OpenMed/multicare-articles huggingface dataset:
Metronomic treatment with low-dose trofosfamide leads to a long-term remission in a patient with docetaxel-refractory advanced metastatic prostate cancer
Authors: Jochen Greiner, Rainer Küfer, Sven N Reske, Volker Martin, Hartmut Döhner, Mark Ringhoffer
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The treatment of metastatic prostate cancer patients refractory to androgen withdrawal and docetaxel therapy is currently discouraging and new therapeutic approaches are vastly needed. Here, we report a long-term remission over one year in a 68-year-old patient with metastatic docetaxel-refractory prostate cancer employing low-dose trofosfamide. The patient suffered from distant failure with several bone lesions and lymph node metastases depicted by a (11) C-Choline positron emission tomography/computerized tomography (PET/CT). After initiation of trofosfamide 100 mg taken orally once a day we observed a steadily decreasing PSA value from initial 46.6 down to 2.1 mug/L. The Choline-PET/CT was repeated after 10 months of continuous therapy and demonstrated a partial remission of the bone lesions and a regression of all involved lymph nodes but one. Taken together we found an astonishing and durable activity of the alkylating agent trofosfamide given in a metronomic fashion. We rate the side effects as low and state an excellent therapeutic ratio of this drug in our patient.
Carbuncle due to Salmonella Enteritidis: a novel presentation
Authors: Wadha Alfouzan, Dieter Bulach, Hidemasa Izumiya, Khaled AlBassam, Simin Sheikh, Nasser Alrubai'aan, M John Albert
Journal: Gut Pathog (2017)
Keywords: carbuncle, s enteritidis, virulence genes, whole genome sequencing
MeSH terms: Case Reports

Background:

Salmonella Enteritidis causes intestinal and extra-intestinal infections, but rarely cutaneous infections. It has never been reported to cause carbuncle (a collection of interconnected furuncles with multiple pustular openings). We report a case of carbuncle due to S. Enteritidis.
Case presentation:
An adult Bangladeshi patient with type 2 diabetes presented with a carbuncle on the left-side of his neck. A pure culture of S. Enteritidis was grown from the pus of the carbuncle. The patient was successfully treated with ciprofloxacin to which the isolate was susceptible. Whole genome sequencing of the strain showed that it possessed three additional virulence genes-pef (for plasmid-encoded fimbriae), spv (for salmonella plasmid virulence), rck (for resistance to complement killing) -responsible for systemic infections that were absent in the genome of a reference S. Enteritidis strain. In phylogenetic analysis, the strain clustered with other S. Enteritidis strains from different parts of the world.
Conclusions:
A weakened immune system of the patient due to diabetes mellitus and the additional virulence genes of the isolate may have contributed to the unusual presentation of carbuncle. The possibility of S. Enteritidis to cause carbuncle should be considered.
Cryptogenic Organizing Pneumonia with Sarcoidosis Overlap: An Atypical Case Study
Authors: Ajmal Nazir Neelambra, Vishak Acharya, Sowmya Sundararajan
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Case summary:
We present a case of a young female with subacute symptoms of cough and progressive dyspnoea. On evaluation, the patient was diagnosed as cryptogenic organizing pneumonia based on her histopathological reports. However, her significant elevation of serum angiotensin-converting enzyme (SACE) levels which drop after treatment with oral steroids, relapse, and clinical presentation pointed towards sarcoidosis as clinical diagnosis.
Discussion:
Here, in this patient, transbronchial biopsy was suggestive of cryptogenic organizing pneumonia along with chest X-ray, and the HRCT finding was also favouring the same. But in this case, we have also seen elevated levels of serum ACE which dropped significantly to the normal level along with a complete clearance of lesions with systemic steroids, and this favours sarcoidosis. Also, the recurrence was in different areas of the lung, and lesions once again responded both clinically and radiologically to steroids with a consistent drop in serum angiotensin-converting enzyme (SACE) levels, which again is a feature common in sarcoidosis. In COP, often complete clearance of the lesions is seldom seen, even though they do respond to steroids but not as dramatically as in our case. Also, recurrence of the lesion with BOOP at different sites is uncommon as it generally progresses in the same site.
Conclusion:
This case report suggests that sarcoidosis as a possible cause of cryptogenic organizing pneumonia is worth considering with the mixed spectrum of presentation as in our case. And to our knowledge, this type of presentation of cryptogenic organizing pneumonia with sarcoidosis as an overlap disease is very rare, and this possibility needs to be explored by more series of such cases.
Hydatid disease of the interventricular septum: Echocardiographic and computed tomography findings
Authors: Brett Wegner, Ruchika Meel, Tamarin Nell, Lamla Nqwata, Michelle Wong
Journal: SA J Radiol (2020)
Keywords: cardiac hydatid disease, computer tomography, interventricular septum, sub-saharan africa, transoesophageal echocardiography

