OpenMed/multicare-articles huggingface dataset:
Case report: Pathological complete response induced by immunochemotherapy in a case of Pulmonary Sarcomatoid Carcinoma staged IIIA-N2
Authors: Yishu Guo, Xianling Liu, Hao Tang, Zhenhua Qiu, Fang Ma, Ao'ran Hu, Chaoyuan Liu, Yapeng Wang
Journal: Front Immunol (2024)
Keywords: conversional therapy, immunochemotherapy, immunotherapy, neoadjuvant therapy, pathological complete response, pulmonary sarcomatoid carcinoma
MeSH terms: Lung Neoplasms / drug therapy, Lung Neoplasms / pathology, Lung Neoplasms / therapy, Case Reports, Research Support, Non-U.S. Gov't, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, B7-H1 Antigen / antagonists & inhibitors, Carcinosarcoma / drug therapy, Carcinosarcoma / pathology, Carcinosarcoma / therapy, Humans, Immunotherapy / methods, Male, Middle Aged, Neoadjuvant Therapy / methods, Neoplasm Staging, Treatment Outcome, B7-H1 Antigen

Pulmonary sarcomatoid carcinoma (PSC) represents a rare and highly aggressive variant of lung cancer, characterized by its recalcitrance to conventional therapeutic modalities and the attendant dismal prognosis it confers. Recent breakthroughs in immunotherapy have presented novel prospects for PSC patients; nevertheless, the utility of neoadjuvant/conversional immunotherapy in the context of PSC remains ambiguous. In this report, we present a middle-aged male presenting with Stage III PSC, notable for its high expression of the programmed death-ligand 1 (PD-L1), initially deemed as non-resectable for sizeable tumor mass and multiple lymph nodes metastases. The patient underwent a transformation to a resectable state after a regimen of three cycles of platinum-based chemotherapy plus immunotherapy. Following definitive surgical resection, the individual realized a pathological complete response (pCR), culminating in a significant prolongation of event-free survival (EFS). This case underscores the viability of employing immunochemotherapy as a neoadjuvant/conversional strategy for chosen cases of PSC.
Case report: First isolation of Yersinia pseudotuberculosis from the blood of a cat
Authors: Raffaele Scarpellini, Massimo Giunti, Cecilia Bulgarelli, Elisabetta Mondo, Erika Esposito, Giammarco Assirelli, Silvia Piva
Journal: Front Vet Sci (2024)
Keywords: yersinia pseudotuberculosis, bacterial, blood, bloodstream infection, feline, yersiniosis
MeSH terms: Case Reports

A 14-year-old female domestic short-haired cat with a diagnosed diabetes mellitus and acromegaly was presented for lethargy and dysorexia. On clinical presentation, the patient showed hyperglycemia, hyperthermia, dull mentation, and dehydration. With the suspicion of an inflammatory or infectious complication of diabetes, she was hospitalized with constant rate infusion of insulin, and empirical ampicillin sulbactam was started. Blood culture revealed positivity for Yersinia pseudotuberculosis and the septic picture was confirmed by blood analysis, with leukocytosis, neutrophilia, and an increased serum amyloid A concentration. The isolated Y. pseudotuberculosis strain showed susceptibility to every antimicrobial tested. During the second day of hospitalization, the onset of hypoglycemia and hypotension was treated with norepinephrine and glucose in fluid therapy. The cat recovered well and was discharged with insulin and amoxicillin-clavulanate. This is the first case of septicemia associated with Y. pseudotuberculosis in a cat, suspected of developing the infection after contact with natural reservoirs such as rodents or birds. This route of transmission should be highlighted especially in relation to the zoonotic potential of the bacteria.
Case report: Dissociative neurological symptom disorder with gait disturbance: taking after the father?
Authors: Wenqi Geng, Yinan Jiang, Jing Wei
Journal: Front Psychiatry (2024)
Keywords: conversion disorder, dissociative neurological symptom disorder, functional neurological disorder, gait, referral and consultation, suggestion therapy
MeSH terms: Case Reports

