OpenMed/multicare-articles huggingface dataset:
Actinomyces and Shewanella algae complicated paediatric mastoiditis: a case report of a multidisciplinary approach
Authors: Mafalda Martins Sousa, Madalena von Hafe, Ana Reis-Melo, Helena Silveira, Gil Coutinho, Carla Pinto Moura
Journal: Access Microbiol (2022)
Keywords: shewanella, actinomycosis, acute otitis media, mastoiditis
MeSH terms: Case Reports

Cerebral venous sinus thrombosis in children is a rare complication of acute mastoiditis that can potentially be fatal. Clinical expertise is essential for early diagnosis and management due to its subtle course. We present the first known case of paediatric acute mastoiditis with venous sinus thrombosis caused by Shewanella algae and Actinomyces europaeus . A 17-year-old male presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography showed mastoid opacification, cerebral sinus thrombosis and an extradural collection. Microbiology revealed the presence of S. algae and A. europaeus . A multidisciplinary approach combining medical and surgical treatment allowed the patient to make a full recovery.
Nephrotic syndrome in primary myelofibrosis with renal extramedullary hematopoiesis and glomerulopathy in the JAK inhibitor era
Authors: Rachele Del Sordo, Rachele Brugnano, Carla Covarelli, Gioia Fiorucci, Franca Falzetti, Giorgio Barbatelli, Emidio Nunzi, Angelo Sidoni
Journal: Clin Nephrol Case Stud (2017)
Keywords: extramedullary hematopoiesis, myelofibrosis, nephrotic syndrome, proteinuria, renal biopsy, renal failure
MeSH terms: Case Reports

Primary myelofibrosis (PMF) is an uncommon form of myeloproliferative neoplasm (MPN) characterized by a proliferation of predominantly megakaryocytes and granulocytes in the bone marrow that, in fully-developed disease, is associated with reactive deposition of fibrous connective tissue, extramedullary hematopoiesis (EMH), and splenomegaly. Kidney involvement is rare and clinically presents with proteinuria, nephrotic syndrome, and renal insufficiency. Renal damage can be due to EMH and glomerulopathy. Renal EMH presents three patterns: infiltration of the interstitium with possible renal failure caused by functional damage of parenchyma and vessels, infiltration of capsule and pericapsular adipose tissue, and sclerosing mass-like lesions that can cause hydronephrosis and hydroureter with obstructive uropathy and renal failure. Glomerulopathy associated with PMF is rarely described, ranging from 1 month to 18 years from diagnosis of the neoplasm to renal biopsy. It is characterized by expansion and hypercellularity mesangial, segmental sclerosis, features of chronic thrombotic microangiopathy (TMA), and intracapillary hematopoietic cells infiltrating in absence of immune-mediated glomerulonephritis. We present a nephrotic syndrome in PMF-related glomerulopathy, associated with EMH, without renal failure, in a patient under treatment for 2 years with JAK2 inhibitor ruxolitinib. Despite treatment, the patient died 7 months after renal biopsy. Nephrologists still know very little about this topic and there is no homogeneous data about incidence, pathogenesis, and optimal treatment of this poor prognostic PMF-associated nephrotic syndrome. We focus on data in the literature in the hope of stimulating hematologists, nephrologists, pathologists to future studies about the natural history of renal involvement, useful for optimal management of this rare pathology.
Surgical resection of a leiomyosarcoma of the inferior vena cava mimicking hepatic tumor
Authors: Junji Ueda, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Masato Yoshioka, Youichi Kawano, Yoshiaki Mizuguchi, Tetsuya Shimizu, Hideyuki Takata, Eiji Uchida
Journal: Case Rep Med (2013)

Introduction. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in the inferior vena cava (IVC). They are malignant, slow-growing tumors with a poor prognosis. This paper reports on a rare case of surgical resection of an IVC leiomyosarcoma mimicking a hepatic tumor. Case Presentation. A 65-year-old Japanese male was admitted for evaluation of an abdominal tumor. Enhanced computed tomography of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images, with no enhancement or washout in late-phase images. We diagnosed this tumor as either a hepatic tumor in the Spiegel lobe or a retroperitoneal tumor such as leiomyosarcoma or liposarcoma and performed a laparotomy. On the basis of surgical findings, we extirpated the tumor by performing a wedge resection of the wall of the IVC and suturing the primary IVC wall. Pathological findings led to a further diagnosis of the tumor as a leiomyosarcoma originating in the IVC. Thirty-seven months after the operation, multiple liver and lung metastases were detected, and the patient died from multiple organic failures. Conclusion. We experienced a rare case of a leiomyosarcoma of IVC mimicking hepatic tumor.
An unusual cause of renal failure; Epstein syndrome
Authors: Manish R Balwani, Divyesh P Engineer, Manoj R Gumber, Vivek B Kute, Rajesh Singh, Himanshu V Patel, Aruna V Vanikar, Dinesh Gera, Pankaj R Shah, Hargovind L Trivedi
Journal: J Nephropharmacol (2015)
Keywords: chronic kidney disease, deafness, epstein syndrome, hemodialysis, megathrombocytopenia
MeSH terms: Case Reports

