OpenMed/multicare-articles huggingface dataset:
Fibroepithelial polyp of palatine tonsil: a case report
Authors: Katerina Marini, Konstantinos Garefis, James Philip Skliris, George Peltekis, Anna Astreinidou, Vasiliki Florou
Journal: Pan Afr Med J (2021)
Keywords: fibroepithelial polyp, case report, surgery, tonsil
MeSH terms: Neoplasms, Fibroepithelial / diagnosis, Polyps / diagnosis, Tonsillar Neoplasms / diagnosis, Case Reports, Aged, Diagnosis, Differential, Female, Humans, Neoplasms, Fibroepithelial / pathology, Neoplasms, Fibroepithelial / surgery, Palatine Tonsil / pathology, Palatine Tonsil / surgery, Polyps / pathology, Polyps / surgery, Tonsillar Neoplasms / pathology, Tonsillar Neoplasms / surgery, Tonsillectomy

Fibroepithelial polyps represent a frequent cutaneous lesion of mesodermal origin, with a prevalence of 1.2% and are rarely located at palatine tonsils. We present a rare clinical report of a 70-year-old female patient with fibroepithelial polyp of palatine tonsil. This entity represents the eighth case of palatine tonsil fibroepithelial polyp in the English literature. She presented with a polypoid mass at the right tonsil and unspecified throat symptoms. Physicians should pay attention to such lesions because of the residual risk of malignant transformation, along with non-specific symptoms. Differential diagnosis was among neurofibroma, lipoma, squamous papilloma and fibroepithelial polyp. Histopathological examination following tonsillectomy showed a structure rich in vesicles inside lamina propria and surrounding inflammation, establishing the diagnosis of a fibroepithelial polyp. It requires vigilance during complete clinical examination, in order to detect masses at patients with throat symptoms that could have remained undiagnosed until they become even life threatening.
SSRI Facilitated Crack Dancing
Authors: Ravi Doobay, Lili Sun, Amish Shah, Pardeep Masuta, Zachary Shepherd
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Choreoathetoid movement secondary to cocaine use is a well-documented phenomenon better known as "crack dancing." It consists of uncontrolled writhing movements secondary to excess dopamine from cocaine use. We present a 32-year-old male who had been using cocaine for many years and was recently started on paroxetine, a selective serotonin reuptake inhibitor (SSRI) for worsening depression four weeks before presentation. He had been doing cocaine every 2 weeks for the last three years and had never "crack danced" before this episode. The authors have conducted a thorough literature review and cited studies that suggest "crack dancing" is associated with excess dopamine. There has never been a documented case report of an SSRI being linked with "crack dancing." The authors propose that the excess dopaminergic effect of the SSRI lowered the dopamine threshold for "crack dancing." There is a communication with the Raphe Nucleus and the Substantia Nigra, which explains how the SSRI increases dopamine levels. This is the first documented case of an SSRI facilitating the "crack dance."
Severe tinnitus in a patient with acquired deafness for over 50 years: a case report
Authors: Saeko Matsuzaki, Naoki Oishi, Kaoru Ogawa
Journal: Biopsychosoc Med (2018)
Keywords: antidepressant, autogenic training, deaf, palpitation, tinnitus
MeSH terms: Case Reports

Background:
There have been many reports on the treatment effect of cochlear implantation and hearing aids in the treatment of tinnitus in patients with severe hearing loss. However, as far as we are aware, there are no reports of investigation of treatment approaches for the tinnitus of deaf patients whose communication is solely carried out in sign language due to a long duration of deafness.
Case presentation:
We experienced a case of severe tinnitus with bilateral deafness for more than 50 years. The patient is a 69-year-old woman who communicates with her family solely in sign language. Family stress triggered the onset of tinnitus, accompanied by sleep disorder and palpitations. At the initial visit, she suffered from severe tinnitus (THI 94) as well as strong tendencies toward depression and anxiety. Because neither the patient nor her family was willing to use cochlear implantation, the administration of an antidepressant and a sleep-inducing agent was started, which resulted in improvement of the psychological conditions. Tinnitus distress, synchronized with the heartbeat, was relieved by the addition of autogenic training. At four and half years after the initial visit, the THI score had dropped to 0, and the subjective tinnitus and palpitation had almost disappeared, with only a low dose of antidepressant necessary.
Conclusion:
A deaf patient with severe tinnitus was successfully treated with drug and psychotherapy.
Two Synchronous Neonatal Tumors: An Extremely Rare Case
Authors: M Rodríguez-Zubieta, K Albarenque, C Lagues, A San Roman, M Varela, D Russo, G Podesta, D Steinberg, C Schauvinhold, A Etchegaray, M T G de Dávila
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

