OpenMed/multicare-articles huggingface dataset:
Case report: Atypical and chronic masticatory muscle myositis in a 5-month old Cavalier King Charles Spaniel. Clinical and diagnostic findings, treatment and successful outcome
Authors: Martin Di Tosto, Carolina Callegari, Kaspar Matiasek, Giuseppe Lacava, Giovanna Salvatore, Sara Muñoz Declara, Barbara Betti, Federica Tirrito
Journal: Front Vet Sci (2022)
Keywords: ckcs, ct, mri, dog, masticatory muscle myositis
MeSH terms: Case Reports

Masticatory muscle myositis (MMM) is the second most common inflammatory myopathy diagnosed in dogs, but it is rarely described in puppies. The disease is characterized by the production of autoantibodies against 2M myofibers contained in masticatory muscle, although the cause of this production is still unclear. The aim of the present case report was to describe the clinical presentation, diagnostic findings, treatment, and follow-up of an atypical case of chronic masticatory muscle myositis in a very young dog. A 5-month old Cavalier king Charles Spaniel (CKCS) was presented to the AniCura Istituto Veterinario Novara with a two weeks, progressive history of lethargy and difficulty in food prehension. Neurological examination revealed bilateral masticatory muscle atrophy, mandibular ptosis with the jaw kept open, inability to close the mouth without manual assistance, jaw pain, and bilateral reduction of palpebral reflex and menace reaction; vision was maintained. A myopathy was suspected. Computed tomography (CT), magnetic resonance imaging (MRI), enzyme-linked immunosorbent assay test for 2M antibodies, and histopathological examination of masticatory muscle biopsy confirmed the diagnosis of MMM. Glucocorticoids treatment was started and clinical signs promptly improved. To the authors' knowledge, this is the first case describing mandibular ptosis in a dog affected by chronic MMM, successfully managed with medical treatment and the first report describing the CT and MRI findings in a young CKCS affected by MMM.
Treatment with rituximab and brentuximab vedotin in a patient of common variable immune deficiency-associated classic Hodgkin lymphoma
Authors: Efren Rael, Kevin Rakszawski, Kristian Koller, Michael Bayerl, Manish Butte, Hong Zheng
Journal: Biomark Res (2016)
Keywords: brentuximab, cvid, hodgkin lymphoma, rituximab
MeSH terms: Case Reports

Background:
Patients with common variable immunodeficiency (CVID) have an increased risk of developing lymphoproliferative diseases, including non-Hodgkins lymphoma (Blood 116:1228-1234, 2010; Blood 119:1650-7, 2012). The incidence and prognosis of Hodgkin lymphoma in this population is not clear, with only a few case reports in the literature. Conventional cytotoxic chemotherapy, although highly efficacious in treating Hodgkin lymphoma in immune competent patients, is problematic in patients with CVID due to the increased risk of infectious complications (Ther Umsch 69:687-91, 2012; Pediatr Hematol Oncol 24:337-42, 2012). Rituximab and brentuximab vedotin are both targeted agents used to treat lymphomas that express CD20 and CD30, respectively. Compared to cytotoxic chemotherapy typically used in Hodgkin lymphoma, these agents are better tolerated with minimal side effects. This makes them an attractive option for treating lymphoma in patients who have significant co-morbidities, including those with immune deficiencies. Additionally, rituximab has been used safely to treat autoimmune cytopenias in patients with CVID5. However, the role of these targeted therapies in CVID-associated Hodgkin lymphoma has not been reported.
Case presentation:
Here we report the case of a 25 year old female diagnosed with CVID-associated classic Hodgkin lymphoma, who achieved a complete remission following treatment with rituximab followed by brentuximab vedotin.
Conclusions:
We demonstrate that rituximab and brentuximab are likely safe and effective in CVID-associated Hodgkin lymphoma, providing a feasible and potentially optimal treatment option for this patient population.
Coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site in a HIV-AIDS patient: A very rare occurrence
Authors: Kabir Abdullahi, Yahaya Mohammed, Saddiku A Sahabi, Mahmood M Dalhat
Journal: Afr J Lab Med (2019)
Keywords: aids, hiv, kaposi sarcoma, molluscum contagiosum
MeSH terms: Case Reports