Epstein syndrome constitutes macrothrombocytopenia without neutrophil inclusion bodies along with deafness and renal failure. A diagnosis of Epstein syndrome was made in a 17 year-old-male patient with macrothrombopathic thrombocytopenia, renal failure and sensorineural hearing loss. Our patient is unique as he presented with rapidly progressive renal failure and developed chronic kidney disease in second decade of life with no symptomatic hearing loss or bleeding tendency. Epstein syndrome needs to be differentiated from Alport syndrome which is more common disease with similar clinical presentation.
Primary Neuroendocrine Breast Carcinoma in a 13-Year-Old Girl: Ultrasonography and Pathology Findings
Authors: Mazamaesso Tchaou, Tchin Darré, Koué Folligan, Akomola Sabi, Lantam Sonhaye, Azanledji Boumé, Akila Bassowa, Solange Adani-Ifé, Gado Napo-Koura
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Neuroendocrine carcinoma (NEC) of the breast is a rare disease and has been scarcely reported by African authors. The authors report a case of breast NEC in a 13-year-old African girl initially diagnosed as an atypical adenofibroma by ultrasonography. Ultrasound-guided biopsy and conventional histological examination indicated two potential diagnoses: primary malignant non-Hodgkin's lymphoma and undifferentiated carcinoma. According to immunohistochemistry performed on paraffin blocks in France, infiltrating ductal carcinoma with a strong neuroendocrine component was confirmed by CD56, CD57, and chromogranin A markers.
Symptomatic Internal Carotid Agenesis in Children
Authors: Abdullah Alhaizaey, Ibrahim Alhelali, Musaed Alghamdi, Ahmed Azazy, Mohammed A Samir
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Carotid artery agenesis is a rare congenital anomaly, and there are controversies in the leading cause for it. We present a 6-year-old girl with resolved focal neurological ischemic stroke that showed bilateral internal carotid artery (ICA) agenesis. Through this paper, we highlight the carotid canal congenital obliteration hypothesis as it may be a risk for such finding.
Retained Barium in the Appendix Is Difficult to Distinguish from Surgical Remnants following Laparoscopic Surgery
Authors: Masakazu Sato, Minako Koizumi, Takahiro Hino, Yu Takahashi, Natsuki Nagashima, Nao Itaoka, Chiharu Ueshima, Maki Nakata, Yoko Hasumi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Surgical materials, such as gauze, can be accidentally left inside of patients following surgery. This iatrogenic complication should be avoided and is often prevented by routine X-ray analysis after surgical abdominal procedures. We report a case of retained barium in the appendix that was difficult to distinguish from surgical remnants. A 41-year-old Japanese female was diagnosed with uterine leiomyoma and underwent laparoscopic myomectomy. The postoperative X-ray test showed a cord-like material in the lower right abdomen that was not captured in the preoperative X-ray test two months prior to the operation. Because of this difference, the area was reexamined laparoscopically. After examination, we concluded that the cord-like material in X-ray tests was in fact retained barium in the appendix. Barium can be retained in the appendix for long periods of time, and retained barium in the appendix can be captured radiographically and can mimic the appearance of surgical remnants, appearing as a cord-like material. The knowledge above combined with detailed interviews before surgery could prevent such confusion during interpretation of X-ray tests after surgery.
Acute Hepatitis A Causing Severe Hemolysis and Renal Failure in Undiagnosed Glucose-6-Phosphate Dehydrogenase Deficient Patient: A Case Report and Review of the Literature
Authors: Iman Abutineh, Kyle Kreitman, Jiten P Kothadia, Bilal Ali, Richa Jain, Ian Clark, Benedict J Maliakkal, Satheesh P Nair
Journal: Case Reports Hepatol (2021)
MeSH terms: Case Reports