Hydatid disease (HD) is prevalent in South Africa, with cardiac HD being a rare but important manifestation to recognise and diagnose. An incidental finding on computed tomography (CT) of the chest in a patient with pulmonary HD prompted further multimodality imaging, which confirmed the presence of cardiac HD involving the interventricular septum. This case report focuses on imaging findings related to cardiac HD, as demonstrated by the CT of the chest and two- and three-dimensional transoesophageal echocardiography. Multimodality imaging is essential to assist in making a diagnosis and providing a detailed assessment of patients with cardiac HD.
Bone marrow negative visceral leishmaniasis in an adolescent male
Authors: S Jetley, S Rana, S Khan, Js Zeeba, Mj Hassan, P Kapoor
Journal: Iran J Parasitol (2013)
Keywords: aspirate, india, leishmaniasis, splenic, visceral
MeSH terms: Case Reports

Visceral Leishmaniasis or Kala Azar is endemic in certain regions of India. In endemic areas, the constellation of fever, progressive weight loss, weakness, pronounced splenomegaly, anemia, leukopenia, and hypergammaglobulinemia is highly suggestive of visceral leishmaniasis. Demonstration of the parasite in liver, splenic or bone marrow aspirates is confirmatory. We present a case in which Leishmania donovani (LD) bodies were demonstrated on splenic aspirate. We were unable to demonstrate LD bodies on bone marrow aspiration.
Case Report: Nicolau syndrome due to etofenamate injection
Authors: Emin Ozlu, Aysegul Baykan, Ragıp Ertas, Yılmaz Ulas, Kemal Ozyurt, Atıl Avcı, Halit Baykan
Journal: F1000Res (2017)
Keywords: complication, nicolau syndrome, etofenamate

Nicolau syndrome, also known as embolia cutis medicomentosa, is a rare complication characterized by tissue necrosis that occurs after injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery and cytotoxic effects of the drug. Severe pain in the immediate postinjection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Etofenamate is a non-steroidal anti-inflammatory drug and a non-selective cyclooxygenase inhibitor. Cutaneous adverse findings caused by etofenamate are uncommon. Herein, we present a case with diagnosis of Nicolau syndrome due to etofenamate injection, which is a rare occurrence.
IMPACT-CABG Trial: Implantation of CD133(+) Stem Cells in Patients Undergoing Coronary Bypass Surgery-Presentation of the First Treated Patient
Authors: Jessica Forcillo, Louis-Mathieu Stevens, Samer Mansour, Ignacio Prieto, Denis-Claude Roy, Nicolas Noiseux
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

The IMPACT-CABG study is the first Canadian randomized-controlled phase II clinical trial aiming to assess the effect of intramyocardial (IM) injections of CD133(+)-selected stem cells in patients referred for coronary artery bypass graft (CABG) with a "chronic" myocardial infarction and persistent left ventricular dysfunction. Patients are followed for 2 years with different imaging techniques including the stress magnetic resonance to evaluate the global and regional myocardial viability. Before the beginning of the randomization, the 5 first patients are treated in an open-label fashion to assess safety and feasibility of the IM CD133(+) injections. Herein, we report the first Canadian patient treated with IM injection of CD133(+) cells during CABG surgery as part of the IMPACT-CABG trial.
QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report
Authors: A Tounsi, L Abid, M Akrout, M Hentati, S Kammoun
Journal: Case Rep Med (2012)

