OpenMed/multicare-articles huggingface dataset:
Pneumococcal-meningitis associated acute disseminated encephalomyelitis (ADEM) - case report of effective early immunotherapy
Authors: Konstantin Huhn, De-Hyung Lee, Ralf A Linker, Stephan Kloska, Hagen B Huttner
Journal: Springerplus (2014)
Keywords: adem, acute disseminated encephalomyelitis, bacterial meningitis, parainfectious disease, streptococcus pneumonia

Introduction:
Unvaccinated patients with history of splenectomy are prone to fulminant courses of Streptococcus pneumoniae-associated bacterial meningitis. Besides direct brain damage those patients may additionally suffer from parainfectious syndromes, notably vasculitis and acute disseminated encephalomyelitis (ADEM). Differentiation and treatment of these immunological reactions is challenging.
Methods:
Case report.
Results:
A 61 year-old woman with history of splenectomy without vaccination for S. pneumoniae presented with progressive headache and meningism. CSF-analysis revealed pleocytosis with microbiological evidence for pneumococcal meningitis. After unsuspicious initial cranial CT imaging and initiation of appropriate antibiotic therapy, MRI two days later showed widespread FLAIR- and T2-hyperintense white matter lesions that further progressed upon follow-up MRI and that fulfilled imaging criteria of ADEM. Meanwhile the patient deteriorated and required mechanical ventilation. Cranial angiography showed no signs of vasculitis or vasospasms. Screening for autoimmune diseases remained negative, however oligoclonal bands turned positive. Brain biopsy mainly revealed perivascular CD4+ T-cells and demyelinated areas. Despite ongoing acute meningitis, a 10-day corticosteroid-pulse was initiated followed by steroid-tapering. Within 4 weeks, clinical and MRI findings ameliorated. In an one-year follow-up visit, the patient significantly recovered, MRI lesions were markedly reduced and no further relapses occurred.
Conclusion:
Acute pneumococcal meningitis in unvaccinated splenectomized patients may be complicated by a monophasic course of parainfectious ADEM that can be controlled with high-dose corticosteroids. Parainfectious vasculitis or cerebritis are important differential diagnoses and exact differentiation of these entities is important to initiate early appropriate immunotherapy.
Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine
Authors: Kaitlyn Vennard, Matthew P Gilbert
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Thyroid storm is a rare endocrine emergency characterized by dysfunction of multiple organ systems. Thyroid storm is more common in Graves' disease and can be precipitated by surgery, trauma, infection, metabolic abnormalities, iodine load, and parturition. We present a diagnostically challenging case of thyroid storm precipitated by radioiodine therapy and accompanied by bradycardia, a rare but life-threatening complication related to treatment for hyperthyroidism.
Synchronous Ovarian and Endometrial Endometrioid Adenocarcinoma Presenting with Nonbacterial Thrombotic Endocarditis and Pulmonary Thromboembolism: Adenocarcinoma with Thrombotic Events
Authors: N K Erturk, A Erturk, D Basaran, N Ozgul
Journal: Case Rep Obstet Gynecol (2015)

Introduction. Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of hypercoagulability in patients with malignant neoplasms. Case Report. A fifty-six-year-old woman presented to the emergency service; the clinical workup revealed deep vein thrombosis in right leg and bilateral massive PTE. As the abdominal sections on the spiral CT revealed a giant pelvic mass of ovarian origin, she was referred to our hospital's gynecologic oncology department. She was scheduled for surgery under enoxaparin. She described numbness on one side of her face. Cranial imaging findings revealed acute ischemic cerebral lesions and transesophageal echocardiogram showed vegetation on the aortic cusp. Under anticoagulation treatment, she underwent hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy. After tumor resection, her neurological symptoms dissolved with aggressive anticoagulant treatment. Pathology result was synchronous endometrial and ovarian adenocarcinoma. Discussion. NBTE is a rare condition often associated with advanced malignancies. Peripheral embolism and venous thrombosis are complications that have been associated with NBTE due to hypercoagulable state. These disorders could be resistant to routine anticoagulant treatment. In case of a thrombotic complication due to ovarian malignancy, surgical resection of the primary tumor may increase the effect of anticoagulant treatment.
From the Deep: Overlap of Neutrophilic Dermatoses Disorders Associated With Acute Myeloid Leukemia
Authors: Miguel Martins, Joana Barbosa, Sofia P Eusébio, Rita Prayce, Pedro Pires
Journal: Cureus (2023)
Keywords: acute myeloid leukaemia, autoimmunity, flt3-inhibitor, hematological malignancies, mediastinitis, neutrophilic dermatosis, neutrophilic panniculitis, pathergy, pyoderma gangenosum
MeSH terms: Case Reports