Infection with hepatitis A virus is usually a self-limited illness that rarely results in fulminant liver failure. Severe hemolysis is an uncommon complication but has been reported in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Here, we report a case with undiagnosed G6PD deficiency who presented with hyperbilirubinemia, severe hemolysis, and acute renal failure precipitated by acute hepatitis A infection.
An unexpected cause of a subcutaneous nodule: a case report of dirofilaria infection
Authors: Bruno Man-Hon Cheung, Yi-Lan Huang, Yie-Wen Lin, Yung-Sen Chang, Shian-Min Liu
Journal: Case Rep Infect Dis (2012)
MeSH terms: Case Reports

Humans are not natural hosts of Dirofilaria; however, pulmonary or subcutaneous infections may occur through mosquitoes transmission. Patients presenting with simple subcutaneous nodules may not seek early medical attention, and hence systemic involvement through hematogenous spread may occur. Definitive diagnosis of Dirofilaria infection is made by histopathological examinations of the infected tissues. We report a patient with an incidental diagnosis of Dirofilaria infection confirmed by histopathological findings of a subcutaneous nodule on the right thigh. The source of infection remains unknown.
Gangrenous meckel's diverticulum in a strangulated umbilical hernia in a 42 year-old woman: a case report
Authors: Ilker Sengul, Demet Sengul, Serhat Avcu, Omer Parlak
Journal: Cases J (2010)

Introduction:
Meckel's diverticulum affects 1 - 3% of general population and is known as the most common anomaly of gastrointestinal tract. However, its estimated lifetime complication rate is approximately 4%. Intestinal obstruction is most common complication of Meckel's diverticulum in adult population.
Case presentation:
In the present study, we reported a 42-year-old female patient with a gangrenous Meckel's diverticulum in a strangulated umbilical hernia sac treated by dissection of diverticulomesenteric bands and diverticulectomy. In 36 months follow-up, there was neither any complication nor recurrence of hernia.
Conclusion:
This case represents a gangrenous Meckel's diverticulum in a strangulated umbilical hernia sac diagnosed in case of emergency. Although it is a very rare phenomenon, we should be vigilant for this entity especially in case of emergency.
Hepatic Abscess in a Returning Traveler with Crohn's Disease: Differentiating Amebic from Pyogenic Liver Abscess
Authors: Daria Gaut, Hannah Shull, Anthony Bejjani, Daniel Kahn
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Liver abscess is a rare but serious complication of Crohn's disease. Patients with Crohn's disease are at risk for pyogenic liver abscesses due to immunosuppressive therapy, fistulous disease, and intraabdominal abscesses. Inflammatory bowel disease patients are also known to have a greater prevalence of amebiasis compared to the rest of the population; however, a higher incidence of amebic liver abscess has not been reported. We describe a case of a liver abscess in a patient with Crohn's disease that was initially presumed pyogenic but later determined to be amebic in origin. Epidemiology, clinical presentation, diagnosis, and treatment of amebic and pyogenic liver abscesses are discussed.
Management of Patella Dislocation in Say-Barber-Biesecker-Young-Simpson's Syndrome: A Report of Two Cases
Authors: Meni Mundama, Serge Ayong, Renaud Rossillon
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Say-Barber-Biesecker-Young-Simpson's syndrome is one of the Ohdo-like syndromes. It is a very rare congenital condition that is commonly defined by its main clinical features that are blepharophimosis, ptosis, mental retardation, and delayed motor development. They are often associated with skeletal manifestations that are joint laxity, long thumbs and toes, and hypoplastic and/or dislocated patellae. To our knowledge, the available literature does not report any case where attention is drawn to management of skeletal aspect of this specific syndrome, especially surgically. We report 2 cases of SBBYS syndrome with patellar dislocation that we followed for 11 years. One case (with bilateral dislocation) was managed conservatively, and the other (with unilateral dislocation) underwent conservative and surgical treatment. Both had good functional outcome at follow-up. This experience shows that patellar abnormality in this condition can be efficiently addressed conservatively and/or surgically with satisfying results.
Euglycemic Diabetic Ketoacidosis in a Sedated Patient after Coronary Artery Bypass Grafting: A Case Report and Literature Review
Authors: Mohamad S Alabdaljabar, Khaled M Abdullah, Ali Almasood, Syed Salman Ali, Abdullah Ashmeg
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Euglycemic diabetic ketoacidosis (EDKA) is a rare and serious adverse effect of sodium-glucose cotransporter 2 inhibitors (SGLT-2i). The diagnosis is challenging due to the rarity, nonspecific symptoms, and absence of the alarmingly high blood glucose levels, and thus, it could be initially missed resulting in delayed treatment. This is particularly important for sedated patients, as the absence of typical clinical signs and symptoms can obscure the diagnosis. We present the case of a patient with type 2 diabetes mellitus on empagliflozin who developed EDKA while sedated after coronary artery bypass grafting (CABG) despite stopping the medication 24 hours prior to surgery. We also summarize the current literature on EDKA after CABG. Physicians must be aware and maintain a high index of suspicion for the illness, especially in patients with T2DM taking SGLT-2i and undergoing a major operation such as CABG. Emergent treatment and multidisciplinary follow-up are needed to improve patient outcomes and mitigate complications. Physicians should also consider identifying the optimal time to discontinue SGLT-2i before major surgeries and possible ketone studies in such patients, especially those sedated following the surgery.
Case report: Left ventricular perforation caused by right ventricular pacemaker lead
Authors: Xiang Huang, Heng Zhou, Xiao-Mei Li, Xiao-Lan Li
Journal: Front Cardiovasc Med (2023)
Keywords: lead migration, left ventricular perforation, pacemaker, right ventricular pacemaker lead, transvenous lead extraction
MeSH terms: Case Reports