Introduction:
There have been numerous reported opportunistic infections among HIV/AIDS patients. However, coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site is a rare finding.
Case presentation:
A 37-year-old man poorly adherent to antiretroviral therapy presented with Molluscum contagiosum and Kaposi sarcoma occurring simultaneously on numerous skin lesions around mid-2017 at Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria.
Management and outcome:
The patient was counselled and re-initiated on a second-line highly active antiretroviral therapy regimen. The patient's lesions resolved three months later.
Discussion:
The case is presented to improve the index of suspicion among clinicians and pathologists on such rare occurrences.
Case Report and Literature Review of a Pathologic Mandibular Fracture from Metastatic Esophageal Adenocarcinoma
Authors: Daniel C O'Brien, Garrett Jones, Maggie Yell, Jason McChesney
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Distant metastasis to the jaws, including the maxilla or mandible, is very rare. Although the mandible is the preferred sight of these rare metastases, it is extremely rare for oral cavity malignancies to present as pathological mandibular fractures. Here, we present a case of esophageal adenocarcinoma metastasizing to the mandible, and the first reported case presenting with a pathological mandibular fracture secondary to esophageal adenocarcinoma. We also review the 9 other reported cases of metastatic esophageal adenocarcinoma to either the maxilla or mandible.
Case report: Documentation of cutaneous only pemphigus vulgaris without history of mucosal lesions in North America
Authors: John Baker, Kristina Seiffert-Sinha, Animesh A Sinha
Journal: Front Immunol (2022)
Keywords: north america, autoantibody, cutaneous, mucosal, pemphigus vulgaris
MeSH terms: Autoimmune Diseases, Pemphigus, Case Reports, Research Support, Non-U.S. Gov't, Autoantibodies, Documentation, Humans, Skin / pathology, Autoantibodies

Background:
Pemphigus is a group of autoimmune blistering diseases including Pemphigus vulgaris (PV) and Pemphigus foliaceus (PF). These conditions exhibit lesions with mucosal or mucocutaneous (PV) or cutaneous (PF) morphology, as framed by the Desmoglein Compensation Hypothesis (DCH). However, some PV patients present with solely cutaneous disease (cPV), and growing evidence suggests the existence of a cPV subtype without any history of mucosal erosions/blisters (cPVwohm), neither of which are predicted by the DCH.
Methods:
Participants were recruited from several outpatient clinical settings and patient support group meetings throughout the US. On intake, subjects provided blood samples and completed questionnaires regarding their disease status.
Results:
We report three cases of clinically and histologically confirmed cPV without history of mucosal lesions (cPVwohm). Of these patients, two do not carry the most common PV associated HLA alleles, DRB1*0402 or DQB1*0503. The same two patients also tested negative for the primary PV associated autoantibodies, anti-desmoglein 3 and anti-desmoglein 1, while in active disease status.
Conclusion:
We confirm the first documented individual cases of cPVwohm in North America, supporting the existence of PV patients that develop cutaneous disease without a history of mucosal lesions, challenging the fidelity of the DCH. Two of the 3 patients reported did not type for the common PV-associated HLA genes or display anti-desmoglein autoantibodies while in active disease, suggesting cPV patients may develop Pemphigus via genetic and immune mechanisms that differ from typical mucosal or mucocutaneous PV.
Case Report: Successful revascularization in massive pulmonary embolism with a large protruding thrombus and dilated cardiomyopathy
Authors: Hendri Susilo, Rerdin Julario, Citrawati Dyah Kencono Wungu
Journal: F1000Res (2021)
Keywords: massive pulmonary embolism, large protruding thrombus, reperfusion, unstable hemodynamic
MeSH terms: Cardiomyopathy, Dilated / complications, Pulmonary Embolism / diagnostic imaging, Pulmonary Embolism / therapy, Thrombosis / diagnostic imaging, Case Reports, Adult, Echocardiography, Humans, Male, Thrombolytic Therapy

