OpenMed/multicare-articles huggingface dataset:
Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management
Authors: Mariam Thalji, Hanan Qunibi, Loai Muhtasib, Hasan Hroob, Ashraf Al-Zughayyar, Rafiq Salhab, Yousef Abu Asbeh
Journal: Front Surg (2023)
Keywords: acute kidney injury, alveolar hemorrhage, leptospirosis, multiorgan failure, upper gi bleeding, weil’s disease
MeSH terms: Case Reports

Leptospirosis is a common zoonotic disease with a wide range of clinical manifestations, specifically in tropical regions. Weil's disease is considered a severe form of leptospirosis seen in a minority of leptospirosis cases with considerable mortality. These patients typically developed the triad of acute renal injury, jaundice, and hemorrhages. Herein, we reported a case of a 28-year-old male transferred to our intensive care unit due to severe leptospirosis with diffuse alveolar hemorrhage, cholestatic jaundice, acute respiratory distress, and renal injury. The patient was successfully managed with appropriate antimicrobial treatment and other supportive management, including mechanical ventilation, vasopressor, and corticosteroid therapy. Ten days after admission, the patient unexpectedly developed uncontrollable massive upper gastrointestinal bleeding, requiring immediate surgical interventions. Splenectomy, partial gastrectomy, along with gastro-esophageal anastomosis were performed. Following a prolonged hospitalization, the patient fully recovered and was discharged home with excellent clinical outcomes. This fulminant leptospirosis case described here should assist in informing medical professionals of the clinical significance of this serious, occasionally fatal illness. Moreover, leptospirosis should be considered in any location wherever risk factors are present, not just in epidemic and tropical areas. In this case, we pointed out that serious complications of leptospirosis, such as hemorrhage, may happen despite their rarity. In such cases, adopting an integrated multidisciplinary team approach is essential to prevent complications and reduce mortality.
Liver cancer with concomitant TP53 and CTNNB1 mutations: a case report
Authors: Juliane Friemel, Markus Rechsteiner, Marion Bawohl, Lukas Frick, Beat Müllhaupt, Mickaël Lesurtel, Achim Weber
Journal: BMC Clin Pathol (2016)
Keywords: ctnnb1, hepatocellular carcinoma (hcc), intratumor heterogeneity, next generation sequencing, tp53
MeSH terms: Case Reports

Background:
In the spectrum of molecular alterations found in hepatocellular carcinoma (HCC), somatic mutations in the WNT/β-catenin pathway and the p53/cell cycle control pathway are among the most frequent ones. It has been suggested that both mutations occur in a mutually exclusive manner and they are used as molecular classifiers in HCC classification proposals.
Case presentation:
Here, we report the case of a treatment-naïve mixed hepatocellular/cholangiocellular carcinoma (HCC/CCC) with morphological and genetic intratumor heterogeneity. Within the predominant part of the tumor with hepatocellular differentiation, a p.D32V mutation in exon 3 of the CTNNB1 gene occurred concomitantly with a TP53 intron 7/exon 8 splice site mutation.
Conclusion:
Intratumor heterogeneity challenges the concept of CTNNB1 and TP53 gene mutations being mutually exclusive molecular classifiers in HCC, which has implications for HCC classification approaches.
Fusobacterium nucleatum Pleural Empyema in a Patient with Progressive Rheumatoid Arthritis and Immunosuppression
Authors: Wesley Tang, Zi Yu Liu, Charles Abreu
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Fusobacterium nucleatum is an anaerobic oral commensal organism that is often associated with inflammatory bowel disease, adverse pregnancy outcomes, respiratory tract infections, and Lemierre's syndrome. Rheumatoid arthritis is often associated with pleuropulmonary manifestations including noninfectious pleural effusions and interstitial lung disease. We present a case of a 47-year-old man with progressive rheumatoid arthritis on immunosuppressive therapy who was found to have a left-sided pleural effusion, thought secondary to possible pneumonia, and was treated with levofloxacin and methylprednisolone. He presented a month later and was found to have a large left-sided thick-walled fluid collection found to be an empyema. A chest tube was placed, and fluid culture grew Fusobacterium nucleatum. The patient was successfully treated with intrapleural fibrinolytic therapy and amoxicillin-clavulanic acid.
Case Report: Reversible Hyperglycemia Following Rapamycin Treatment for Atypical Choroid Plexus Papilloma in an Infant
Authors: Jiale Liu, Minjie Luo, Siyuan Lv, Shaohua Tao, Zhu Wu, Lihua Yu, Danna Lin, Lulu Huang, Li Wu, Xu Liao, Juan Zi, Xiaorong Lai, Yuting Yuan, Wangming Zhang, Lihua Yang
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: atypical choroid plexus papilloma, case report, infant, insulin, rapamycin, reversible hyperglycemia
MeSH terms: Choroid Plexus Neoplasms / pathology, Choroid Plexus Neoplasms / therapy, Glioma, Hyperglycemia / chemically induced, Hyperglycemia / drug therapy, Papilloma, Choroid Plexus / pathology, Papilloma, Choroid Plexus / surgery, Case Reports, Humans, Infant, Sirolimus / adverse effects, Sirolimus