We report a case of a newborn with two synchronous tumors-sialoblastoma and hepatoblastoma-diagnosed at 20 weeks of gestation by magnetic resonance imaging (MRI) and ultrasonography (US). The aim of this study was to describe the management of this case together with a review of the literature. Our patient had a large facial tumor associated with extremely high alpha-fetoprotein levels. Diagnosis of the tumors was made by surgical biopsy, showing typical features in both. Sialoblastoma is a potentially aggressive tumor. In our case, the Ki67 index in the sialoblastoma was between 20 and 30%, indicating a possibly unfavorable behavior. The infant underwent surgery and chemotherapy in different steps. Complete surgical resection with clean margins is considered to be the best treatment option for sialoblastoma. Only four similar cases were previously reported. Timely management by a multidisciplinary team is essential in these difficult cases. In our patient, outcome was good at the time of this report.
Case Report: SARS-CoV-2 as an unexpected causal agent of predominant febrile hepatitis
Authors: Paraskevas Filippidis, Francois van Ouwenaller, Alberto Cerutti, Anaïs Geiger-Jacquod, Christine Sempoux, Giuseppe Pantaleo, Darius Moradpour, Frederic Lamoth
Journal: F1000Res (2021)
Keywords: covid-19, hepatology, liver, serology
MeSH terms: COVID-19, Hepatitis / diagnosis, Case Reports, Adult, Fever / etiology, Humans, Male, Polymerase Chain Reaction, SARS-CoV-2

Background: Respiratory symptoms and pneumonia are the predominant features of Coronavirus disease 2019 (COVID-19) due to emerging SARS-CoV-2 virus, but extrapulmonary manifestations are also observed. For instance, some degree of liver injury has been described among patients requiring hospital admission for severe COVID-19. However, acute febrile hepatitis as an initial or predominant manifestation of COVID-19 has been rarely reported. Case presentation: A 34-year-old man without underlying medical conditions presented with fever of unknown origin for two weeks in the absence of respiratory symptoms or other complaints. Laboratory testing revealed isolated acute hepatitis, for which an extensive microbiological work-up did not reveal identification of the causal agent. PCR testing for SARS-CoV-2 on a nasopharyngeal swab was negative on two occasions and initial serology for SARS-CoV-2 (at 15 days from symptoms onset) was also negative. However, repeated SARS-CoV-2 serological testing at 30 days demonstrated seroconversion leading to the diagnosis of COVID-19-related hepatitis. The patient's condition progressively improved, while transaminases steadily declined and eventually returned back to normal within 30 days. Conclusions: We describe here a unique case of SARS-CoV-2 isolated febrile hepatitis in a young and previously healthy man, which was diagnosed by demonstration of seroconversion, while PCR screening was negative. This case report highlights the role of repeated serological testing for the diagnosis of extrapulmonary manifestations of COVID-19.
Deceiving Phenotypic Susceptibility Results on a Klebsiella pneumoniae Blood Isolate Carrying Plasmid-Mediated AmpC Gene blaDHA-1
Authors: Susan Realegeno, Kevin Ward, Omai B Garner, Shangxin Yang
Journal: Front Cell Infect Microbiol (2021)
Keywords: dha-1, klebsiella pneumoniae, carbapenem resistance, plasmid-mediated ampc, whole-genome sequence analysis
MeSH terms: Klebsiella Infections, Klebsiella pneumoniae / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, Anti-Bacterial Agents / pharmacology, Asia, Bacterial Proteins / genetics, Europe, Female, Humans, Microbial Sensitivity Tests, Multilocus Sequence Typing, Plasmids / genetics, beta-Lactamases / genetics, Anti-Bacterial Agents, Bacterial Proteins, beta-Lactamases