Dissociative neurological symptoms disorder (DNSD), or conversion disorder, frequently manifests with unexplained neurological symptoms, necessitating referral to psychiatry following preliminary diagnosis in neurology. We present a case of an adolescent female patient with gait disturbance as the predominant clinical presentation, and delve into the diagnosis and interdisciplinary intervention process. Given neuroimaging deviations detected and familial similar presentations, the organic etiology was confirmed. However, the aberrant gait remained unexplained ultimately prompting psychiatric consultation resulting in the diagnosis of DNSD. Interventions consisting of health education, suggestive therapy, and physiotherapy notably improved gait disturbance. However, at follow-up, the patient presented with a depressive episode. It was deduced that undiagnosed psychosocial factors, notably familial dynamics, likely contributed to this decline. Eventually, transformed relation patterns among family members as well as antidepressant treatment were instrumental in attaining symptom remission.
Case report: Blindness associated with Learedius learedi trematode infection in a green sea turtle, Chelonia mydas, of the northern Red Sea
Authors: Danny Morick, Vanessa M Bachmann, Eli Shemesh, Ana Maria Botero-Anug, Ziv Zemach-Shamir, Zahi Aizenberg, Nadav Davidovich, Daphne W Goldberg, Gaston Kan, Ron Ofri, Dan Tchernov, Yaniv Levy
Journal: Front Vet Sci (2023)
Keywords: learedius learedi, red sea, spirorchiid, blindness, green sea turtle, optic nerve
MeSH terms: Case Reports

Spirorchiid blood flukes are widespread in sea turtles, causing disease and mortality in their populations, with high prevalence in several ocean basins. Besides being leading parasitic causes of sea turtle strandings in several parts of the world, these infectious agents can cause endocarditis, vasculitis, thrombosis, miliary egg granulomas, and aneurysms, which ultimately may compromise the survival of green sea turtles. More severe cases may also result in multifocal granulomatous meningitis or pneumonia, both of which can be fatal. Herein, we report the first case of severe trematode infection, Caused by Learedius learedi, in a green sea turtle in the northern Red Sea; this infection is associated with bilateral blindness. Necropsy revealed multiple granulomas with intralesional trematode eggs in the optic nerve, eyes, spleen, heart, and lungs. The parasite was identified as Learedius learedi through specific primers of the ribosomal genome and COI sequences obtained from GenBank. Altogether, these findings emphasize the importance of recognizing the systemic nature of this particular fluke infection to ultimately protect the lives of these marine animals and ensure the sustainability of these species in the wild.
Case Report: The leopard sign as a potential characteristic of chronic granulomatous disease-associated colitis, unrelated to colitis severity
Authors: Takuro Nishikawa, Takahiro Tomoda, Aki Nakamura, Jun Nagahama, Akihito Tanaka, Shuji Kanmura, Mari Kirishima, Akihide Tanimoto, Tsubasa Okano, Takahiro Kamiya, Kentaro Okamoto, Susumu Kirimura, Tomohiro Morio, Yasuhiro Okamoto, Hirokazu Kanegane
Journal: Front Immunol (2023)
Keywords: chronic granulomatous disease, colitis, endoscopy, haematopoietic cell transplantation, leopard sign
MeSH terms: Colitis / complications, Colitis / etiology, Gastrointestinal Diseases / complications, Granulomatous Disease, Chronic / complications, Granulomatous Disease, Chronic / diagnosis, Granulomatous Disease, Chronic / therapy, Case Reports, Research Support, Non-U.S. Gov't, Colonoscopy, Humans, Prednisolone, Prednisolone

Background:
Chronic granulomatous disease (CGD) is an inborn immune disorder in which the phagocytic system cannot eradicate pathogens, and autoinflammation occurs. Approximately half of the patients have associated gastrointestinal symptoms. Although most cases with CGD-associated colitis present nonspecific histology, colonoscopy in some cases shows brownish dots over a yellowish oedematous mucosa, which is termed a "leopard sign". However, the significance of these signs remains unclear.
Methods:
We collected data from patients with CGD whose colonoscopic findings showed the leopard sign.
Results:
Three patients with CGD and leopard signs were enrolled in this study. One patient underwent colonoscopy for frequent diarrhoea and weight gain failure, and another for anal fistula. The third patient was without gastrointestinal symptoms and underwent colonoscopy as a screening test before allogeneic haematopoietic cell transplantation (HCT). Endoscopic findings showed a mild leopard sign in the first case; however, non-contiguous and diffuse aphthae were observed throughout the colon. The other two cases were unremarkable except for the leopard sign. All the patients achieved remission with oral prednisolone or HCT. One patient underwent colonoscopy after HCT; results revealed improvements in endoscopy (including the leopard sign) and histological findings. However, another patient underwent colonoscopy after prednisolone treatment; this revealed no change in the leopard sign.
Conclusion:
The leopard sign in the colon may be a characteristic endoscopic finding of CGD, even in patients who do not develop severe gastrointestinal symptoms; however, it does not reflect the severity of CGD-associated colitis.
Etanercept treatment for pediatric toxic epidermal necrolysis induced by deflazacort: a case report and literature review
Authors: Min Song Jeong, Yun Young Choi, Yo Han Ahn, Kyeonghun Lee, Ji Soo Park, Dong In Suh
Journal: Front Immunol (2024)
Keywords: steven johnson syndrome, deflazacort, etanercept, pediatric, severe cutaneous adverse reaction, toxic epidermal necrolysis
MeSH terms: Etanercept / therapeutic use, Stevens-Johnson Syndrome / diagnosis, Stevens-Johnson Syndrome / drug therapy, Stevens-Johnson Syndrome / etiology, Case Reports, Review, Child, Preschool, Humans, Male, Pregnenediones / toxicity, Randomized Controlled Trials as Topic, deflazacort, Etanercept, Pregnenediones