We report the case of a man in his 50s with refractory acute myelomonocytic leukaemia (AML) who presented with neck swelling, fever, and elevated levels of C-reactive protein (CPR) after venous punctures. An infected haematoma was presumed, but the patient showed no signs of improvement under broad-range antibiotics, and microbiological results were negative. The subsequent development of a rapidly evolving erythematous-violaceous plaque around a site that had previously punctured on the extensor surface of the right arm prompted us to reconsider the clinical setting as a whole and consider the hypothesis of deep neutrophilic dermatosis (ND) associated with haematologic malignancy. A biopsy of the arm lesion showed an aseptic neutrophilic infiltrate, confirming this diagnosis. The patient was initially treated with high-dose intravenous corticosteroids, resulting in a dramatic improvement of the skin lesions.
Adenoid cystic carcinoma of the trachea: a clinico-pathological analysis
Authors: Abderrahim Elktaibi, Massine Elhammoumi, Adil Boudhas, Adil Arsalane, Fayçal Eloueriachi, Mohamed Oukabli, Elhassane Kabiri, Abderrahmanne A L Bouzidi
Journal: Pan Afr Med J (2015)
Keywords: adenoid cystic carcinoma, primary malignant tumor, trachea
MeSH terms: Carcinoma, Adenoid Cystic / pathology, Dyspnea / etiology, Tracheal Neoplasms / pathology, Case Reports, Review, Biopsy, Carcinoma, Adenoid Cystic / diagnosis, Carcinoma, Adenoid Cystic / therapy, Female, Follow-Up Studies, Humans, Laryngoscopy / methods, Middle Aged, Tomography, X-Ray Computed, Tracheal Neoplasms / diagnosis, Tracheal Neoplasms / therapy

Primary malignant tracheal tumors are not common and adenoid cystic carcinoma (ACC) of trachea is very rare. The diagnosis is often delayed due to the atypical symptoms. We report an extremely rare case of ACC of proximal trachea, in a 55-year-old female who presented with a 12 month history of progressive dyspnea. Laryngoscopy and computed tomography revealed a broad-based polypoidal mass arising from posterior wall of the proximal trachea. Biopsy confirmed the diagnosis of ACC. The patient underwent a complete surgical resection and post operative radiotherapy. Six months follow-up of the patient did not reveal local recurrence or distant metastases. The literature of tracheal ACC is reviewed.
Left internal mammary artery injury requiring resuscitative thoracotomy: a case presentation and review of the literature
Authors: Ammar Al Hassani, Yassir Abdul Rahman, Ahad Kanbar, Ayman El-Menyar, Abubaker Al-Aieb, Mohammad Asim, Rifat Latifi
Journal: Case Rep Surg (2012)

Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed without delay. Objective. To describe an external cardiac tamponade caused by massive tension hemothorax from penetrating injury of the left internal mammary artery (LIMA). Method. A case presentation treated at the Level I trauma center at Hamad General Hospital, in Doha, Qatar and review of the literature on LIMA injuries reported cases. Results. LIMA injury as a cause of hemothorax is not uncommon, but to our knowledge our case is the first massive tension hemothorax with witnessed cardiac arrest reported in the literature requiring emergency thoracotomy, performed in trauma room, with full recovery. Conclusion. Injury to the LIMA with massive tension hemothorax requires immediate resuscitative thoracotomy.
Cesarean Scar Pregnancy and Successful Ultrasound-Guided Removal after Uterine Artery Ligation
Authors: Vito Leanza, Giosuè Giordano Incognito, Ferdinando Antonio Gulino, Attilio Tuscano, Monia Cimino, Marco Palumbo
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