Pulmonary embolism is a potentially life-threatening condition. Despite advances in diagnostics, lack of consensus and delays in determining the diagnosis of pulmonary embolism are still important problems. We report the diagnosis and management of a 37-year-old man suffering from massive pulmonary embolism, a large protruding thrombus, and dilated cardiomyopathy. Echocardiography showed dilatation of all cardiac chambers, a large protruding thrombus in the right atrium to the inferior vena cava, impaired left and right ventricular systolic function, and global hypokinetic of the left ventricle with eccentric left ventricular hypertrophy. A thoracic computerized tomography scan showed pulmonary embolism with infarction. The patient's blood pressure was 60/40 mmHg and heart rate was 110 bpm. The patient was diagnosed with high-risk acute pulmonary embolism. We gave him hemodynamic support and reperfusion therapy with a loading dose of 250,000 units of Streptokinase followed by 100,000 units/hour for 24 hours. After revascularization, the patient's hemodynamic condition improved. The diagnosis of acute pulmonary embolism is based on clinical symptoms, hemodynamic changes, or radiological examination. Unstable hemodynamic underlies high-risk stratification. Hypotension or shock results from obstruction of the pulmonary artery which causes increased right ventricular afterload and acute right ventricular dysfunction. Reperfusion with thrombolysis therapy could provide good outcomes in this patient. Prolonged anticoagulation should be given to prevent the recurrence of venous thromboembolism.
Pseudomonas luteola Bacteremia in Newly Diagnosed Systemic Lupus Erythematosus
Authors: Mazin Barry
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Pseudomonas luteola is rarely considered as a human pathogen.There are only fewer than twenty reported cases of P. luteola infections since 1950. It has been described in both immunocompromised and immunocompetent patients as a cause of both nosocomial and community-acquired infections. We report a rare case of P. luteola infection in a previously healthy patient who was admitted to hospital with a first presentation of Systemic Lupus Erythematosus (SLE) presenting with P. luteola bacteremia.
Non-surgical Removal of Dens Invaginatus in Maxillary Lateral Incisor Using CBCT: Two-year Follow-up Case Report
Authors: Babita Pradhan, Yuan Gao, Libang He, Jiyao Li
Journal: Open Med (Wars) (2019)
Keywords: cone-beam computed tomographic imaging, dens invaginatus, dens invaginatus removal, dental operating microscope, ultrasonics

A 14-year female presented with an atypical looking tooth #7 with a sinus tract on tooth #8. A gutta-percha point inserted into the sinus tract confirmed the affected tooth #7. A radiographic examination of tooth showed a lateral radiolucency with respect to tooth #7. Cone-beam computed tomographic imaging was done for the three-dimensional reconstruction analysis. Dens invaginatus (Oehler's type III) with pulp necrosis and chronic apical periodontitis was the definitive diagnosis. Use of the dental operating microscope and ultrasonics helped in the removal of the invaginated structure. At the two year follow-up, no clinical and radiographic evidence of infection was observed.
Splenosis: A Rare Etiology for Bowel Obstruction-A Case Report and Review of the Literature
Authors: George Younan, Edward Wills, Gordon Hafner
Journal: Case Rep Surg (2015)

Splenosis is a historically uncommon etiology for bowel obstruction. Autotransplanted splenic tissues following surgery or trauma of the spleen are known to occur in multiple locations of the abdominal cavity and pelvis. The small bowel mesentery is a blood vessel-rich environment for growth of splenic fragments. We present a case of a 36-year-old male patient who sustained a gunshot wound to his left abdomen requiring a splenectomy and bowel resection fifteen years prior to his presentation with small bowel obstruction requiring exploration, adhesiolysis, and resection of the mesenteric splenic deposit. Our aim in this report is to provide awareness of splenosis as an etiology for bowel obstruction, especially with increased incidence and survival following abdominal traumas requiring splenectomies. We also stress on the importance of history and physical examination to include splenosis on the list of differential diagnoses for bowel obstruction.
Pembrolizumab and tavokinogene telseplasmid electroporation in metastatic melanoma
Authors: Yonatan Dollin, Jason Rubin, Richard D Carvajal, Helene Rached, James R Nitzkorski
Journal: Int J Surg Case Rep (2020)
Keywords: electroporation, il-12, immunotherapy, melanoma, tavokinogene telseplasmid
MeSH terms: Case Reports