We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.
Granulicatella adiacens and Abiotrophia defectiva Native Vertebral Osteomyelitis: Three Cases and Literature Review of Clinical Characteristics and Treatment Approach
Authors: Cinzia Puzzolante, Gianluca Cuomo, Marianna Meschiari, Andrea Bedini, Aurora Bonazza, Claudia Venturelli, Mario Sarti, Cristina Mussini
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Granulicatella adiacens and Abiotrophia defectiva are an increasingly recognized cause of osteoarticular infections. We describe two cases of G. adiacens and one case of A. defectiva native vertebral osteomyelitis (NVO) and review all published cases. Nine cases of G. adiacens NVO and two cases of A. defectiva NVO were previously described. Patients were usually middle-aged men, and classical risk factors for NVO were present in half of the cases. Concomitant bacteremia was reported in 78.6% of cases, and concurrent infective endocarditis occurred in 36.4% of this sub-group of patients. Many different antibiotic schemes were recorded, with median treatment duration of 6 weeks. In the most recent reports, glycopeptides represented the most frequent empirical therapy, possibly due to the increasing emergence of G. adiacens and A. defectiva penicillin-resistant strains. Stabilization surgery was rarely required (14.3% of cases), and clinical cure was generally achieved. In conclusion, Granulicatella spp. and Abiotrophia spp. NVO is rare but increasingly described. A total antibiotic course of six weeks seems to be appropriate for noncomplicated cases, and clinical outcome is generally favorable.
Mania Following Bereavement: State of the Art and Clinical Evidence
Authors: Claudia Carmassi, Katherine M Shear, Martina Corsi, Carlo Antonio Bertelloni, Valerio Dell'Oste, Liliana Dell'Osso
Journal: Front Psychiatry (2020)
Keywords: bereavement, bipolar disorder, complicated grief, funeral mania, manic episode, manic onset

Bereavement is the state of loss, determined in most of the cases by the death of a close person. It is probably the greatest sorrow that can occur in an individual life. Grief is a normal, healthy response to loss, evolving through stages in the process of mourning. In some cases, bereavement may lead to the outburst of manic episode: despite literature data being scarce, reports have explored this important clinical entity, variously called as "funeral mania" or "bereavement mania". We systematically reviewed the literature exploring the possible relationships between bereavement and the onset of a manic episode, both first or recurrent pre-existing episode, besides describing a case report on a manic episode in the aftermath of a loss event, with an accurate evaluation of prior mild mood spectrum instability, supporting the role of loss-events as potential risk factor for bipolar illness progression. This article tries summarizing existing evidence on the debate whether clinicians should consider mania as a possible bereavement reaction.
Role of ultrasound evaluation for the diagnosis and monitoring of thyroid tuberculosis: A case report and review of the literature
Authors: Gao-Yi Yang, Dan Zhao, Wen-Zhi Zhang, Jun Meng, Jun Li, Xiao-Hong Li, Hai-Fang Wan
Journal: Oncol Lett (2015)
Keywords: thyroid tuberculosis, ultrasound, ultrasound-guided core-needle biopsy

Thyroid tuberculosis (TT) is an extremely rare condition, with acute abscess formation being the most uncommon form of presentation. Mycobacterium tuberculosis may affect the thyroid gland through hematogenous spread from an extra-thyroid focus of disease or by direct extension from adjacent cervical lymph nodes. Due to the non-specific imaging findings and the variable clinical manifestations, TT is rarely diagnosed promptly prior to percutaneous biopsy or surgery. The present study reports the dynamic monitoring of the sonographic features of a case with thyroid tuberculosis that was diagnosed by a thyroid ultrasound (US) scan, confirmed by a US-guided core-needle biopsy and followed-up sonographically during the whole course of treatment.
A Case Report of Wernicke's Encephalopathy Associated With Schizophrenia
Authors: Jingqi He, Jinguang Li, Zhijun Li, Honghong Ren, Xiaogang Chen, Jinsong Tang
Journal: Front Psychiatry (2021)
Keywords: wernicke's encephalopathy, classic triad, non-alcoholic, schizophrenia, thiamine
MeSH terms: Case Reports