Toxic epidermal necrolysis (TEN) is a life-threatening mucocutaneous disorder commonly caused by drugs. TEN is often treated with corticosteroids, intravenous immunoglobulin (IVIG), or cyclosporine; however, the efficacy of these treatments is controversial. Etanercept (a TNF-α antagonist) was proven to decrease skin-healing time in a randomized clinical trial. Herein, we report the case of a 44-month-old boy who developed TEN due to deflazacort as the probable culprit drug and was successfully treated with etanercept. The patient presented to the emergency department complaining of erythematous maculopapular rashes and vesicles all over the face and body, with vesicles on the hands, feet, and trunk. Symptoms started 4 days before presentation, with edema of the upper lip, which progressed to erythematous macules over the body. He was started on deflazacort for nephrotic syndrome 21 days before the visit. Approximately 20% of the body surface area (BSA) was covered by vesicular lesions. Under the diagnosis of Steven Johnson syndrome/TEN, deflazacort was discontinued, and intravenous dexamethasone (1.5 mg/kg/day), a 5-day course of IVIG (0.4 mg/kg/day), and cyclosporine (3 mg/kg/day) were administered. The lesions seemed to be stationary for 3 days, but on the 6th day of hospitalization, when IVIG was discontinued, the vesicular lesions progressed to approximately 60% of the BSA. Etanercept 0.8 mg/kg was administered subcutaneously. Lesions stopped progressing, and bullous lesions started epithelialization. However, on the 15th day, around 30% of the BSA was still involved; thus, a second dose of etanercept was administered. No acute or sub-acute complications were observed. In conclusion, the use of etanercept in children with TEN that is not controlled with conventional therapy is both effective and safe.
Renally Dosed Cefepime Leading to Cefepime-Induced Neurotoxicity: A Case Report
Authors: Megan Smith, Chris Mehdizadeh, Avrodet Mourkus, Saad A Ansari
Journal: Cureus (2024)
Keywords: altered mental status evaluation, cefepime-induced neurotoxicity, drug-induced seizures, neurology and critical care, pseudomonas endocarditis, renal dosing
MeSH terms: Case Reports

Cefepime is a broad-spectrum fourth-generation cephalosporin with activity against both gram-positive and gram-negative bacteria, including Pseudomonas aeruginosa. Cefepime is most commonly used for urinary tract infections, soft tissue infections, and febrile neutropenia. Up to 15% of ICU patients on cefepime may experience cefepime-induced neurotoxicity (CIN), with risk factors including renal dysfunction, excessive dosage, elevated serum cefepime concentrations, and history of prior brain injury. The adverse effects of CIN, including encephalopathy, seizures, and coma can be resolved with drug cessation, antiepileptics, or hemodialysis. Here, we present the case of CIN in a 59-year-old female patient with long-term cefepime antibiotic prescription for Pseudomonas bacteremia and endocarditis with multiple risk factors for reduced renal function. We discuss the relevant risk factors and preventive measures that may have prevented her from developing CIN, as well as the importance of early recognition and prevention of CIN in patient care.
Case and Management Considerations of Low-Grade Cystic Duct Stump Dysplasia after Laparoscopic Cholecystectomy
Authors: Claire Ufongene, Saran Kunaprayoon, Juan Mestre
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