Background:
Perforation of the interventricular septum and left ventricular (LV) free wall by a right ventricular (RV) lead is an extremely rare and potentially life-threatening complication. In this case report, we discussed the diagnosis and management of a very unusual complication of pacemaker (PM) implantation, i.e., LV perforation brought on by an RV pacing lead.
Case summary:
A 92-year-old man was admitted to Xiangyang No.1 People's Hospital due to a complete atrioventricular block. We performed a dual-chamber PM implantation; however, on the second postoperative day (POD), pacemaker failure occurred. Thoracic computed tomography (CT) scan showed that RV lead had pierced the interventricular septum and LV free wall. A transvenous lead extraction of the penetrating lead was performed uneventfully, and RV lead was refixed at the lower RV septum on the 5th POD.
Discussion:
Identification of high-risk patients is mandatory to prevent this serious complication, and transvenous lead extraction with cardiac surgery backup may be an option.
Cystic poorly differentiated squamous cell carcinoma of the scalp, a rare scalp tumor: Case report and literature review
Authors: Amjad Shah, Jaweria Akram, Abdelrahman Abdelaal, Layth Alateeq, Mohamed Ben-Gashir, Atalla Hammouda
Journal: Int J Surg Case Rep (2019)
Keywords: cystic, dermoid, epidermoid cyst, malignant, metastatic, squamous cell carcinoma, trichilemmal carcinoma

Introduction:
Cutaneous cystic lesions have broad differentials ranging from common benign entity to rare malignant lesions. Clinical evaluation of the lesion is the key to differentiation, as some rare malignant entities may simulate benign lesions. A high index of suspicion should be maintained for any aggressive behavior, which may require more thorough evaluation, including histopathology and radiographic imaging studies. We report a rare case of cystic poorly differentiated squamous cell carcinoma (CPDSCC) of the scalp.
Case presentation:
We report a case of a 37-year-old Filipino expatriate male who presented with a scalp swelling which had been gradually increasing in size for four months and was operated upon with a working diagnosis of sebaceous cyst. On post-op excisional biopsy, it turned out to be poorly differentiated cystic squamous cell carcinoma of the scalp. On further workup, no metastasis or other primary was found. Complete re-excision of the lesion with no evidence of residual tumor was achieved. Long-term follow-up was lost, as the patient left for his native country.
Conclusion:
Though cystic cutaneous lesions are very commonly encountered in clinical practice, high suspicion for malignancy should be maintained if the lesion shows any aggressive behavior. Prompt investigation should be done before surgery to determine the nature of the disease and the most effective management for the patient. Poorly differentiated cystic squamous cell carcinoma should also be considered in the differential diagnosis of cystic cutaneous lesions show aggressive behavior.
Genomic test ends a long diagnostic odyssey in a patient with resistance to thyroid hormones
Authors: Todor Arsov, Chengmei Xie, Nan Shen, Dan Andrews, Carola G Vinuesa, Olivija Vaskova
Journal: Thyroid Res (2019)
Keywords: genomic testing, hashimoto thyroiditis, resistance to thyroid hormones, whole exome sequencing
MeSH terms: Case Reports