Introduction:
Tavokinogene Telseplasmid Electroporation Therapy (TAVO) and Pembrolizumab therapy is being studied in subjects with immune checkpoint inhibitor (ICI) resistant melanoma. TAVO is a novel office-based local therapy shown to be effective in patients with advanced melanoma. The technique involves the direct injection of a plasmid encoding IL-12 into an accessible tumor driven by electroporation. The tumor cells have then been shown to express high levels of IL-12 resulting in a local inflammatory response within the tumor microenvironment.
Presentation of case:
The patient with stage IIB, pT3b melanoma was treated with primary tumor resection and found to have a negative sentinel node biopsy. She subsequently developed regional recurrence and was treated with inguinal lymphadenectomy and adjuvant Nivolumab. Despite therapy, she had progression of disease with skin and subcutaneous metastases (in-transit lesions), brain and liver lesions, hilar and iliac nodal disease. She was transitioned to nivolumab + ipilimumab, and Talimogene Laherparepvec (T-VEC) therapy for the in-transit lesions, without success. Stereotactic radiosurgery was used for the brain metastasis. Groin subcutaneous and in-transit lesions were treated with TAVO and intravenous pembrolizumab. Serial physical exams and CT scans were used to assess response.
Discussion:
All lesions treated with TAVO resolved. An abscopal response was also noted: hilar and mediastinal lymphadenopathy resolved. The liver mass and pelvic lymphadenopathy decreased in size, and her brain metastasis remained stable after radiation.
Conclusion:
This case suggests that combination TAVO and Pembrolizumab is a safe and effective local treatment for ICI resistant metastatic melanoma in the setting of rheumatoid arthritis. An abscopal effect was also noted through control of systemic disease.
A Case of Rare Complication of Inguinal Parietoplasty according to Lichtenstein: Entero Cutaneous Fistula
Authors: K B Kouakou, K I Anzoua, M Traore, B K I Leh, A B N'Dri, A S Ekra, B A Kouakou, R Lebeau, B Diané
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Lichtenstein intervention is currently the classic model of the regulated treatment of inguinal hernias by direct local approach. This "tension-free" technique satisfies both patients and practitioners. However, it does not often evade severe complications of parietal surgery. The authors report their treatment experience in rural Africa of a late enterocutaneous fistula which aggravated an inguinal hernia repair according to the Lichtenstein procedure. Physiopathology, diagnosis, and treatment of that disease are analyzed in the light of literature.
Therapeutic strategies to overcome EGFR mutations as acquired resistance mechanism in ALK-rearranged non-small-cell lung cancer: Case Reports
Authors: Lionel Michaux, Alexandre Perrier, Camille Mehlman, Hussa Alshehhi, Antonin Dubois, Roger Lacave, Florence Coulet, Jacques Cadranel, Vincent Fallet
Journal: Front Oncol (2023)
Keywords: alk rearrangement, egfr, non-small cell lung cancer, resistance mutation, tyrosine kinase inhibitors
MeSH terms: Case Reports

Introduction:
ALK tyrosine kinase inhibitors (ALK TKIs) have improved prognosis in ALK-rearranged (ALK +) non-small-cell lung cancer (NSCLC). However, drug resistance mechanisms occur inevitably during the course of treatment leading to disease progression. Activation of epidermal growth factor receptor (EGFR) bypass signaling pathway is an uncommon cause of acquired resistance to ALK TKIs.
Method:
We present two patients with EML4-ALK rearranged NSCLC, developing an acquired EGFR resistance mutation after receiving multiple lines of ALK TKIs.
Results:
While preclinical models have showed encouraging data, there is a critical need for clinical studies on treatment strategies to overcome this drug resistance. Three real-life therapeutic approaches were used in this report: i) using brigatinib, an inhibitor targeting both ALK and EGFR tyrosine kinases; ii) combining two ALK TKIs together; and iii) delivering doublet platinum chemotherapy. In case 1, time to treatment failure (TTF) was 9.5 months with brigatinib; in case 2, TTF was 10 months with combined TKIs (osimertinib and brigatinib), whereas TTF with chemotherapy was only 2 months. Tolerability profile TKIs combotherapy was acceptable.
Conclusion:
These case reports underline the therapeutic complexity of EGFR-acquired resistance mutation in ALK+ NSCLC and offers some leads to solve this real-life clinical challenge.
Postoperative myocardial injury in a patient with left ureteric stone and asymptomatic COVID-19 disease
Authors: Nadeem Kassam, Omar Aziz, Ally Zain Ismail, Rodgers Swai, Samina Somji, Robert Mvungi, Mustaafa Bapumia, Aliakber Zehri, Salim Surani
Journal: Pan Afr Med J (2020)
Keywords: coronavirus disease 2019 (covid-19), myocardial infarction, severe acute respiratory syndrome coronavirus 2, ureteric calculi
MeSH terms: Coronavirus Infections / complications, Heart Injuries / physiopathology, Pneumonia, Viral / complications, Postoperative Complications / physiopathology, Ureteral Calculi / surgery, Case Reports, Asymptomatic Diseases, COVID-19, Coronavirus Infections / diagnosis, Fatal Outcome, Heart Injuries / etiology, Humans, Hypertension / complications, Male, Middle Aged, Pandemics, Pneumonia, Viral / diagnosis, Risk Factors

