OpenMed/multicare-articles huggingface dataset:
A case report on imaging findings of rare segmental necrotizing granulomatous neuritis of leprosy involving ulnar nerve
Authors: S B S Netam, Nilesh Gupta, Nobal Chandrakar
Journal: Qatar Med J (2024)
Keywords: abscess, leprosy, magnetic resonance imaging, ulnar nerve, ultrasonography
MeSH terms: Case Reports

Introduction:
Segmental necrotizing granulomatous neuritis (SNGN) is a rare complication of leprosy involving peripheral nerves. It can appear alone in cases of pure neuritic leprosy or in combination with cutaneous lesions.
Case presentation:
A 15-year-old female diagnosed with borderline tuberculoid leprosy who received prior multidrug therapy presented 2 years later with occasional pain and tingling sensations along the inner aspect of her right arm and forearm. Imaging findings suggested SNGN, which was corroborated by cytopathological examination. She was considered relapsed from leprosy, and multi-drug therapy and steroids were started, following which she reported a decrease in the size of the swelling along with no further deterioration of the sensorineural deficit.
Discussion:
SNGN, which is one of the rare complications of leprosy, can create diagnostic dilemmas as its differential diagnoses include reversal reactions, and peripheral nerve tumors (such as schwannoma and neurofibroma), which have been outlined in this article. SNGN is more likely when magnetic resonance imaging (MRI) shows a well-defined ovoid lesion with central necrosis and peripheral rim enhancement.
Conclusion:
The incidence of SNGN is on the rise due to multi-drug therapy. In our case, the patient developed SNGN, which was considered a relapse from leprosy, and multi-drug therapy and steroids were started, following which the patient reported a significant reduction in the size of the swelling with no further deterioration of the sensorineural deficit. Hence, an appropriate diagnosis of SNGN through ultrasonography and MRI will lead to favorable outcomes, ultimately benefiting the patient.
Large Left Atrial Thrombus in a Patient With Severe Mitral Stenosis and Atrial Fibrillation Despite Anticoagulant Therapy: A Case Report
Authors: Silvio Nocco, Laura Concas, Marco Fei
Journal: Cureus (2024)
Keywords: cardiac mass, echocardiography, left atrial dilatation, left atrial thrombus, mitral stenosis
MeSH terms: Case Reports

This case report highlights a patient with atrial fibrillation, severe mitral stenosis, and left atrial dilatation who developed a large thrombus, despite being on anticoagulant therapy. The complexity of thrombus formation in patients with multiple risk factors is described, emphasising the need for regular echocardiographic assessments to detect and monitor thrombi, even in patients undergoing anticoagulant treatment. The interplay between atrial fibrillation, mitral stenosis, and left atrial dilatation contributes to thrombus formation, requiring a multidisciplinary approach to the management of these patients. Further research is needed to improve our understanding of the optimal treatment strategies for such cases. Timely identification and intervention are critical to mitigate the risk of thromboembolic complications in these high-risk patients.
Case report: Clinical features of pediatric acute myeloid leukemia presenting with cardiac tamponade: a case series study and literature review
Authors: Tonghui Li, Xue Tang, Xuezhi He, Lei Zhang, Ya Zhang, Lulu Wang, Shilin Liu, Guichi Zhou, Feiqiu Wen, Sixi Liu, Huirong Mai, Ying Wang
Journal: Front Oncol (2024)
Keywords: acute myeloid leukemia, cardiac myeloid sarcoma, cardiac tamponade, pediatric, pericardial effusion
MeSH terms: Case Reports

Objective:
This study aims to elucidate the clinical features observed in cases of pediatric acute myeloid leukemia (AML) initially presenting with cardiac tamponade and to share treatment experiences.
Materials and methods:
Five pediatric patients were initially diagnosed with AML accompanied by cardiac myeloid sarcoma (MS). The diagnosis was established by examining our hospital records and reviewing pertinent literature from 1990 to July 2023, accessible through MEDLINE/PubMed. We comprehensively assessed the clinical characteristics and treatment modalities employed for these patients.
Result:
Five pediatric patients presented with acute symptoms, including shortness of breath, malaise, cough, and fever, leading to their hospitalization. Physical examination revealed irritability, hypoxia, tachypnea, tachycardia, and hypotension. Initial detection utilized chest X-ray or echocardiogram, leading to subsequent diagnoses based on pericardial effusion and/or bone marrow examination. Two patients received chemotherapy at the time of initial diagnosis, one with cytarabine and etoposide, and the other with cytarabine and cladribine. Post-treatment, their bone marrow achieved remission, and over a 2.5-year follow-up, their cardiac function remained favorable. Unfortunately, the remaining three patients succumbed within two weeks after diagnosis, either due to receiving alternative drugs or without undergoing chemotherapy.
Conclusion:
This is the first and largest case series of pediatric AML patients with cardiac MS, manifesting initially with cardiac tamponade. It highlights the rarity and high mortality associated with this condition. The critical factors for reducing mortality include identifying clinical manifestations, conducting thorough physical examinations, performing echocardiography promptly, initiating early and timely pericardial drainage, and avoiding cardiotoxic chemotherapy medications.
Case report: Uncommon manifestations of Rosai-Dorfman disease in the liver mimicking HCC
Authors: Huipeng Ren, Hao Zhang, Qinyun Wan, Yuhui Pang, Hongzhe Tian, Zhuanqin Ren, Yuan Cai
Journal: Front Oncol (2024)
Keywords: rosai-dorfman disease, extranodal lesion, hepatic lesions, histiocytosis, non-langerhans cell histiocytosis
MeSH terms: Case Reports