A correct management of cesarean scar pregnancy (CSP) is mandatory to avoid further complications. There is no consensus for the standard therapy and the most frequent methods used are not free from failures and sequelae. A 38-year-old woman was admitted referring amenorrhea lasting 9 weeks, pelvic pain, and vaginal bleeding. She had three previous cesarean sections. Transvaginal ultrasound showed a gestational sac of 16 mm in the cervico-isthmic site and inside the thickness of the uterine wall, and the dosage of beta-human chorionic gonadotropin was 12,770 mU/mL. A diagnosis of CSP was done, and an ultrasound-guided removal after uterine artery cervical branch ligation was performed. The follow-up was uneventful. Even if not yet codified in the literature, our therapeutic procedure should be considered in other similar cases in the future, as it potentially limits the possible iatrogenic problems and reduces intraoperative and postoperative bleeding to a minimum.
Fifteen-Year Follow-Up of a Case of Surgical Retreatment of a Single Gingival Recession
Authors: Luca Francetti, Silvio Taschieri, Nicolò Cavalli, Stefano Corbella
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Purpose:
The aim of the present case report was to describe the retreatment of the single gingival recession in aesthetic area, in the presence of scar formation and consequent impairment of aesthetic appearance.
Methods:
A young patient with one single recession of 4 mm of 2.1 was treated with coronally advanced flap and subepithelial connective tissue graft, through a microsurgical approach that aimed at the removal of the scarred fibrous tissue. The intervention was performed using a surgical microscope as a magnification device.
Results:
Fifteen years after the surgical treatment, a substantial stable resolution of the gingival recession could be observed. Moreover, a further improvement of the aesthetic appearance could be observed.
Conclusions:
This case report suggests that periodontal microsurgery could be an effective approach for the retreatment of gingival recessions and, in long-term evaluation, to reduce the aesthetic problem due to the presence of scar formation. Further studies with a larger sample size are needed to better evaluate its efficacy.
Complications of Self-Injected Facial Fillers: A Treatment Conundrum in the UK
Authors: Jessica Blanchard, Julia Palmer, Enamul Ali, Leo Cheng
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

There has been a rise in nonsurgical cosmetic procedures seen within the UK population in the past decade. A change in legislation has placed restrictions on the distribution and provision of such treatments. Therefore, patients may seek alternative methods to bring about a change to their appearance, such as self-injection of a filler. Complications may include oral ulceration, foreign body tissue reaction, and infection due to a lack in sterility during injection. Such presentations may mimic that of oral cancer and can lead to misdiagnoses and undue cost to the National Health Service. This case highlights the common features leading to correct identification of patients self-injecting with facial fillers and discusses the controversy surrounding the economic aspects of their care. We would like to report one such case presenting to our oral and maxillofacial surgical unit.
Case report: Is exchange transfusion a possible treatment for metabolic decompensation in neonates with methylmalonic aciduria in the setting of limited resources?
Authors: Xiaoyu Cui, Na Li, Hong Xue, Fang Zhang, Jianbo Shu, Yang Liu
Journal: Front Pediatr (2022)
Keywords: exchange transfusion, hyperammonemia, metabolic decompensation in methylmalonic aciduria, neonate, primary hospital
MeSH terms: Case Reports

Hyperammonemia is a serious complication of methylmalonic acidemia, with high mortality and permanent neurological sequelae in survivors. Primary hospitals are often the first admission hospitals for these children but are limited by their experience and facilities to provide rapid and effective treatment, increasing the risk of death in children with methylmalonic acidemia's metabolic crisis. In this report, we reported a case of a 7-day-old male neonate with decompensated methylmalonic acidemia, who underwent automatic peripheral arteriovenous exchange transfusion. The serum ammonia level of the boy decreased significantly post exchange transfusion. Therefore, we put forward the suggestion of exchange transfusion for hyperammonemia, in combination with medical therapy, in children with inborn errors of metabolism as an initial treatment option in primary hospitals if a rapid transfer to a center with dialysis facilities is not possible.
Orthodontic Management of Midline Diastema in Mixed Dentition
Authors: Arvind Kumar, Raghvendra M Shetty, Uma Dixit, K Mallikarjun, Anil Kohli
Journal: Int J Clin Pediatr Dent (2011)
Keywords: mesiodens, midline diastema, orthodontic treatment
MeSH terms: Case Reports