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified on 8thDecember 2019 in Wuhan, Hubei, China, and has since spread globally to become an emergency of international concern. Patients infected with SARS-CoV-2 may be asymptomatic or present with symptoms ranging from mild clinical manifestations: such as fever, cough, and sore throat to moderate and severe form of the disease such as pneumonia and acute respiratory distress syndrome (ARDS). In some patients, SARS-CoV-2 can affect the heart and cause myocardial injury which is evidenced either by electrocardiographic (ECG) changes or by a rise in serum troponin level. Patients with myocardial involvement are generally at risk of developing severe illness and tend to have a poor outcome. We hereby present a case of a hypertensive male patient with undiagnosed, asymptomatic COVID-19, who underwent an emergency urologic procedure for ureteric calculi. He eventually sustained a postoperative myocardial injury resulting in his demise. This case highlights the importance of detailed preoperative assessment and anticipation of complications during this global pandemic.
Acute adult-onset still's disease presenting as pulmonary hemorrhage, urticaria, angioedema and leukemoid reaction: a case report and literature review
Authors: Sergio A Mora Alfonso, Daniel M Cuestas Rodríguez, John D Londoño, Rafael Valle-Oñate, Gerardo Quintana
Journal: Springerplus (2015)
Keywords: adult-onset still’s disease, angioedema, leukemoid reaction, pulmonary hemorrhage, urticaria

Introduction:
Adult-onset Still's disease is a rare systemic inflammatory disorder of unknown aetiology characterized by the classic triad of persistent high spiking fevers, joint pain and a distinctive salmon-colored bumpy rash however, the multiorgan involvement can be present.
Case description:
A 40-year-old woman previously healthy was referred to our hospital with 7 days of high fever and generalized arthralgia, The physical exam revealed angioneurotic edema detected on soles, palms and tongue and widespread red, urticated plaques in a symmetrical distribution affecting the arms, dorsal hands, upper and lower chest and back. Followed 5 days later by fever, the patient presented dyspnea, cough and hypoxemia, the imaging studies showed unilateral consolidation and pleural effusion. The bronchoscopy with bronchoalveolar lavage and skin biopsy were consistent with neutrophilic urticarial. The hematological disorders, infections and other autoimmune diseases were excluded.
Discussion and evaluation:
The diagnosis of adult-onset Still's disease can be very difficult. There are no specific tests and reliance is usually placed on a symptom complex and the well described typical rash seen in most patients. In recent years, however, other cutaneous manifestations of Adult-onset Still's disease have been reported but these are not so well known.
Conclusions:
The evidence of rare manifestations is growing and the early clinical presentation of Adult-onset Still's is extremely variable, making diagnosis difficult. For this reason, data on early clinical presentation of the disease are of interest. We reported the first case of acute Adult-onset Still's disease with the association of pulmonary hemorrhage, urticaria and angioedema including a rare systemic manifestation as leukemoid reaction.
Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report
Authors: Emma Foster-Thomas, Marianne Aznar, Daniel Indelicato, Shermaine Pan, Eunji Hwang, Peter Sitch, Keith Horner, Ed Smith, Simona Gaito
Journal: Int J Part Ther (2022)
Keywords: chemotherapy, dental toxicity, head and neck cancer, late effects, pediatric, proton beam therapy
MeSH terms: Case Reports

Purpose:
Radiation therapy is an independent risk factor for adverse sequelae to the oral cavity and dentition in childhood cancer survivors. However, dental toxicities after radiation therapy often are underreported and there are minimal published data on disturbances in tooth development after proton beam therapy (PBT). We present the long-term clinical and radiographic dental findings 8 years after treatment completion for a patient treated with PBT and chemotherapy for rhabdomyosarcoma.
Materials and methods:
Clinical follow-up data of patients treated with PBT within the Proton Overseas Programme (POP) is stored in a National Database and curated by a dedicated outcomes unit at the Christie NHS PBT center. This case report was identified from the extraction and analysis of data for pediatric head and neck cancer patients in this database for a service evaluation project.
Results:
The permanent dentition in this patient aged 3.5 years at the time of treatment was severely affected with abnormal dental development first observed 3.5 years after treatment completion. PBT delivered mean doses of 30 Gy(RBE = 1.1) to the maxilla and 25.9 Gy(RBE = 1.1) to the mandible.
Conclusion:
Significant dental development abnormalities occurred in this pediatric patient, despite doses in areas being lower than the proposed thresholds in the literature. Improved descriptions of dental toxicities and routine contouring of the maxilla and mandible are needed to correlate dosimetric data. The dose to teeth should be kept as low as reasonably possible in younger patients until the dose thresholds for dental toxicities are known.