Rosai-Dorfman-Destombes disease (RDD) is a rare non-Langerhans cell histiocytosis (LCH) disorder characterized by systemic extranodal lesions. Common cases include skin lesions, whereas liver lesions are rare. This study presents a case of a 66-year-old woman with a solitary extranodal liver lesion who underwent successful surgical treatment followed by glucocorticoid therapy. The patient did not experience any symptoms before surgery. The liver lesion was incidentally discovered during a routine ultrasound examination. Enhanced CT scan revealed the lesion with the characteristic of washout, similar to primary hepatic cancer (HCC). CT scans of the head, neck, chest, and abdominal pelvis revealed no lymph node or other organ lesions. After surgery, the liver lesion was diagnosed as RDD, and subsequent whole-body examinations did not reveal any skin lesions. The definitive diagnosis was solid liver RDD in adults. Although there were no typical cases of bilateral cervical lymph node lesions, ultrasound and CT examinations promptly detected liver lesions, leading to the correct diagnosis through surgical resection. The findings from this case indicate that RDD can occur in rare extrasegmental areas, and the imaging characteristics of liver lesions are not specific, indicating the importance of avoiding delayed diagnosis.
Large vestibular schwannomas presenting in the late state of pregnancy: a case report and literature review
Authors: Mingbin Bao, Yunsen He, Ye Tao, Li Liu, Yuheng Li, Yongjun Zhu, Qinjiang Huang, Mengjun Zhang, Bo Wu, Hao Wang
Journal: Front Neurol (2023)
Keywords: multidisciplinary, neuroma, pregnancy, surgery, vestibular schwannoma
MeSH terms: Case Reports

Vestibular schwannomas in pregnancy have rarely been reported, and there is a lack of in-depth discussion on the experience of management of massive acoustic neuromas in pregnancy. Herein, we present a pregnant woman with a giant vestibular schwannoma and obstructive hydrocephalus who presented at 30 weeks of gestation. She was initially misdiagnosed as having a pregnancy-related reaction of headache, dizziness, and vomiting that had occurred 2 months earlier. After observation at home, her symptoms progressed at 30 weeks of gestation, and imaging findings revealed a brain tumor in the CPA region with secondary cerebella tonsil herniation and obstructive hydrocephalus, and she was transferred to our center for treatment. Consequently, we relieved her hydrocephalus with a ventriculoperitoneal shunt (V-P shunt) and used corticosteroids to simulate fetal maturation. After 10 days, her mental condition deteriorated, and her right limb muscle strength gradually decreased until grade 0 (MMT Grading). Finally, under a joint consultation with the Department of Neurosurgery, Obstetrics, and Anesthesiology, she underwent a cesarean section under general anesthesia and first-stage tumor removal at 31 weeks of gestation. Upon discharge, the previously observed neurological deficits, which were reversible and had manifested during her gestational period, had been successfully resolved, and the fetus had been conserved. The neuroimaging confirmed the complete tumor removal, while the neuropathologic examination revealed a vestibular schwannoma. Therefore, we recommend early diagnosis and treatment for these patients, especially people with headaches, vomiting, and sudden hearing loss during pregnancy. Herein, we concluded that our cases provide a valuable experience in the latest acceptable time frame for the operation to prevent irreversible neurological impairment and premature delivery in late pregnancy.
Implementing neuropsychological rehabilitation following severe traumatic brain injury in a low-to-middle income country: a case report
Authors: Alexa Caitlin Soule, Taryn Jane Fish, Jill Winegardner, Leigh Schrieff-Brown
Journal: Front Rehabil Sci (2024)
Keywords: tbi, executive function, memory, neuropsychology, rehabilitation, single-case study
MeSH terms: Case Reports