Midline diastema is a space between the central incisors. Although physiologic transitory maxillary midline diastema is observed in children during eruption of maxillary anterior teeth in most cases, it is self-corrected after eruption of maxillary canines. However, midline diastema unrelated to the eruption of teeth has been observed owing to various etiologic factors. Treatment to align the central incisors depends on the predisposing factors.
A case report of pneumonia due to non-tuberculous mycobacteria in an immunocompetent patient
Authors: Olukemi Adekanmbi, Sulaiman Lakoh
Journal: Pan Afr Med J (2021)
Keywords: non-tuberculous mycobacteria, case report, immunocompetent, pneumonia, tuberculosis
MeSH terms: Mycobacterium Infections, Nontuberculous / diagnosis, Nontuberculous Mycobacteria / isolation & purification, Pleural Effusion / diagnosis, Pneumonia, Bacterial / diagnosis, Case Reports, Adult, Humans, Male, Mycobacterium Infections, Nontuberculous / microbiology, Nigeria, Pleural Effusion / microbiology, Pneumonia, Bacterial / microbiology

Non-tuberculous mycobacteria are uncommon pathogens in immunocompetent individuals. We report an unusual case of pneumonia with pleural effusion caused by co-infection with two species of non-tuberculous mycobacteria in an immunocompetent man in Nigeria. The case highlights the possibility of the occurrence of a disease caused by these pathogens in an unusual host in a setting where they are rarely isolated as well as the challenges faced in diagnosis.
MRA-based 3D-printed heart model-an effective tool in the pre-surgical planning of DORV
Authors: Alpa Bharati, Swati Garekar, Vijay Agarwal, Suleman A Merchant, Narayan Solanki
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A three-dimensional (3D) printed heart model based on contrast-enhanced MR angiography data was obtained in an 8-month-old male child with double-outlet right ventricle. The model could successfully show the spatial relationship between the aortic annulus, the pulmonary valve and the ventricular septal defect. The patient underwent complete intracardiac repair based on the 3D model. MR angiography images could be successfully used to create a true-size 3D heart model, which significantly helped in assessing the routability of the ventricular septal defect to the aorta, leading to successful intracardiac repair in our patient.
Clinical Analysis of Congenital Deficient Tracheal Cartilage Rings: Six Case Reports and a Literature Review
Authors: Jing Ma, Chen Meng, Zhiyu Feng, Xiaorong Han, Shuaishuai Liu, Na Liu, Weiwei Zhu
Journal: Front Pediatr (2020)
Keywords: airway obstruction, airway stent, bronchoscopy, congenital tracheal stenosis, pediatric stridor, tracheal reconstruction, tracheal rings deficiency
MeSH terms: Case Reports

Congenital deficiency of tracheal rings is a rare tracheal malformation that can cause central airway obstruction. Herein we reported the clinical data of six patients with symptomatic congenital deficient tracheal rings. There were five cases, with isolated short-segment absent cartilage ring located on the distal trachea (three cases), cervical trachea (one case), and distal trachea combined with bilateral bronchi (one case). Among them, four (4/5) received surgical tracheal resection, three fully recovered, and one died of severe infection. Besides that, one patient, who could not be weaned off the mechanical ventilation, died after rejecting surgery. One case had episodes of recurrent dyspnea and extubation failure due to long-segment tracheomalacia after repair of esophageal atresia and tracheoesophageal fistula. For this patient, deficient cartilage rings were suspected and confirmed at the age of 26 months. Moreover, the clinical characteristics of 12 cases with congenital deficient tracheal cartilage rings reported in previous literature were reviewed. The different characteristics between short- and long-segment deficient cartilage rings were discussed.
Nivolumab Induced Thyroid Dysfunction: Unusual Clinical Presentation and Challenging Diagnosis
Authors: Carmine Iadarola, Laura Croce, Erica Quaquarini, Cristina Teragni, Sara Pinto, Antonio Bernardo, Rodolfo Fonte, Michele Marinò, Mario Rotondi, Luca Chiovato
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: pd-1, autoimmune, graves' disease, hyperthyroidism, hypothyroidism, immune checkpoint inhibitors, nivolumab, thyroid
MeSH terms: Case Reports

