OpenMed/multicare-articles huggingface dataset:
Uncommon presentation of complicated internal hernia through the appendices epiploicae ring of adhesion: a clinical case study
Authors: Mohamed Said Ghali, Mona S Shehata, Mohammed Al Obahi, Raed M Al-Zoubi, Ahmad Zarour
Journal: Front Surg (2024)
Keywords: adhesion internal hernia, appendices epiploicae, falciform ligament, hernia, surgery

Background:
Internal hernias are infrequent, yet serious, medical conditions with potentially severe consequences. An internal hernia resulting from an Appendices epiploicae (AE) ring is an especially rare cause, with a mere nine documented instances worldwide.
Case report:
This report presents the case of a 58-year-old male who suffered from an internal hernia originating from an AE ring. The condition led to a gangrenous small bowel, which was treated by laparotomy and resection of the affected segment, followed by primary anastomosis. The post-operative recovery was favorable.
Conclusion:
Internal hernias, although rare, warrant immediate attention and early intervention to preclude detrimental outcomes, as illustrated in this particular case.
Case report: Uncommon presentation of Salmonella Dublin infection as a large paravertebral abscess
Authors: Kang An, Zengxiang Wu, Cejun Zhong, Shuangqing Li
Journal: Front Med (Lausanne) (2023)
Keywords: salmonella dublin, abscess drainage, case report, paravertebral abscess, thoracolumbar spine
MeSH terms: Case Reports

Background:

Salmonella Dublin is a zoonotic pathogen that is associated with invasive infections and high morbidity and mortality rates. Here we present the case of a 78-year-old man with a rare manifestation of a paravertebral abscess in the thoracolumbar spine caused by Salmonella Dublin.
Case presentation:
The patient had a history of spinal tuberculosis and poorly controlled diabetes. The abscess was successfully managed by drainage, and a 12-week course of moxifloxacin resulted in complete recovery. Salmonella Dublin was identified using culture-based serotyping. The patient resided in an environment where cattle farming is common; he consumed raw beef and unpasteurized milk, suggesting a potential source of infection.
Discussion:
Increasing the awareness of Salmonella Dublin as a potential cause of spinal abscesses is important, particularly in patients with structural spinal abnormalities. The timely initiation of appropriate antimicrobial therapy based on susceptibility testing is recommended. This case highlights the pathogenic potential of Salmonella Dublin and emphasizes the importance of effectively managing invasive Salmonella infections.
Growth Hormone Therapy for Small for Gestational Age Short Stature Develops Type 2 Diabetes
Authors: Naohiro Nomura, Yuko Tanabe, Miki Minami, Junji Takaya, Kazunari Kaneko
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Growth Hormone therapy has been shown to induce transient insulin resistance in children, and there is concern regarding the diabetogenic potential of GH therapy in children born small for gestational age (SGA). In this case, female patient born SGA with a weight of 2,750 g (-1.73 standard deviation (SD)) and length of 45.5 cm (-2.6 SD). The patient's father and paternal grandfather were diagnosed with type 2 diabetes mellitus. At 3 years of age, the patient presented with short stature; height and weight were 85 cm (-2.5 SD) and 13 kg (-0.19 SD), respectively. She was placed on GH therapy. At 11 years of age, her fasting blood glucose and hemoglobin A1c levels were 116 mg/dL and 7.4%, respectively. Blood test results were negative for anti-glutamic acid decarboxylase and anti-islet antigen-2 antibodies. The patient discontinued GH therapy and started diet therapy and oral metformin (500 mg/day) administration. Five months later, the hemoglobin A1c level was 5.3% and glycemic control further improved. To our knowledge, family history may be an important risk factor for GH-induced diabetes. So, the GH dosage for patients born SGA with family history of diabetes should be adjusted so as not to be too excessive, and long-term follow-up studies will be required to evaluate fully the effects of GH therapy for them.
Case Report: Unmasking sustainable left ventricular recovery in chronic heart failure with axillary temporary mechanical circulatory support
Authors: Aarti Desai, Shriya Sharma, Caitlyn Luce, Jose Ruiz, Rohan Goswami
Journal: Front Cardiovasc Med (2024)
Keywords: hf-cs, impella, cardiogenic shock, heart failure, ischemic cardiomyopathy, mechanical circulatory support, transplantation
MeSH terms: Case Reports

