lipomatous Variant Mammary-Type Myofibroblastoma of the Lateral Tongue
Authors: Matthew Spalti, Firoozeh Samim, Livia Florianova
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Mammary-type myofibroblastoma (MTMF) is an unusual and rare benign tumor that typically presents in older men or post-menopausal females. A 53-year-old female presented with a 6-month history of an asymptomatic pink/white submucosal nodule involving the left lateral tongue. Clinical examination showed a 5 mm × 5 mm × 5 mm firm submucosal nodule with intact overlying mucosa. Differential diagnoses focused on benign nodular connective tissue tumors. An excisional biopsy was performed and submitted for histopathological examination. The patient underwent conservative local excision. Histopathology and immunocytochemistry revealed a lipomatous variant of MTMF. Hematoxylin and eosin sections revealed an unencapsulated soft tissue lesion with a lobular growth pattern. The neoplasm was biphasic, comprising adipose tissue and cellular fibrous components. By immunohistochemistry, tumor cells were positive for desmin, estrogen receptor, and CD34. In summary, we presented an unusual case of a lipomatous variant of myofibroblastoma on the tongue. MTMF rarely occurs in the head and neck and its accurate diagnosis necessitates awareness of its histomorphological spectrum and application of appropriate immunohistochemical stains.
Case report: Exploring chemoradiotherapy-induced leukoencephalopathy with 7T imaging and quantitative susceptibility mapping
Authors: Gaetano Celardo, Elena Scaffei, Bianca Buchignani, Graziella Donatelli, Mauro Costagli, Paola Cristofani, Raffaello Canapicchi, Rosa Pasquariello, Michela Tosetti, Roberta Battini, Laura Biagi
Journal: Front Neurol (2024)
Keywords: 7 tesla, brain damage, chemoradiotherapy, leukoencephalopathy, neurotoxicity, ultra-high field mri
MeSH terms: Case Reports

Chemotherapy and radiotherapy are widely used in the treatment of central nervous system tumors and acute lymphocytic leukemia even in the pediatric population. However, such treatments run the risk of a broad spectrum of cognitive and neurological deficits. Even though the correlation with cognitive decline is still not clear, neuroradiological defects linked to white matter injury and vasculopathies may be identified. Thanks to the use of 7T MRI it is possible to better define the vascular pattern of the brain lesions with the added advantage of identifying their characteristics and anatomical localization, which, however, are not evident with a conventional brain scan. Moreover, the use of Quantitative Susceptibility Mapping (QSM) makes it possible to discriminate between calcium deposits on vessels (chemo-radiation-induced) and hemoglobin deposition in radio-induced cavernomas, speculating, as a result, about the pathophysiology of iatrogenic brain damage. We describe the case of a 9 year-old boy with a T-type acute lymphoid leukemia who had previously been treated with polychemotherapy and high-dose RT. To better define the child's neuroradiological pattern, 7T MRI and QSM were performed in addition to conventional imaging examinations. Our case report suggests the potential usefulness of a QSM study to distinguish radio-induced vascular malformations from mineralizing microangiopathy.
New-Onset Monosomy 7-Induced Pancytopenia in a 66-Year-Old Woman
Authors: Jordan M Brock, Colten Dillinger, David Covey, Jayton A Lim, David E Martin
Journal: Cureus (2024)
Keywords: acute myeloid leukemia (aml), bone marrow biopsy (bmb), monosomy 7, myelodysplastic syndrome (mds), severe pancytopenia
MeSH terms: Case Reports