Introduction: Wernicke's encephalopathy (WE) is a severe neurological syndrome often associated with alcoholism. Clinicians tend to ignore WE in other non-alcoholic clinical settings related to malnutrition and thiamine deficiency, resulting in delayed diagnosis. The diagnosis becomes more difficult when WE is secondary to psychiatric illnesses as symptoms can be masked by the primary disease. Case Presentation: We present a case of a 56-year-old female patient with schizophrenia who was admitted to the hospital for mental and behavioral disorder, without history of alcohol. She presented symptoms of ophthalmoplegia and high muscular tension, and the brain MRI showed symmetric lesions in the bilateral basal ganglia and third ventricle. She responded well to thiamine and was discharged on hospital day 22. Conclusion: The psychiatrists should be on the alert for starvation-induced WE, especially for patients suffering from malnutrition. WE is a preventable and treatable disease, so once suspected of WE, patients ought to take adequate supplements of thiamine immediately.
Case Report: Rituximab Improved Epileptic Spasms and EEG Abnormalities in an Infant With West Syndrome and Anti-NMDAR Encephalitis Associated With APECED
Authors: Go Kawano, Takaoki Yokochi, Ryuta Nishikomori, Yoriko Watanabe, Keizo Ohbu, Yukitoshi Takahashi, Haruo Shintaku, Toyojiro Matsuishi
Journal: Front Neurol (2021)
Keywords: west syndrome, anti-n-methyl-d-aspartate receptor encephalitis, autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome, epileptic spasms, hypsarrhythmia, infantile spasms, rituximab
MeSH terms: Case Reports

Background: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy is a rare autosomal recessive disorder caused by a mutation in the autoimmune regulator gene. Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy typically exhibit hypoparathyroidism, adrenocortical failure, and chronic mucocutaneous candidiasis. There are only a few case reports of autoimmune encephalitis during autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy, but not as an initial manifestation. Furthermore, there are no reports of patients with infantile spasms/West syndrome with autoimmune encephalitis, partly because the median age for paediatric patients with anti-N-methyl-D-aspartate receptor encephalitis, which is the most frequent and best characterised in paediatric autoimmune encephalitides, is 13-14 years. Herein, we present a case of a 3-month-old infant with autoimmune encephalitis as an initial manifestation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy who later developed infantile spasms/West syndrome. Case Presentation: A 3-month-old girl was admitted to our hospital with a fever, involuntary movements in all four limbs, and right-side facial palsy. Acute central nervous system demyelination diseases were suspected from neuroimaging findings and the presence of the cerebrospinal fluid oligoclonal band. She did not respond to multiple methylprednisolone pulse therapies and later developed infantile spasms/West syndrome and diabetes mellitus. Rituximab, a chimeric mouse/human monoclonal antibody directed against human CD20 which depletes B cells, was initially administered as a treatment for autoimmune encephalitis. Unexpectedly, this treatment resulted in complete spasm cessation and resolution of hypsarrhythmia. The patient eventually showed severely delayed developmental milestones, and her electroencephalography findings showed periodic generalised slow spike-and-wave pattern. Conclusions: Despite the limited ability to extrapolate findings from a single case, rituximab's effects may suggest that B cells play a crucial role in infantile spasms/West syndrome mechanisms; use of rituximab as an aetiology-specific treatment for infantile spasms/West syndrome patients with autoimmune encephalitis or its effectiveness for infantile spasms/West syndrome patients with other underlying mechanisms warrants further investigation.
A Patient With Thiamine Deficiency Exhibiting Muscle Edema Suggested by MRI
Authors: Kenichiro Murate, Yasuaki Mizutani, Toshiki Maeda, Ryunosuke Nagao, Kouichi Kikuchi, Sayuri Shima, Yoshiki Niimi, Akihiro Ueda, Shinji Ito, Tatsuro Mutoh
Journal: Front Neurol (2018)
Keywords: magnetic resonance imaging, muscle edema, myalgia, neuropathy, thiamine deficiency
MeSH terms: Case Reports