Background:
Mechanical circulatory support (MCS), temporary or durable, is essential in patients with acute heart failure presenting in cardiogenic shock (CS). MCS is fundamental in patients with advanced heart failure when used as a bridge to decision, transplant or left ventricular recovery. Limited data on acute-on-chronic heart failure (HF) patients exists in the era of axillary mechanical circulatory support with the Impella 5.5. We describe a case of chronic ischemic cardiomyopathy, HF-CS, in a patient who underwent Impella placement, medical optimization, and explant, now with sustained normalization in ejection fraction.
Case summary:
A Caucasian female in her 50 s was referred to our center for evaluation for advanced therapies, including transplantation or durable left ventricular assist device placement. Her initial ejection fraction was 30% with comorbidities including multivessel coronary artery disease revascularized with 3 vessel bypass grafting ten years prior, type 2 diabetes (A1c 8.6%), and peripheral vascular disease. During her evaluation, she had acute decompensation leading to cardiogenic shock and required hospitalization with inotrope initiation, which was unable to be weaned. She was approved for organ transplant and listed; however, she required escalation of support and eventual placement of right axillary Impella 5.5. While on Impella support, her vasoactive needs reduced, and she was found to have left ventricular recovery and tolerated the initiation of guideline medical therapy. After three weeks of support, the Impella was weaned and explanted, and the patient was discharged. She remains stable with a sustained ejection fraction of greater than 50% with NYHA class 1 functional status at follow-up. One year later, the patient showed sustained myocardial recovery with guideline-directed medical therapy (GDMT).
Conclusion:
Our case highlights a unique approach in patients with long-standing (>5 years) heart failure who may benefit from early consideration for axillary support and concomitant optimization with guideline-directed medical therapy to assess for explant and native heart recovery.
Endoscopic Vitrectomy Combined with 3D Heads-Up Viewing System in Treating Traumatic Ocular Injury
Authors: Yuan-Shao Cheng, Chung-Hao Hsiao, Wei-Ping Hsia, Hung-Ju Chen, Chia-Jen Chang
Journal: J Ophthalmol (2024)

Purpose:
To investigate effects and complications of endoscopic vitrectomy combined with 3D heads-up viewing system in treating traumatic ocular injury. Patients and Methods. This is a retrospective interventional case series in a tertiary referral center in Taiwan, and we included patients of traumatic ocular injury, and they underwent endoscopic vitrectomy combined with a 3D heads-up viewing system.
Results:
Fourteen eyes of traumatic globe injury from 14 patients were studied over a 30-month period. Preoperative VA ranged from no light perception (NLP) to 6/6. Postoperative visual acuity improved in 11 of the 14 eyes (79%). Until 6 months after surgery, all eyes had attached retina. The median logMAR BCVA was 2.4 at the first visit and 1.19 at the last visit (p = 0.0028). No subject suffered from retinal detachment, endophthalmitis, or other severe complications.
Conclusions:
Vitrectomy using endoscopy combined with 3D heads-up viewing system allowed early evaluation and intervention in traumatic ocular injuries. Most of our cases showed both anatomical and visual acuity improvements.
Methicillin-Resistant Staphylococcus aureus Cellulitis Causing Meningitis From Hematogenous Dissemination: A Case Report
Authors: Omar M Masarweh, Suhail Saad-Omer, Michael Rohr, Neha Meda, Nicole Brenner
Journal: Cureus (2024)
Keywords: cellulitis, infectious diseases, meningitis, methicillin resistant staphylococcus aureus (mrsa), septic emboli, valvular endocarditis
MeSH terms: Case Reports

Methicillin-resistant Staphylococcus aureus meningitis is commonly associated with surgical procedures that closely interact with the central nervous system; however, hematogenous spread via bacteremia is rarely reported. Here, we present a case of methicillin-resistant Staphylococcus aureus meningitis as a complication of a diabetic foot infection that disseminated into a bloodstream infection causing infective endocarditis, discitis, vertebral osteomyelitis, and meningitis that was successfully treated with intravenous daptomycin and rifampin.
Primary Malignant Melanoma of the Small Intestine Presenting with Peritonitis: A Case Report
Authors: Alireza Khooei, Sahar Seifnia, Amin Dalili, Hossein Bavandi, Saeid Dehghan Nezhad, Motahare Ebrahimnejad
Journal: Iran J Pathol (2024)
Keywords: malignant melanoma, peritonitis, small intestine
MeSH terms: Case Reports