Carbapenem-resistant Klebsiella pneumoniae (CRKP) frequently causes hospital-acquired infections and is associated with high morbidity and mortality. CRKP can have multiple resistance mechanisms and only a few can be routinely detected by commercial molecular or phenotypic assays making surveillance for CRKP particularly challenging. In this report, we identified and characterized an unusual non-carbapenemase-producing CRKP carrying a rare plasmid-borne inducible AmpC gene, blaDHA-1 . The isolate was recovered from blood culture of a 67-year-old female presenting with sepsis post bladder surgery and ureteral stent removal. The primary isolate displayed an indeterminate susceptibility pattern for ceftriaxone by broth microdilution, but was susceptible by disk diffusion with one colony growing within the zone of inhibition. The ceftriaxone resistant colony was sub-cultured and had a minimum inhibitory concentration (MIC) of 2 ug/ml for imipenem (intermediate) and a zone size of 18 mm for ertapenem (resistant), but remained susceptible to cefepime and meropenem. Further phenotypic characterization of this sub-cultured isolate showed carbapenemase activity. Whole genome sequencing (WGS) revealed the presence of two subpopulations of a K. pneumoniae (MLST sequence type 11) from the primary blood culture isolate: one pan-susceptible to beta-lactams tested and the other resistant to the 3rd generation cephalosporins and ertapenem. WGS analysis identified the resistant K. pneumoniae harboring IncFIB(K) and IncR plasmids and the presence of plasmid-borne beta-lactam resistance genes blaOXA-1 and blaDHA-1, an inducible AmpC gene. Additional resistance genes against quinolones (aac(6')-Ib-cr, oqxA, oqB), aminoglycoside (aph(3')-Ia), sulfonamide (sul1), and tetracycline (tet(A)) were also identified. DHA-1 positive K. pneumoniae have been previously identified outside the US, particularly in Asia and Europe, but limited cases have been reported in the United States and may be underrecognized. Our study highlights the importance of using both extended phenotypic testing and WGS to identify emerging resistance mechanisms in clinical Enterobacterales isolates with unusual antimicrobial resistance patterns.
Increased Expression of Autophagy Protein LC3 in Two Patients With Progressing Chronic Lymphocytic Leukemia
Authors: Daniela S Arroyo, Cecilia M Rodriguez, Claudio Bussi, Clarisa Manzone-Rodriguez, Darío Sastre, Viviana Heller, Carmen Stanganelli, Irma Slavutsky, Pablo Iribarren
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: lc3, autophagy, cancer, chronic lymphocytic leukemia, progressing
MeSH terms: Autophagy, Leukemia, Lymphocytic, Chronic, B-Cell / pathology, Microtubule-Associated Proteins / metabolism, Mutation, Case Reports, Research Support, Non-U.S. Gov't, Adult, Disease Progression, Female, Humans, Leukemia, Lymphocytic, Chronic, B-Cell / metabolism, Male, Middle Aged, Prognosis, MAP1LC3A protein, human, Microtubule-Associated Proteins

Chronic lymphocytic leukemia (CLL) is the most common type of adult leukemia in the western hemisphere. It is characterized by a clonal proliferation of a population of CD5+ B lymphocytes that accumulate in the secondary lymphoid tissues, bone marrow, and blood. Some CLL patients remain free of symptoms for decades, whereas others rapidly become symptomatic or develop high-risk disease. Studying autophagy, which may modulate key protein expression and cell survival, may be important to the search for novel prognostic factors and molecules. Here, we applied flow cytometry technology to simultaneously detect autophagy protein LC3B with classical phenotypical markers used for the identification of tumoral CLL B cell clones. We found that two patients with progressing CLL showed increased expression of the autophagy protein LC3B, in addition to positive expression of CD38 and ZAP70 and unmutated status of IGHV. Our data suggest that activation of autophagy flux may correlate with CLL progression even before Ibrutinib treatment.
Long-acting paliperidone in Ekbom's syndrome in Lewy body dementia: A case report
Authors: Laura Orsolini, Diana Corona, Virginio Salvi, Umberto Volpe
Journal: Transl Neurosci (2022)
Keywords: ekbom syndrome, lai, delusional parasitosis, long-acting injectable antipsychotic, paliperidone, paliperidone palmitate
MeSH terms: Case Reports

Introduction:
Ekbom Syndrome (ES) is characterised by fixed, delusional beliefs that one's body is infested by parasites or other vermin in absence of supporting clinical evidence. Antipsychotic (AP) treatment, including long-acting injectable (LAI) AP in subjects with poor compliance, is prescribed to manage behavioural and psychotic symptomatology.
Objectives:
We describe a 70-year-old woman who was hospitalised after experiencing new-onset delusions of infestation with visual and tactile hallucinations that led to bizarre behaviours and progressive social withdrawal.
Methods:
She was diagnosed with ES and was initially treated with risperidone 3 mg; however, due to poor compliance and a lack of insight, she was switched to LAI palmitate paliperidone (LAI-PP). She was followed up for 8 months, administering Positive and Negative Syndrome Scale, Montreal Cognitive Assessment, Global Assessment of Functioning, Brief Psychiatric Rating Scale, neurocognitive assessment, and neuroimaging.
Results:
After a progressive cognitive deterioration, she was diagnosed with an ES secondary to Lewy body dementia (DLB).
Conclusion:
The LAI-PP treatment determined a complete clinical remission of psychotic symptoms despite the emergence of an iatrogenic akinetic-rigid syndrome. The delay of confirmatory neurological diagnosis, the associated risky behaviours of the patient, and poor treatment adherence led clinicians to prescribe LAI-PP following a good clinical response to oral paliperidone. However, in the case of a suspected DLB diagnosis, the prescription of an LAI-PP as a first-line strategy should be carefully evaluated.
A Case of Lepromatous Leprosy With Erythema Nodosum Leprosum
Authors: Lily Park, Carly E Wallace, Gabriella Vasile, Christopher Buckley
Journal: Cureus (2023)
Keywords: erythema nodosum leprosum, immunologic reaction, lepromatous leprosy, leprosy, multidrug antibiotic therapy, mycobacterium leprae
MeSH terms: Case Reports