In this study, atypical choroid plexus papilloma was treated with high-dose rapamycin for 17 days preoperatively in an infant. Rapamycin significantly reduced the blood supply to the tumor while reducing the tumor volume, and most of the tumor was resected successfully. However, the infant developed hyperglycemia related to the rapamycin dose, which was effectively controlled by adjusting the dose and applying insulin.
Poorly differentiated carcinoma with neuroendocrine features in two patients with sinonasal tumours: a report of two cases
Authors: Victor Chimezie Okebalama, John Ifeanyi Nwadiokwu, Ehioghae Osaze, Ayeni Akinwunmi Ayodeji, Obinna Mike Chinatu-Nwankwo
Journal: Pan Afr Med J (2022)
Keywords: poorly differentiated, case report, neuroendocrine, sinonasal, tumour
MeSH terms: Carcinoma / pathology, Carcinoma, Neuroendocrine / diagnosis, Carcinoma, Neuroendocrine / pathology, Carcinoma, Neuroendocrine / therapy, Neoplasms, Glandular and Epithelial, Neuroendocrine Tumors, Case Reports, Fluorouracil, Humans, Male, Tomography, X-Ray Computed, Fluorouracil

Neuroendocrine tumors can be described as rare, heterogeneous, epithelial tumours with principally neuroendocrine differentiation that can be harboured in the sinonasal cavities. Owing to the intermingling of its clinical, radiological and histopathological features, the diagnosis of poorly differentiated sinonasal carcinomas with neuroendocrine features is a daunting one. Many of these tumours have a poor prognosis. In our two cases, patients presented with nasal cavity obstruction and growth of 8 & 5-months duration, respectively. Intranasal growths with intracranial extensions were noted in computed tomography scans in both patients. Our first patient failed to complete his cycle of induction chemotherapy (Cisplatin and 5-fluorouracil) and died 8 months after presentation while our second patient completed his cycle of induction chemotherapy but died 1year, 6months, after presentation, as he was unable to get the planned radiotherapy. Indeed, late presentations, intracranial metastasis, and poor treatment compliance can contribute to the poor outcome of these tumours.
An Abrasion, a Prosthetic Shoulder, and a Cat with a Licking Tendency: Case Report and Literature Review of P. multocida Joint Seeding
Authors: William F Abel, Christopher S Eckman, Robert P Summers, William S Sessions, Amanda E Schnee
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Pasteurella multocida is a pathogen well known for its zoonotic transmission, most commonly by cats and dogs. When bacteremia ensures from an infection, patients with foreign objects present in their bodies, including prosthetic joints and mesh implants, become vulnerable to seeding. There have been multiple documented cases in which P. multocida bacteremia has resulted in infection of both native and prosthetic joints. Furthermore, cases have been documented in which patients with P. multocida bacteremia have developed meningitis and neurological complications. Here, we present a patient with multiple comorbidities including multifactorial immunocompromise, advanced age, and multiple prosthetic joints who developed prosthetic joint infection and spinal osteomyelitis after the development of Pasteurella bacteremia. Aggressive treatment was undertaken given her risk factors, and a combination of antibiotics and surgery was utilized, with the patient making a full recovery.
Atypical Spitz Nevi: A Case Report and Review of the Literature
Authors: Amanda Filiberto, Christine Fuller, Jennifer Rhodes
Journal: Eplasty (2015)
Keywords: atypical spitz nevi, comparative genomic hybridization, histomorphology, malignant melanoma, pagetoid
MeSH terms: Case Reports