Malignant melanoma of the small intestine is mostly a metastatic tumor of other primary lesions, especially of skin origin. Primary malignant melanoma of the small intestine is very uncommon. The clinical presentation is usually nonspecific, thus leading to late diagnosis. We report a 42-year-old man who presented to the emergency department of Imam-Reza Hospital with symptoms and signs of peritonitis and was a candidate for emergency laparotomy and enterectomy. The medical and family history were unremarkable. A bulky mass was seen 190 cm away from the Treitz band, and a diagnosis of malignant melanoma was confirmed by histologic and immunohistochemical study. Further clinical examination revealed no primary tumor elsewhere, so the diagnosis of primary small intestinal melanoma was concluded. Although metastatic malignant melanoma in the GI tract is common, the primary one is a very rare entity. The diagnosis could be challenging because a thorough investigation is needed to rule out the possible initial origin.
Extensively and multidrug-resistant bacterial strains: case studies of antibiotics resistance
Authors: Bandar Almutairy
Journal: Front Microbiol (2024)
Keywords: saudi arabia, antimicrobial resistance, case histories, extensively drug-resistant (xdr), multidrug resistance (mdr)
MeSH terms: Review

The development of antibiotic resistance compromises the effectiveness of our most effective defenses against bacterial infections, presenting a threat to global health. To date, a large number of research articles exist in the literature describing the case reports associated with extensively drug-resistant (XDR) and multidrug-resistant (MDR) bacterial strains. However, these findings are scattered, making it time-consuming for researchers to locate promising results and there remains a need for a comparative study to compile these case reports from various geographical regions including the Kingdom of Saudi Arabia. Additionally, no study has yet been published that compares the genetic variations and case reports of MDR and XDR strains identified from Saudi Arabia, the Middle East, Central Europe, and Asian countries. This study attempts to provide a comparative analysis of several MDR and XDR case reports from Saudi Arabia alongside other countries. Furthermore, the purpose of this work is to demonstrate the genetic variations in the genes underlying the resistance mechanisms seen in MDR and XDR bacterial strains that have been reported in Saudi Arabia and other countries. To cover the gap, this comprehensive review explores the complex trends in antibiotic resistance and the growing risk posed by superbugs. We provide context on the concerning spread of drug-resistant bacteria by analyzing the fundamental mechanisms of antibiotic resistance and looking into individual case reports. In this article, we compiled various cases and stories associated with XDR and MDR strains from Saudi Arabia and various other countries including China, Egypt, India, Poland, Pakistan, and Taiwan. This review will serve as basis for highlighting the growing threat of MDR, XDR bacterial strains in Saudi Arabia, and poses the urgent need for national action plans, stewardship programs, preventive measures, and novel antibiotics research in the Kingdom.
Case report: POEMS syndrome masquerades as diabetic foot
Authors: Guang-Xin Zhou, Li Xiao, Yong-Min Bi, Fen Yang, Cai-Zhe Yang, Da Zhang
Journal: Front Neurol (2024)
Keywords: poems syndrome, diabetic foot, endocrinological manifestations, muscle weakness, peripheral neuropathy
MeSH terms: Case Reports

We present the case of a 54-year-old woman with reasonable blood sugar control who presented with a diabetic foot combined with severe peripheral neuropathy and vascular disease. Lower limb muscle weakness, muscle atrophy, skin pigmentation, and emaciation were also observed. Although her muscle strength improved after glucocorticoid treatment, it remained challenging to account for the other symptoms in this particular patient with chronic inflammatory demyelinating polyneuropathy. Plump liver and spleen, hidden bone lesions combined with seemingly unexplained cerebral infarction, and serous effusion led us to suspect polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. The abnormal proliferation of monoclonal plasma cells and a significant increase in vascular endothelial growth factor (VEGF) levels confirmed the diagnosis of POEMS syndrome. After 1 month of treatment with lenalidomide and dexamethasone, the diabetic foot ulcers healed, and the symptoms of myasthenia and fatigue improved. Diabetic feet may represent only the tip of the iceberg of an underlying POEMS syndrome. Our report aimed to increase awareness of this rare yet significant situation, advocating for the prompt identification and treatment of POEMS syndrome.
Impact of Clinical Examination and Gamma Knife Surgery in Stage IV Breast Cancer With Brain Metastasis
Authors: Nandan M Shanbhag, Martin C Tom, Albert Duncan, Abdulrahman Bin Sumaida
Journal: Cureus (2024)
Keywords: brain metastasis, clinical examination, gamma knife radiosurgery, multidisciplinary treatment, stage iv breast cancer
MeSH terms: Case Reports