Erythema nodosum leprosum is an immunologic reaction that occurs in patients with lepromatous leprosy. We present the case of a 23-year-old female with a one-week history of fever and painful erythematous nodules along her upper and lower extremities. The patient had immigrated to the United States from Micronesia, where she was partially treated for leprosy two years prior. Histological examination from a punch biopsy demonstrated noncaseating granulomatous inflammation with numerous bacilli highlighted by the Fite stain. The acid-fast bacilli smear was positive. Given the patient's clinical, laboratory, and histological findings, a diagnosis of lepromatous leprosy with a type 2 erythema nodosum leprosum reaction was established. Multidrug antibiotic therapy with rifampin, dapsone, minocycline, and prednisone was initiated, following the addition of clofazimine. Early recognition and treatment of leprosy are crucial to preventing chronic and disabling complications, especially in instances of systemic inflammatory responses such as erythema nodosum leprosum.
Microscopic Polyangiitis Initially Presumed to Be Endocarditis
Authors: Takahiro Kaneko, Shunsuke Hino, Yosuke Iijima, Norio Horie
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitides (AAVs), which include fever of unknown origin (FUO), are rare diseases characterized by necrotizing inflammation of small blood vessels and the presence of ANCAs. Microscopic polyangiitis (MPA) is a subtype of the AAVs. Although the prevalence of AAVs has generally increased over the last 20 years, there have been rare reports from the dental and oral surgery field. In this article, we present a case of MPA suspected to be infective endocarditis (IE) following tooth extraction.
Crescentic glomerulonephritis with dual positive anti-GBM and C-ANCA/PR3 antibodies
Authors: Bolanle A Omotoso, Helen P Cathro, Rasheed A Balogun
Journal: Clin Nephrol Case Stud (2016)
Keywords: anca-associated vasculitis, antiglomerular basement membrane antibody disease, crescentic gn
MeSH terms: Case Reports

Antiglomerular basement membrane (anti-GBM) antibodies are more often accompanied by myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) than by proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA). Both disease processes can affect the kidneys and/or the lungs. Patients with dual positive disease may have an atypical presentation which may delay diagnosis and treatment. Here we report a case of crescentic glomerulonephritis associated with positive PR3-ANCA and anti-GBM antibodies who underwent both lung and kidney biopsies.
Hybrid endoscopic-microscopic surgery for dumbbell-shaped trigeminal schwannoma: case report and literature review
Authors: Xinning Li, Song Han, Xiaoyu Sun, Yang Bai, Qiyan Zhang, Sizhe Feng, Guobiao Liang
Journal: Front Oncol (2023)
Keywords: dumbbell-shaped trigeminal neurinoma, skull base lesions, subtemporal approach, supracerebellar-infratentorial approach, synchronous endoscopy and microsurgery
MeSH terms: Case Reports