A case of atypical ("pagetoid") compound Spitz nevus on the face of a 2-year-old girl is reported with a review of the literature. The nevus was composed of broad but laterally demarcated compound proliferation of enlarged fusiform and epithelioid melanocytes, with florid pagetoid scatter above the junction. Immunohistochemical analyses revealed the Ki-67 proliferation index to be relatively low. Given the histomorphological overlap with melanoma, an array-based comparative genomic hybridization approach revealed a subthreshold gain in chromosome 1q and gain in distal chromosome 17q, with no other associated chromosomal gains or losses. These molecular aberrations suggested a partially transformed tumor, without adequate evidence for a molecular diagnosis of melanoma. Because of the diagnostic dilemma posed by these lesions, recent research has focused on molecular alterations that may help differentiate Spitz tumors from malignant melanomas.
Rapid Spontaneous Total Fusion of Neuropathic Arthropathy of the Wrist After Limited Intercarpal Arthrodesis: A Case Report and Brief Literature Review
Authors: Ke Xu, Guangzhi Wu, Weizhong Zhang, Wei Yu, Shusen Cui, Zhan Zhang
Journal: Front Surg (2022)
Keywords: case report, limited intercarpal arthrodesis, neuropathic arthropathy, spontaneous total fusion, wrist
MeSH terms: Case Reports

Background:
Previous reports on the treatment of neuropathic arthropathy of the wrist were generally conservative, with few case reports of treatment with osteoarticular surgery.
Case presentation:
A 25-year-old right-handed male complained of unpainful swelling of the dorsal aspect of his right wrist for 3 years. He was at that time diagnosed with synovitis and radiocarpal arthritis. The patient underwent a partial Four-Corner Arthrodesis and Synoviectomy to preserve motor function. Over the next 2 months, his right wrist also developed painful redness, with progressive swelling and stiffness. Rheumatoid arthritis, tuberculosis arthritis, and infectious diseases were ruled out in this case. Magnetic resonance imaging (MRI) indicated that he had Chiari II syringomyelia so the patient was eventually diagnosed with destructive neuropathic arthropathy (syringomyelia). After 2 months of conservative treatment, the patient's right wrist spontaneously and completely fused and the pain disappeared.
Conclusion:
Neuropathic arthropathy of the wrist is a rare but clinically significant disease due to its effect on the function of the active limb. Surgeons should rule out a diagnosis of it when treating patients with wrist swelling and osteoarticular abnormalities, otherwise, limited intercarpal arthrodesis should not be taken as a treatment option. Inappropriate partial surgery is likely to lead to rapid total fusion of neuropathic arthropathy of the wrist.
Pulmonary infarction mimicking a lung mass: a case report
Authors: Balakrishnan Jayakrishnan, Saif Musabah Al-Mubaihsi, Nisrien Elfatih Elhassan, Rashid Fuad Al-Sukaiti, Jojy George, Younis Said Al-Alawi, Adil Hashim Al-Kindi
Journal: Pan Afr Med J (2021)
Keywords: pulmonary embolism, case report, lung cancer, pulmonary infarction
MeSH terms: Lung Neoplasms / diagnosis, Pulmonary Embolism / diagnosis, Pulmonary Infarction / diagnosis, Case Reports, Adult, Biopsy, Diagnosis, Differential, Humans, Male, Positron-Emission Tomography, Pulmonary Embolism / pathology, Pulmonary Infarction / pathology, Tomography, X-Ray Computed

Pulmonary infarction usually appears as a wedge-shaped opacity with its base placed laterally. Rarely, pulmonary infarctions may appear as a well-defined rounded opacity mimicking lung cancer and surgical lung biopsy may often be required for definitive diagnosis. We report a patient who was admitted with submassive pulmonary embolism who had an incidental finding of a well-defined opacity in computed tomography (CT) scan. The lesion was avid on positron emission tomography (PET) scan and the patient was a smoker. So, we investigated him further with a percutaneous and later a thoracoscopic lung biopsy. Tumour-like pulmonary infarction is often a challenge for the clinicians.
Askin tumor mimicking a hydatid cyst of the lung in children: case report
Authors: El Hassane Kabiri, Abderrahmane Al Bouzidi, Meryem Kabiri
Journal: Pan Afr Med J (2014)
Keywords: askin tumor, chemotherapy, surgery
MeSH terms: Bone Neoplasms / diagnosis, Bone Neoplasms / therapy, Echinococcosis, Pulmonary / diagnosis, Lung Neoplasms / diagnosis, Lung Neoplasms / therapy, Pneumonectomy, Sarcoma, Ewing / diagnosis, Sarcoma, Ewing / therapy, Case Reports, Chemoradiotherapy, Adjuvant / methods, Child, Diagnosis, Differential, Fatal Outcome, Humans, Male, Time Factors, Treatment Failure, Askin Tumor