Background:
Resistance to thyroid hormones is a very rare condition, which is often misdiagnosed and mistreated. The cases where there is a concomitant autoimmune thyroid disorder are ultra-rare and particularly challenging to treat. Diagnostic and research-based genomic testing can sometimes identify pathogenic variants unrelated to the primary reason for testing (incidental findings).
Case presentation:
We present a patient with thyroid resistance associated with hypothyroid Hashimoto thyroiditis. The long diagnostic odyssey spanning over 20-years included repeated misdiagnoses and mistreatments and was concluded by a research-based genomic testing, identifying a "de novo" THRB pathogenic variant. The varying sensitivity of various tissues to thyroid hormones accompanied by hypothyroid Hashimoto thyroiditis continues to pose a significant treatment challenge.
Conclusions:
Thyroid hormone resistance continues to be an un(der)- and misdiagnosed thyroid condition whose management is particularly challenging when associated with autoimmune thyroid disease. Whole exome sequencing has the potential to identify THRB pathogenic variants as incidental findings. Reporting such secondary findings from genomic testing may be particularly important in the context of the rarity of the condition and the potential clinical consequences of misdiagnosis and mistreatment.
Puerperal uterine inversion managed by the uterine balloon tamponade
Authors: Mariétou Thiam, Mouhamadou Mansour Niang, Lamine Gueye, Fatou Rachel Sarr, Marie Edouard Faye Dieme, Mamadou Lamine Cisse
Journal: Pan Afr Med J (2015)
Keywords: uterine inversion, postpartum hemorrhage, uterine balloon tamponade
MeSH terms: Puerperal Disorders / therapy, Uterine Balloon Tamponade, Uterine Inversion / therapy, Case Reports, Female, Humans, Young Adult

The uterine inversion is a rare and severe puerperal complication. Uncontrolled cord traction and uterine expression are the common causes described. We report a case of uterine inversion stage III caused by poor management of the third stage of labor. It was about a 20 years old primigravida referred in our unit for postpartum hemorrhage due to uterine atony. After manual reduction of the uterus, the use of intra uterine balloon tamponade helped to stop the hemorrhage. The uterine inversion is a rare complication that may cause maternal death. The diagnosis is clinical and its management must be immediate to avoid maternal complications.
A presumptive case of cutaneous emergomycosis in a female patient with HIV - Maseru, Lesotho
Authors: Waheeba M H Madani, Wayne Grayson
Journal: S Afr J Infect Dis (2022)
Keywords: emmonsia, hiv, emergomyces africanus, emergomycosis, fungal infection, skin
MeSH terms: Case Reports

Emergomycosis is a recently described emerging opportunistic fungal infection among individuals living with HIV, in whom it is a cause of significant mortality and morbidity. This article retrospectively reports on a presumptive case of extensive cutaneous emergomycosis in a young immunocompromised patient from Lesotho. The histopathological features on skin biopsy were in keeping with emergomyces infection. The lesions responded to treatment with amphotericin B and oral fluconazole.
Contribution:
This case contributes to the existing evidence that as an emergent opportunistic infection, emergomycosis is possibly widespread in Africa but the true extend of the disease is not fully defined. This is further aggravated by the diagnostic difficulty as a result of limited resources in some areas in the region.
Percutaneous Aspiration (AngioVac) of a Mitral Valve Vegetation followed by a Transcatheter Mitral Valve-in-Valve Intervention
Authors: Jack Xu, Shravan Turaga, Jay Bhama, Srikanth Vallurupalli, Gaurav Dhar
Journal: Methodist Debakey Cardiovasc J (2022)
Keywords: endocarditis, percutaneous aspiration, valve-in-valve intervention
MeSH terms: Bioprosthesis, Heart Valve Prosthesis Implantation / adverse effects, Heart Valve Prosthesis, Case Reports, Cardiac Catheterization, Humans, Mitral Valve / diagnostic imaging, Mitral Valve / surgery, Prosthesis Design, Prosthesis Failure, Treatment Outcome

The AngioVac transcatheter aspiration system (Angiodynamics) is used to percutaneously extract thrombi as well as vegetations typically growing from the right heart. We report a case of a failed mitral stented bioprosthesis due to a large vegetation that was treated successfully with AngioVac evacuation through a transseptal puncture followed by valve-in-valve intervention in the same setting.