In recent years, immune checkpoint inhibitors (ICIs) had a great impact in cancer therapy. ICIs display a peculiar toxicity profile, which is characterized by autoimmune-like manifestations against multiple organs, including endocrine glands. We hereby report the case history of two patients who experienced nivolumab-induced endocrine immuno-related adverse events (irAEs). Thyroid dysfunction in both patients presented with a low serum level of TSH. However, endocrine evaluation showed a completely different etiology and clinical evolution. The two patients' histories indicate that nivolumab can cause a large spectrum of thyroid and endocrine dysfunctions resulting in cumbersome diagnostic problems. In these peculiar patients the evaluation of endocrine experts is warranted.
Granular cell tumor of the toe: a case report
Authors: Federico Tamborini, Mario Cherubino, Stefano Scamoni, Luigi A Valdatta
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Granular cell tumor is a rare tumor of unknown etiology that more commonly affects the oral cavity but can also occur at other sites. The majorities of granular cell tumors are benign and present as a singular dermal nodule. We discuss a case of granular cell tumor of the fourth toe in a 54-year-old patient that was treated with conservative surgery, instead of amputation, and reconstruction with a dermal regeneration template.
Subretinal fluid in eyes with active ocular toxoplasmosis observed using spectral domain optical coherence tomography
Authors: Yanling Ouyang, Fuqiang Li, Qing Shao, Florian M Heussen, Pearse A Keane, Nicole Stübiger, Srinivas R Sadda, Uwe Pleyer
Journal: PLoS One (2015)
MeSH terms: Subretinal Fluid / metabolism, Tomography, Optical Coherence / methods, Toxoplasmosis, Ocular / diagnosis, Toxoplasmosis, Ocular / pathology, Research Support, Non-U.S. Gov't, Choroidal Neovascularization / pathology, Humans, Macular Edema / pathology, Retinal Necrosis Syndrome, Acute / pathology, Retrospective Studies, Toxoplasmosis, Ocular / metabolism

Purpose:
To describe the clinical finding of subretinal fluid (SRF) in the posterior pole by spectral domain optical coherence tomography (SD-OCT) in eyes with active ocular toxoplasmosis (OT).
Design:
Retrospective case series.
Participants:
Thirty-nine eyes from 38 patients with active OT [corrected]..
Methods:
Eyes with active OT which underwent SD-OCT were reviewed. SRFs in the posterior pole were further analyzed.
Main outcome measures:
Presence of SRF; its accompanying features, e.g. retinal necrosis, cystoid macular edema (CME), choroidal neovascularization (CNV); and longitudinal changes of SRF, including maximum height and total volume before and after treatment.
Results:
SRF presented in 45.5% (or 15/33) of eyes with typical active OT and in 51.3% (or 20/39) of eyes with active OT. The mean maximum height and total volume of SRF were 161.0 (range: 23-478) µm and 0.47 (range: 0.005-4.12) mm3, respectively. For 12 eyes with SRF related to active retinal necrosis, SRF was observed with complete absorption after conventional anti-toxoplasmosis treatment. The mean duration for observation of SRF clearance was 33.8 (range: 7-84) days. The mean rate of SRF clearance was 0.0128 (range: 0.0002-0.0665) mm3/day.
Conclusions:
SRF (i.e., serous retinal detachment) is a common feature in patients with active OT when SD-OCT is performed. The majority of SRF was associated with retinal necrosis and reacted well to conventional therapy, regardless of total fluid volume. However, SRF accompanying with CME or CNV responded less favorably or remained refractory to conventional or combined intravitreal treatment, even when the SRF was small in size.