Background:
The surgery of dumbbell-shaped trigeminal neurinomas (TN) remains one of the most formidable challenges for neurosurgeons because of its location at great depth in the cranium and proximity to vital neurovascular structures.
Objective:
To describe the feasibility of a novel technique, synchronous endoscopy and microsurgery via combined far-lateral supracerebellar-infratentorial and subtemporal approach, for resection of this rare entity.
Methods:
A 53-year-old women presented with progressive left facial numbness for 2 months. Imaging examinations revealed a left-sided dumbbell-shaped TN afflicting the middle and posterior cranial fossa, and a single-stage combined multiportal endoscopic microscopic approach was attempted for tumor resection. Initially, a purely endoscopic far-lateral supracerebellar-infratentorial approach was used to remove the posterior fossa component with the aid of tentorium incision. Subsequently, a microsurgical subtemporal interdural approach was performed for the exposure and separation of tumor within the Meckel cave. Finally, the tumor was pushed into the porus trigeminus under microscopy, thus enabling tumor extraction for the supracerebellar space under endoscopy without anterior petrosectomy.
Results:
The patient evolved favorably without additional neurological deficit after surgery, and postoperative imaging showed a complete resection of the tumor.
Conclusion:
We describe the first account of multi-corridor hybrid surgery for removal of TN in a dumbbell configuration, which enables one-stage total tumor removal with minimal added morbidity. This hybrid technique may be an effective piece of the surgeon's armamentarium to improve outcomes of patient with complex skull-base lesions. Further studies with larger case numbers are warranted to confirm the prognostic significance of this technique.
Lymphoepithelioma-like carcinoma of the breast: a case report and review of the literature
Authors: Kouhen Fadila, Abbad Faycal, Jabri Lamiaa, Belghiti Mohammed, Ismaili Nabil
Journal: Pan Afr Med J (2019)
Keywords: breast cancer, lymphoepithelioma-like carcinoma, rare
MeSH terms: Breast Neoplasms / diagnosis, Carcinoma, Squamous Cell / diagnosis, Lymphoma / diagnosis, Case Reports, Review, Breast Neoplasms / pathology, Carcinoma, Squamous Cell / pathology, Cell Proliferation, Diagnosis, Differential, Female, Humans, Middle Aged

Lymphoepithelioma-like carcinoma of the breast is uncommon with only 21 patients documented in the literature. It can wrongly be diagnosed as medullary carcinoma and certain types of lymphoma due to undifferentiated proliferation of malignant epithelial cells with prominent lymphoid infiltration. In this paper, we present a case of LELC of the breast in a 64-year-old female with breast LELC and a discussion based on a review of the literature.
Extensive anogenital warts: a multidisciplinary surgical management
Authors: Kostas Chondros, Konstantinos Graikos, Athanasios Klambatsas, Nikolaos Dimasis
Journal: Pan Afr Med J (2018)
Keywords: anogenital warts, hpv infection, anus obstruction, condylomata acuminata
MeSH terms: Condylomata Acuminata / diagnosis, Patient Care Team / organization & administration, Surgeons / organization & administration, Case Reports, Condylomata Acuminata / surgery, Humans, Male, Middle Aged

Genital warts are a major worldwide healthcare problem of sexually active population. Apart from direct association with cervical cancer, male patients experience HPV-related condylomata in several locations in the anogenital area. Extensive growth, multifocality and difficult accessibility wart sites are demanding and often require multidisciplinary surgical management. In our case, we present a male patient with extensive anogenital warts treated by a team of surgeons in several steps.
Case Report: Liraglutide for Weight Management in Beckwith-Wiedemann Syndromic Obesity
Authors: Marina Caputo, Tommaso Daffara, Simonetta Bellone, Valentina Mancioppi, Paolo Marzullo, Gianluca Aimaretti, Flavia Prodam
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: beckwith-wiedemann syndrome, liraglutide, obesity, syndromic obesity, weight
MeSH terms: Anti-Obesity Agents / therapeutic use, Beckwith-Wiedemann Syndrome / complications, Liraglutide / therapeutic use, Obesity / drug therapy, Case Reports, Adolescent, Humans, Male, Obesity / etiology, Treatment Outcome, Anti-Obesity Agents, Liraglutide

Genetic obesity, including syndromic and non-syndromic forms, represents a minority of cases compared to essential obesity but gene dysregulations lead to complex clinical conditions that make their management particularly difficult. Among them, Beckwith-Wiedemann syndrome (BWS) is a multisystem human genomic imprinting disorder characterized by overgrowth. We describe the first case of liraglutide treatment in an 18-year-old boy patient affected by BWS complicated by macroglossia, cryptorchidism, nephroblastoma, organomegaly, microscopic lymphocytic colitis, pharmacologically treated arterial hypertension, obesity, and obstructive sleep apnea syndrome. He presented a normal cognitive development. Body mass index at the time of first transition visit in the adult endocrinology department at the age of 18-years-old was 40.6 kg/m2 without glucose metabolism impairment. Lifestyle interventions failed because of poor compliance. During 20 months of 3.0 mg liraglutide treatment, a weight loss of 19 kg (-13.3%) and BMI reduction of 6.8 points were registered without side effects. To date, liraglutide treatment was effective on obesity in 7 subjects with Prader Willy Syndrome and 14 with melanocortin-4 receptor mutations. The efficacy of liraglutide in BWS could be related to a crosstalk among glucagon-like peptide (GLP)-1 system, mechanisms related to the cyclin-dependent kinase inhibitor 1C (CDKN1C), and dopamine mesolimbic circuit. Clinical trials aiming at a tailored medicine in genetic obesity are needed.