Askin tumor is a malignant small round cell tumor that originates from the thoracopulmonary region, usually observed in young subjects. We report a case of askin tumor in a 11 year-old men, who had in his past history a surgery for hydatid cyst of the liver, actually hospitalised for right pulmonary upper lobe mass of the lung. After resection of the mass, the pathological exam confirmed the diagnosis of primitive neuroectodermal tumor (PNET). An adjuvant treatment (radiotherapy and chemotherapy) was done; the patient died 11 months after surgery. Askin tumor is an exclusion diagnosis not always readily made.
Case Report: Atypical Cornelia de Lange Syndrome
Authors: Vito Leanza, Gabriella Rubbino, Gianluca Leanza
Journal: F1000Res (2014)
Keywords: facial dysmorphia, ultrasound

Cornelia de Lange Syndrome (CdLS) (also called Bushy Syndrome or Amsterdam dwarfism), is a genetic disorder that can lead to several alterations. This disease affects both physical and neuropsychiatric development. The various abnormalities include facial dysmorphia (arched eyebrows, synophrys, depressed nasal bridge, long philtrum, down-turned angles of the mouth), upper-extremity malformations, hirsutism, cardiac defects, and gastrointestinal alterations. The prevalence of this syndrome is approximately one per 15,000. Ultrasound is not the perfect means to diagnose CdLS, however, many abnormalities can be detected prenatally by scrupulous image observation. We report an atypical CdLS case characterized by increased nuchal translucency in the first trimester, normal karyotype, saddle nose, micrognathia with receding jaw, low set ears, facies senilis, arthrogryposis of the hands, absence of the Aranzio ductus venous, dilatation of gallbladder and bowel, a unique umbilical artery, increased volume of amniotic fluid, and intrauterine growth retardation ending with the interruption of pregnancy.
Successful use of adalimumab as a conservative treatment for bilateral knee lipoma arborescens in patient with psoriatic juvenile idiopathic arthritis - case report and review of literature
Authors: Marijan Frkovic, Magdalena Kujundzic, Mislav Cavka, Marija Jelusic
Journal: Front Pediatr (2022)
Keywords: tnf inhibitor, adalimumab, juvenile idiopathic arthritis, lipoma, magnetic resonance imaging, synovectomy
MeSH terms: Case Reports

Lipoma arborescens (LA) is a chronic, slowly progressive intra-articular mass associated with the proliferation of synovial villi. It can affect one or several joints and has been commonly described in adults with degenerative joint disease. Most patients have been diagnosed with MRI and/or biopsy findings and are usually treated with partial or total synovectomy. Case reports of LA in children, particularly with juvenile idiopathic arthritis (JIA) are scarce. We present a 16-year-old girl with a prolonged course of psoriatic JIA (initial bilateral knee affection and subsequent involvement of wrists and elbows combined with psoriatic scalp lesions) and LA of both knees. Psoriatic JIA has been diagnosed at the age of 13, with immediate start of methotrexate (MTX) therapy. Several weeks later, magnetic resonance imaging (MRI) of the right knee, performed with the aim of the most swollen joint additional evaluation, revealed synovial changes consistent with LA; arthroscopic biopsy confirmed the diagnosis. After two years of MTX treatment, despite the successful maintenance of minimal JIA activity except for repetitive bilateral knee swelling, control MRI revealed bilateral knee lesions identical to those described two years earlier in the right knee. Following the step-up approach in JIA treatment, the TNF inhibitor adalimumab was added in therapy. Finally, six months later, clinical reduction of both knees swelling was noticed with almost complete LA regression in the right, and partial regression in the left knee, confirmed by final MRI control. A conservative approach, including TNF inhibitors, instead of usually performing synovectomy, seems like a reasonable option in cases of LA with underlying JIA.
Lung Transplantation following Emergency Pneumonectomy in a Polytraumatized 18-Year-Old
Authors: Pascal Gräff, Nico Bruns, Christian Kühn, Christian Krettek, Axel Haverich, Michaela Wilhelmi
Journal: Case Rep Transplant (2021)
MeSH terms: Case Reports