Metastatic breast cancer often presents with significant diagnostic and treatment challenges. This case report highlights the crucial role of thorough clinical examination and history-taking in diagnosing and managing a patient with metastatic breast cancer, mainly focusing on the successful integration of Gamma Knife radiosurgery (GKRS). We present a case of a 68-year-old postmenopausal woman with metastatic breast cancer, initially presenting with a primary tumour in the left breast and later developing a solitary brain metastasis (BM) in the left temporal lobe. Following neoadjuvant chemotherapy and left mastectomy, the patient experienced involuntary movements in the right arm, leading to the discovery of the brain lesion. Critical to this diagnosis was a detailed clinical examination emphasising the importance of vigilant monitoring in cancer management. The patient underwent GKRS, offering a focused and less invasive treatment approach with favourable outcomes. This case underscores the value of clinical vigilance in managing complex breast cancer cases. The integration of GKRS as a targeted treatment modality for BM represents a pivotal aspect of modern oncological care, especially for patients with multiple treatment modalities. This report emphasizes the importance of clinical examination in the early detection of complications such as BM in breast cancer patients. Furthermore, it demonstrates the effectiveness of GKRS in managing such metastases, reinforcing its role as a valuable tool in the multidisciplinary treatment approach for advanced breast cancer.
Graves' Disease-Induced Psychosis Refractory to Intensive Medical Management Requiring Non-voluntary Thyroidectomy for Psychosis Resolution: A Case Report
Authors: Zachary J Anderson, Sreekant Avula, Ameya Kumar, Deepon Sarkar, Laura LaFave
Journal: Cureus (2024)
Keywords: gland, hormone, plasmapheresis, psychosis, thyroid, thyrotoxicosis
MeSH terms: Case Reports

Graves' disease is an autoimmune disorder characterized by hyperthyroidism, ophthalmopathy, and dermatopathy. The chief thyroid hormone abnormality is the elevation of thyroid hormone, resulting in an overexcitation of the sympathetic and central nervous systems. Psychosis due to Graves' disease is rarely the first presenting symptom, but it is an essential complication of those with severe or untreated disease. Most patients respond well to standard medical management for Graves' disease, although there exists a small subset of people who do not. There are few cases describing patients with psychosis without underlying psychiatric disorders who require intensive care admission and thyroidectomy for necessary management of refractory psychosis secondary to thyrotoxicosis. Here, we present a case of a patient without medical or surgical history who presented with severe psychosis due to untreated Graves' disease requiring non-voluntary thyroidectomy for definitive management.
Rare giant ovarian metastasis arising from a small primary lung adenocarcinoma: a case report
Authors: Baofeng Wang, Youjuan Jia, Jiang Wang, Zhenjiang Zhang, Yilin Ding, Hengxiao Lu
Journal: Front Surg (2023)
Keywords: anaplastic lymphoma kinase gene (alk), immunohistochemical staining, lung adenocarcinoma (luad), ovary metastasis, tumor markers
MeSH terms: Review