Myelodysplastic syndrome (MDS) is characterized by failure to initiate hematopoiesis or impaired maturation of cells, often presenting with pancytopenias with or without associated fatigue, infections, or inappropriate bleeding and bruising. Karyotype analyses of MDS patients commonly show deletion of the q arm of chromosome 7, suggesting loss of this region is likely implicated in the insufficient hematopoiesis seen in MDS. The predisposition to deletion of 7q is commonly inherited, with clinical presentation in early childhood associated with pancytopenia or hematological malignancy. In this case, we present a 66-year-old female who was incidentally found to be pancytopenic in the emergency department while being evaluated for dyspnea, with a bone marrow biopsy later confirming a diagnosis of MDS with monosomy 7. Sporadic loss of 7q can occur at any stage in life without any family history of hematological disease. Our patient has no known personal or family history of MDS, with normal blood counts during hospitalization three years prior, suggesting de novo loss of 7q occurring at greater than 60 years of age.
How to treat major depressive disorder with shorter-duration hypomanic episodes? A case report
Authors: Jiashu Yao, Shenpang Wang, Yifei Li, Jiating Xu, Ruihuan Ye, Yuedi Shen, Wei Chen, Ning Dai
Journal: Front Psychiatry (2024)
Keywords: covid-19, bipolar spectrum disorder, major depressive disorder with shorter-duration hypomanic episodes, subthreshold bipolar disorder, treatment
MeSH terms: Case Reports

Here we report on a case of a 61-year-old female patient with 7-year history of major depressive disorder with shorter-duration hypomanic episodes who was prescribed with antidepressants which turned out to be ineffective. After a COVID-19 infection, the patient's clinical presentation became sufficient for the diagnosis of bipolar disorder and she was consistently effective on a mood stabilizer and an atypical antipsychotic. The course of treatment in this case suggests bipolar disorder is not a binary disorder, but a continuous spectrum disorder. For patients suffering from major depressive disorder with shorter-duration hypomanic episodes, mood stabilizers and atypical antipsychotics are possibly more suitable than antidepressants.
Perphenazine in Treatment-Resistant Schizophrenia
Authors: Michael R Hower, Surya Kumar Karlapati, Anil K Bachu
Journal: Cureus (2024)
Keywords: antipsychotic management, aripiprazole, haloperidol, inpatient psychiatry services, paliperidone, perphenazine, psychosis, recurrent psychosis, risperidone, schizophrenia
MeSH terms: Case Reports

Antipsychotics are considered a gold standard treatment for schizophrenia. However, there is considerable variation in antipsychotic medication choice. Factors considered involved include symptomatology, prior response, and adverse reactions. This case report presents a 38-year-old male patient with schizophrenia in acute psychosis refractory to several antipsychotics. Hypotheses for the mechanism of action of antipsychotics and psychopharmacology are discussed, and treatment resistance is defined. The patient's psychiatric, medical, and social history and past antipsychotic medications are reviewed. Afterward, the rationale for initiating perphenazine is discussed, and the patient's improvement with this medication is examined. Current literature on perphenazine's efficacy is also reviewed and discussed alongside its limitations.
Thoracic endovascular aortic repair under venoarterial extracorporeal membrane oxygenation for acute aortic dissection patients: a case report
Authors: Leilei Zhu, Pingping Dong, Liwen Du, Kai Xun, Peng Liu, Xiaozhen Lu, Yongwei Shi
Journal: Front Cardiovasc Med (2023)
Keywords: v-a ecmo, aortic dissection, case report, thoracic endovascular aortic repair, type a aortic dissection
MeSH terms: Case Reports

Background:
Open repair and replacement of the diseased aorta is still the standard treatment for type A aortic dissection (TAAD) in most patients. In endovascular treatment alone, ensuring adequate blood supply to the brain while covering the dissection with a stent is difficult.
Case presentation:
This study includes a 71-year-old male patient with type A aortic dissection presented at a recent follow-up examination after having undergone thoracic endovascular aortic repair (TEVAR) plus left subclavian artery chimney stent reconstruction for descending aortic dissection 5 years ago. Preoperative computed tomographic angiography, computed tomographic perfusion, and transcranial Doppler showed an intact cerebral arterial ring and good collateral circulation. We successfully performed an endovascular repair of the thoracic aorta with venoarterial extracorporeal membrane oxygenation (V-A ECMO) to protect the craniocerebral blood supply, greatly increase the safety of the operation, and ensure a good prognosis.
Conclusion:
TEVAR under V-A ECMO protection is beneficial for patients with TAAD because of its minimal trauma, rapid recovery, few complications, and low mortality.