Introduction. On rare occasions, a pneumonectomy needs to be performed after a severe polytrauma. Statistically, this procedure increases the mortality rate to 50%. One option to reduce this high rate could be an organ transplantation if a matching organ can be found. However, the current literature lacks any documentation of such a case. One reason for this stems from the fact that regulations for organ transplantation are very restricted and rarely allow exceptions. In addition, the chance for survival of polytraumatized patients in need of organs in the acute phase of the therapy is often quite unsure. Case Presentation. In this paper, we present the case of an 18-year-old patient who was involved in a serious motorcycle accident. His injury severity score was 29, but he suffered from severe bleeding in his lung which made a pneumonectomy necessary. The procedure led to a severe deterioration of his overall condition. An ECMO therapy was initiated, which effectively only slowed the aggravation. Therefore, he was transferred to our clinic where he was stabilized temporarily. A few days later, his situation turned worse. Since he had no other chance of survival, he was scheduled for a lung transplantation and was assigned an organ. After the transplantation, he stabilized quickly and recovered almost completely. Discussion. In this report, we want to show that an exception to the rules for organ transplantation might make sense on rare occasions. However, to increase the chance for any success, patients must be transferred to highly specialized clinics capable of treating patients with severe conditions. This might be the only chance for those patients to survive.
Robot-Assisted Laparoscopic Prostatectomy in a Prostate Cancer Patient Undergoing Continuous Ambulatory Peritoneal Dialysis
Authors: Sohei Kuribayashi, Kentaro Takezawa, Yohei Okuda, Masataka Kawamura, Nozomu Kishimoto, Go Tanigawa, Koichi Tsutahara, Tetsuya Takao, Seiji Yamaguchi
Journal: J Endourol Case Rep (2017)
Keywords: laparoscopy, peritoneal dialysis, prostatectomy, robot
MeSH terms: Case Reports

Background: Robot-assisted laparoscopic prostatectomy (RALP) has become the gold standard treatment for organ-confined prostate cancer. However, no proper surgical approach or appropriate postsurgical management of RALP has been established for a patient undergoing peritoneal dialysis. Here, we present a case of a peritoneal dialysis patient who underwent RALP and reinstated peritoneal dialysis with no trouble associated with peritoneal dialysis. Case Presentation: The patient was a 61-year-old man with organ-confined prostate cancer. He had been on peritoneal dialysis for 2 years. The peritoneal dialysis catheter was routed subcutaneously from the left lateral region into the abdominal cavity at the paramedian region. RALP was performed by the transperitoneal anterior approach. The surgical maneuver was not influenced by the peritoneal dialysis catheter at all. At the end of surgery, the incised peritoneum was sutured and closed tightly. After surgery, peritoneal dialysis was temporarily interrupted for 2 weeks. Then it was safely reinitiated with no complications. Conclusion: Transperitoneal RALP with complete peritoneal repair can be a standard treatment option for a prostate cancer patient undergoing peritoneal dialysis.
Case Report: Acute hydrotherapy with super-saturated hydrogen-rich water for ankle sprain in a professional athlete
Authors: Dejan Javorac, Valdemar Stajer, Sergej Ostojic
Journal: F1000Res (2020)
Keywords: ankle sprain, hydrotherapy, molecular hydrogen
MeSH terms: Ankle Injuries / therapy, Athletic Injuries / therapy, Hydrotherapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Athletes, Humans, Hydrogen, Male, Water, Water, Hydrogen

Background: The traditional treatment of soft tissue injuries consists of the RICE protocol - rest, ice, compression, and elevation, followed for up to 72 hours after a trauma. Although designed as an immediate therapy to reduce inflammation that occurs after an acute injury, the RICE protcol might not be the best way to promote healing due to limiting blood flow. Molecular hydrogen (H 2) has recently been put forward as a possible adjuvant treatment in musculoskeletal medicine, yet limited data are available concerning its effectiveness as a first-aid intervention. Case report: We report here a case of an elite professional athlete who suffered a grade II ankle sprain, and who subsequently received six sessions of ankle and foot hydrotherapy (e.g. 30-min at every four hours) with super-saturated hydrogen-rich water during the first 24 hours post-injury. The pain VAS self-completed by the patient dropped from 50 points (moderate pain) at baseline (immediately after injury) to 20 points (mild pain) at 24-h follow-up. Ankle swelling dropped by 2.8% and dorsiflexion range of movement improved by 27.9% from baseline to follow-up, respectively. Conclusions: Our case has indicated that an acute multi-session hydrotherapy with hydrogen-rich water might be a helpful treatment in terms of pain, swelling reduction and regaining range of motion after an ankle sprain.