Cholecystectomies have become one of the more commonly practiced procedures. As a result, there has been a rise in neoplastic changes in excised specimens. Due to this, surgeons must be prepared to manage possible malignancy after resecting what was previously thought to be a benign gallbladder. While management for high-grade dysplasia has been more clearly laid out in literature, data on management of low-grade dysplasia are limited. Here, we report a novel case of a 46-year-old woman with an incidental low-grade dysplasia of the cystic duct stump after a laparoscopic cholecystectomy for biliary colic. The decision was made to excise the remaining stump without further surveillance postoperatively given benign pathology findings. More documented cases and their management and ultimately longitudinal cohort studies will help facilitate the creation of guidelines for managing this particular pathology.
Case Report: Neurological adverse events in subject with myasthenia gravis after PCSK9 inhibitor administration
Authors: Věra Adámková, Martina Vitásková, Jaroslav A Hubáček
Journal: Front Cardiovasc Med (2024)
Keywords: pcsk9 inhibitor, cholesterol, myasthenia gravis, treatment, undesirable side effect
MeSH terms: Case Reports

Background:
Myasthenia gravis is a rare chronic autoimmune neuromuscular disorder mainly caused by autoantibodies to the nicotinic acetylcholine receptor. Cholesterol is an essential molecule that affects the distribution and proper functioning of this receptor. Several reports have described the potential worsening of myasthenia gravis in patients treated with statins.
Case presentation:
The patient was an obese 72 years old man, past smoker, diagnosed with ischaemic heart disease, type 2 diabetes mellitus and lipid metabolism disorder. Statin treatment was not implemented because of chronic myasthenia gravis and PCSK9i monotherapy [Repatha (evolucamab), 140 mg] was implemented to treat dyslipidaemia. Within 24 h after the first dose of PCSK9i the patient developed severe muscle weakness, joint pain, fever, and general discomfort, lasting for several days. Despite strong advice against the second dose administration, this was self-administered approximately 2 weeks later, leading to report significant worsening of the muscle problems, leading to the patient admittion to the neurology department where he was being treated for myasthenia gravis attack.
Conclusion:
Based on the neurologist's conclusion, it can be assumed that in this case, treatment with PCSK9i resulted in significant worsening of the patient's chronic disease.
Biochemical outcome in metastatic prostate cancer patients following prostate-directed radiotherapy
Authors: Heba Maged Ayoub, Fifi Mostafa Elsayed, Maha Lotfy Zamzam, Ihab Mohamed Hassanin, Eman Essam Elsemary
Journal: Ecancermedicalscience (2024)
Keywords: biochemical outcome, low volume, metastatic prostate cancer, prostate-directed radiotherapy
MeSH terms: Case Reports

Background:
The role of cytoreductive local radiotherapy (RT) in metastatic prostate cancer (mPCa) has recently been established. This study aimed to evaluate the biochemical outcome of local RT in mPCa.
Methods:
This randomised controlled phase III study was conducted at the Clinical Oncology Department, Suez Canal University Hospital. Eligible participants were de-novo or metachronous mPCa patients with Eastern Cooperative Oncology Group performance status of 0-2. Participants were randomised to receive either cytoreductive prostate-directed RT in addition to standard care or standard care alone. The conventional radiation schedule of 70 Gy/35 fractions or the hypofractionated schedule of 55 Gy/20 fractions were delivered. The primary endpoint was biochemical progression-free survival (BPFS), and the secondary endpoint was overall survival (OS). Survival and post-hoc analyses were performed using Cox regression and the Kaplan-Meier method with the log-rank test.
Results:
Between 23 November 2020 and 21 2022, 70 patients were enrolled in this study. Of them, 34 patients were assigned to the prostate RT group, and 29 patients were assigned to the control group. At a median follow-up of 12 months, the median BPFS has not been reached for the prostate RT group compared to 4.067 months for the control group (HR: 0.147, p < 0.001). Subgroup analysis showed that the median BPFS was statistically significantly correlated with low-volume (95% CI, 0.004 to 0.262, p = 0·001) and hormonal-sensitive metastatic disease (95% CI, 0.010 to 0.192, p < 0·001). The median OS was 16.33 months for the prostate-RT group compared to 11.33 months for the control group (HR: 0.313, p = 0.003).
Conclusion:
Prostate-directed RT improved BPFS and OS in mPCa patients, particularly in those with low volume and hormonal-sensitive disease.
Trial registration:
This trial is registered on (27/4/2023), retrospectively registered with pactr.samrc.ac.za, PACTR202305854600529, URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25510.
Amlodipine-induced buccal lichenoid lesions: A case report
Authors: Mohamed Pauzi Muhammad Hafiz, Abdul Kadir Azidah, Mat Yudin Zainab
Journal: Malays Fam Physician (2024)
Keywords: adverse drug reaction, amlodipine, lichen planus, lichenoid eruptions, oral ulcer
MeSH terms: Case Reports