This intricate case report details an exceptionally rare incidence of ovarian metastasis originating from a primary lung adenocarcinoma (LUAD). The relative rarity of this metastatic pathway in medical literature indicates significant diagnostic challenges. This patient was initially found to have both the ovarian tumor and lung nodule and they were originally considered independent primary tumors, derived from radiological interpretations and biomarker profiling. Nevertheless, subsequent postoperative histopathological and immunohistochemical staining evaluations identified ovarian tumors as invasive adenocarcinoma metastasized from lung. The lung and ovary tumor both showed marked anaplastic lymphoma kinase gene (ALK) protein expression by immunohistochemistry. The molecular pathologic genetic testing for lung tumor also revealed ALK rearrangement positive. The complexity of this case underscores the essentiality of maintaining a high degree of diagnostic vigilance, particularly when confronting synchronous tumors. In addition, immunohistochemical staining plays an important role in diagnosing the ovarian neoplasm's metastatic nature and determining the primary site of metastatic adenocarcinoma. For lung cancer with ovary metastasis patients, the adopting an adaptable treatment approach responsive to evolving diagnostic evidence can improve the accuracy of diagnosis and avoid excessive treatment of patients.
Management of a Patient With Ankylosing Spondylitis and Multiple Comorbidities Who Underwent a Percutaneous Nephrolithotomy Using an Innovative Positioning Strategy
Authors: Ranjay Mahaseth, Mridul Dhar, Revanth B Challa, Vikas K Panwar, Ravi Chaudhary
Journal: Cureus (2024)
Keywords: ankylosing spondylitis, bronchoscopy, percutaneous nephrolithotomy, pulmonary emphysema, renal calculi
MeSH terms: Case Reports

Ankylosing spondylitis (AS) is a chronic inflammatory disorder leading to bony ankylosis, ossification, and fibrosis of the spine. Airway management is difficult in these patients due to restricted head and neck movement as well as a stiff body posture. This also poses challenges in lying down supine as well as surgical positioning. We report a case of a patient with AS and multiple co-morbidities who underwent a percutaneous nephrolithotomy for renal calculi, and the customisations made in anaesthetic and surgical techniques to safely perform the procedure.
Swallowing capacity and gravity of the laryngotracheal aspiration risk in atypical cerebellar stroke: case report
Authors: Sara Virgínia Paiva Santos, Brenda Carla Lima Araújo, Claudia Sordi, Carla Patrícia Hernandez Alves Ribeiro Cesar, Daniela da Costa Maia de Andrade, Thaisa Soares Caldas Batista, Sheila Schneiberg
Journal: Codas (2023)
MeSH terms: Deglutition Disorders / etiology, Stroke / complications, Case Reports, Deglutition, Female, Humans, Middle Aged

This case report aimed to evaluate the swallowing capacity and the severity of the risk of laryngotracheal aspiration of a 52-year-old female patient with atypical and rare stroke, with major injury in the cerebellar pathway. In order to measure swallowing capacity and risk of aspiration a routine clinical assessment used in the speech therapy clinic was performed and two valid clinical tests were used: Massey Bedside Swallowing Screen (MBSS) and Gugging Swallowing Screen (GUSS). After evaluation with the clinical tests, it was observed that the patient had reduced swallowing capacity, performance characterized as pathological, 100% dysfunction in the water swallowing test (MBSS), presence of choking, coughing, change in vocal quality and anterior escape. In the assessment of risk of aspiration with the GUSS, the patient presented moderate dysphagia and risk of laryngotracheal aspiration.This case report demonstrated that moderate dysphagia is found in a stroke patient with lesions that affect the cerebellum. Standardized and validated clinical tests such as GUSS and MBSS should also be used to assess the risk of dysphagia after stroke at ambulatory care.
Bacteremia caused by Comamonas kerstersii in a patient with acute perforated appendicitis and localized peritonitis: case report and literature review
Authors: Yingmiao Zhang, Kun Li, Yu Zhan, Lifeng Shi, Yi Zeng, Hui Wang, Zhongxin Lu
Journal: Front Med (Lausanne) (2023)
Keywords: 16s rrna, comamonas kerstersii, bacteremia, case report, perforated appendicitis
MeSH terms: Case Reports

Comamonas kerstersii (C. kerstersii) is a Gram-negative bacterium that was initially thought to be non-pathogenic to humans and is abundant in the environment. In recent years, with the availability of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) that enable fast and accurate bacterial identification, there have been increasing number of reports of human infections caused by C. kerstersii, indicating that this organism has emerged as human pathogen. In fact, most clinical isolates of C. kerstersii are recovered from peritoneal liquid, and bacteremia has been infrequently reported. Here, we report a case of bacteremia caused by C. kerstersii in a 28-year-old male patient with acute perforated appendicitis and localized peritonitis and present a comprehensive review of C. kerstersii infections in pathogenic diagnosis and clinical treatment as well as prognosis, thus providing a better understanding of C. kerstersii-related infections.