Myalgia is sometimes observed in patients with thiamine-deficiency neuropathy. However, the detailed mechanism(s) underlying muscular manifestations have been poorly elucidated. We herein report a possible patient with thiamine-deficiency neuropathy exhibiting muscle weakness and myalgia in lower limbs. The patient exhibited abnormal muscle signal intensities on MRI corresponding to the site of myalgia. After thiamine replacement therapy, rapid improvement of clinical symptoms and abnormal MRI findings were observed. Muscle MRI findings in this case implicated the possible mechanism of myalgia observed in patients with thiamine deficiency neuropathy.
Viper bites complicate chronic agrochemical nephropathy in rural Sri Lanka
Authors: Anjana Silva, Rivikelum Samarasinghe, Senaka Pilapitiya, Niroshana Dahanayake, Sisira Siribaddana
Journal: J Venom Anim Toxins Incl Trop Dis (2014)
Keywords: agricultural nephropathy, anuria, chronic kidney disease, epidemiology, snakebite
MeSH terms: Case Reports

Snakebite is a common occupational health hazard among Sri Lankan agricultural workers, particularly in the North Central Province. Viperine snakes, mainly Russell's viper envenomation, frequently lead to acute renal failure. During the last two decades, an agrochemical nephropathy, a chronic tubulointerstitial disease has rapidly spread over this area leading to high morbidity and mortality. Most of the epidemiological characteristics of these two conditions overlap, increasing the chances of co-occurrence. Herein, we describe four representative cases of viperine snakebites leading to variable clinical presentations, in patients with chronic agrochemical nephropathy, including two patients presented with acute and delayed anuria. These cases suggest the possibility of unusual manifestations of snakebite in patients with Sri Lankan agrochemical nephropathy, of which the clinicians should be aware. It could be postulated that the existing scenario in the Central America could also lead to similar clinical presentations.
Primary intracranial leiomyosarcoma: report of a case and review of the literature
Authors: Sakeer Hussain, Anil Nanda, Marjorie Fowler, Federico L Ampil, Gary V Burton
Journal: Sarcoma (2006)
MeSH terms: Case Reports

A 26-year old man presented with a 3-month history of a progressively enlarging palpable parieto-occipital mass. A CT scan indicated the lesion arose from the dura with bony destruction. A stealth assisted craniotomy was performed with the provisional diagnosis of osteoblastic meningioma. Further histopathologic analysis of the intracranial mass was consistent with leiomyosarcoma. Staging evaluation, including CT and PET scans, demonstrated no other sites of disease. Despite complete surgical resection and radiotherapy to the resection site, the disease recurred locally and systematically 5 months later. Primary intracranial mesenchymal tumors are rare and few cases have been previously reported. Outcomes have been universally poor and current therapeutic approaches appear to have only limited benefit.
The horror of wrong-site surgery continues: report of two cases in a regional trauma centre in Nigeria
Authors: Arinze Nwosu
Journal: Patient Saf Surg (2015)
Keywords: medical errors, patient safety, wrong- site surgery, “universal protocol”, “who surgical safety checklist”

Background:
Wrong- site surgeries are iatrogenic errors encountered in the course of surgical patient management. Despite the 'never do harm' pledge in the 'Hippocratic Oath' drafted in 5(th) century BC, man is after all human, with this limitation manifesting in the physician's art despite his best intention. Beyond the catastrophic consequences of wrong- site surgery on the patient and surgeon, and the opprobrium on the art of medicine, the incidents have come to be regarded as a quality-of-care indicator. Orthopaedic surgery is a specialty with a preponderance of this phenomenon and the attendant medico-legal issues relating to malpractice claims. Consequently the specialty had pioneered institutional initiatives at preventing these 'friendly-fires'. Awareness and implementation of these initiatives however remain low in many parts of the world, hampered by a culture of denial and shame.
Case presentation:
This report presents two cases of wrong-site surgery following trauma from road-traffic accident. The first case was a closed reduction of the 'wrong' dislocated hip in the trauma/emergency unit under the care of senior residents, while the second case was attempted wrong-site surgery on the right leg in a patient with fracture of the left tibia, in conjunction with bilateral femoral fracture and right radio-ulnar fracture; by an experienced Chief Consultant Orthopaedic Surgeon operating elective list. Both are orthopaedic cases, each with some trauma to both lower extremeties. Neither of the cases was formally mentioned anywhere in clinical discourse in the hospital, much less a formal report or audit.
Conclusion:
There was no formal, institutionalized process to prevent wrong-site surgery in the health institution and this could have been largely responsible for these incidents. An open, mandatory process of reporting such incidents for relevant audit and awareness is necessary, as a mechanism for prevention rather than blame or punishment.