Buccal lichenoid lesions (BLLs) are characterised by a unique, linear whitish striation in the buccal region and can be accompanied by ulcers, plaques, erythemas, atrophies and blisters. They are distinguished from oral lichen planus (OLP) by the association of the administration of a drug or contact with a metal. Herein, we present the case of a 42-year-old woman with underlying hypertension with amlodipine-induced BLLs. She complained of a 1-month history of right buccal whitish streaks and oral ulcers 2 months after taking amlodipine. She visited a private otorhinolaryngology clinic, and a biopsy for the right buccal ulcer was conducted. The biopsy result showed features suggestive of OLP. The patient was then diagnosed with OLP. Her symptoms were persistent despite treatment, so a dental referral was made. Amlodipine was suspected as the cause of her condition and was therefore stopped. Her condition gradually resolved after amlodipine withdrawal. Hence, primary care physicians should be aware of BLLs as one of the adverse drug reactions of amlodipine so that prompt management can be taken to avoid further debilitating impacts on patients.
Metagenomic next-generation sequencing to investigate infectious keratitis by Corynespora cassiicola: a case report
Authors: Shuo Xu, Shui Lu, Yan Gu, Hongjuan Sun, Minghui Ma, Yue Leng, Wenhui Liu
Journal: Front Med (Lausanne) (2023)
Keywords: corynespora cassiicola, fungal keratitis, keratoplasty, metagenomic next-generation sequencing, voriconazole
MeSH terms: Case Reports

In this report, the case of a 65-year-old immunosuppressed female who presented with recurring redness and irritation in her right eye for 2 months is described. Ocular examination revealed conjunctival congestion, feather-like greyish-white corneal deep stromal infiltrate, white, floccular material sprawling from the anterior chamber angle and hypopyon. The in vivo confocal microscopy (IVCM) instantly confirmed fungal keratitis, and empirical antifungal therapy was thus administered. The patient exhibited therapeutic penetrating keratoplasty, however, due to the progression of infection and the lack of identified pathogens. The fungal isolate was identified as Corynespora cassiicola by metagenomic next-generation sequencing (mNGS) of the host cornea. The patient responded well to intensive conservative therapy and subsequent surgical therapy. To our knowledge, this case represents the first case of C. cassiicola infection from China, highlighting the emergence of a rare fungus that causes keratitis. Furthermore, mNGS has the capability to facilitate prompt identification and timely management of challenging ocular infections that are difficult to diagnose.
Fulminant fatal pneumonia and bacteremia due to Aeromonas dhakensis in an immunocompetent man: a case report and literature review
Authors: Lei Jiang, Qiquan Zhao, Dairong Li, Jia Gao, Xiaobing Zhang, Qian Shu, Xiaoli Han
Journal: Front Cell Infect Microbiol (2024)
Keywords: aeromonas dhakensis, bacteremia, housekeeping gene sequencing, metagenomic next-generation sequencing, pneumonia
MeSH terms: Aeromonas / genetics, Aeromonas / isolation & purification, Aeromonas / pathogenicity, Bacteremia / diagnosis, Bacteremia / microbiology, Bronchoalveolar Lavage Fluid / microbiology, Gram-Negative Bacterial Infections / diagnosis, Gram-Negative Bacterial Infections / microbiology, Case Reports, Review, Adult, Fatal Outcome, High-Throughput Nucleotide Sequencing, Humans, Lung / microbiology, Lung / pathology, Male, Metagenomics, Pneumonia, Bacterial / diagnosis, Pneumonia, Bacterial / microbiology

Background:

Aeromonas dhakensis is associated with soft tissue infection, bacteremia and gastroenteritis. Involvement of respiratory system in adults is extremely rare. We report a case of fulminant pneumonia and bacteremia due to A. dhakensis in a patient without underlying diseases.
Case presentation:
A 26-year-old man became ill suddenly with pneumonia after swimming in a river. Despite intensive support measures in the intensive care unit, he died 13 hours after admission and 4 days after his first symptoms. Autopsy showed abundant Gram-negative bacteria, massive inflammatory cell infiltration, edema, necrosis and hemorrhage in lung tissue. A. dhakensis was isolated from blood culture taken at admission and bronchoalveolar lavage fluid (BALF) after intubation. Moreover, A. dhakensis was also detected in lung tissue by metagenomic next-generation sequencing (mNGS) assay. The infection may have come from river water.
Conclusion:
In patients who develop a fulminant pneumonia after contacting an aquatic environment, A. dhakensis should be alerted and mNGS may aid in the detection of aquatic pathogens by being more sensitive and specific versus traditional bacterial culture.