Introduction:
TBI incidence and distribution are largely overrepresented in low- to middle-income countries (LMICs), such as South Africa (SA), with substantial associated human and financial costs. However, access to rehabilitation for the public is severely limited and not standard practice in SA. Given this background, studies demonstrating the successful implementation of neuropsychological rehabilitation in a LMIC setting are important. Published studies of this nature are generally lacking in this context. Further, there is a need to evaluate interventions that can be implemented at a low cost. To this end, we report on a neuropsychological rehabilitation program for an individual with severe TBI in a LMIC context, aimed at improving his capacity for activities of daily living.
Method:
A 33-year-old, South African male who sustained a severe traumatic brain injury (TBI) partook in a neuropsychological intervention aimed at remediating functional deficits and enhancing independent functioning. The intervention utilised principles of Goal Management Training and external memory aids, with reliance on procedural memory and errorless learning, to target the participant's impairments in executive functioning and memory through the use of assistive technology-namely smart device applications.
Results:
Data collected pre- and post-intervention on formal neuropsychological measures demonstrated no significant change in cognition. However, observational data and qualitative feedback from the participant's family indicated notable improvement in performance on everyday tasks with reduced number of errors and reduced need for external prompting whilst completing intervention tasks across sessions.
Discussion:
In the context of severe TBI, neuropsychological rehabilitation can facilitate gains in independent functioning. This study provides support for the value of neurorehabilitation especially for interventions that can be rolled out at low cost and should serve as impetus for further such research in South Africa, where neuropsychological rehabilitation infrastructure and services are lacking.
Pure Open Ankle Dislocation Leading to Isolated Lateral Ligament Complex Tear: A Rare Case
Authors: Taha El Aissaoui, Aboubacar Lawan, Adnane Lachkar, Najib Abdeljaouad, Hicham Yacoubi
Journal: Cureus (2024)
Keywords: ankle and foot, antibiotic, open dislocation, pure ankle dislocation, debridement
MeSH terms: Case Reports

Pure open ankle dislocation is a rare orthopedic emergency characterized by the absence of associated bony lesions, necessitating prompt and immediate management to prevent disastrous complications. This article details a distinctive case of open pure ankle dislocation in an 18-year-old female following a motorcycle accident, resulting in a 6-cm wound and a dislocated left ankle with a concurrent tear of the anterior talofibular ligament and calcaneofibular ligament. Immediate reduction under sedation was performed, followed by intensive debridement and ligament repair in the operating room. Postoperatively, the patient received antibiotic coverage for five days and underwent immobilization for six weeks. At the 18-month follow-up, the patient exhibited a complete range of motion with no reported pain or instability. This study contributes to the existing literature by presenting a successful treatment paradigm, providing valuable insights for practitioners encountering similar cases.
Denosumab combined with precision radiotherapy for recurrent giant cell tumor of the thoracic spine: a case report and literature review
Authors: Zukang Miao, Ming Xu, Kai Zheng, Hai Gong, Ning Yan, Qian Chen, Xiuchun Yu
Journal: Front Neurol (2024)
Keywords: denosumab, giant cell tumor of bone, local recurrence, radiotherapy, spine
MeSH terms: Case Reports

Giant cell tumors of the spine have a high recurrence rate owing to their special anatomical site; hence, further treatment after recurrence is very challenging. Achieving effective tumor control and improving the long-term quality of life of the patients are the main treatment purposes to consider for recurrent giant cell tumors of the spine. A patient showing giant cell tumor recurrence of the thoracic spine after curettage received denosumab combined with precision radiotherapy, through which the tumor gained good control and the patient could regain normal functioning. A review of the relevant literature suggested that denosumab combined with radiotherapy is an effective new approach for the treatment of recurrent giant cell tumors of the spine.
A Case Study of Furunculosis following an Ayurvedic Oil Massage, Sudation Therapy, and Lessons to Learn
Authors: Satyajit Pandurang Kulkarni, Pallavi Satyajit Kulkarni, S Kumar
Journal: Case Rep Dermatol Med (2024)
MeSH terms: Case Reports

India has a long history of using sudation therapy and oil massage as Ayurvedic treatments. However, nothing is known about its side effects, and just two studies have identified side effects as cutaneous adverse drug reactions brought on by Ayurvedic oil massage. We are presenting the example of a 72-year-old adult man who visited our hospital and had his right knee massaged with Nirgudi oil followed by sudation therapy. Erythema, papules, itchiness, and scorching pain were some of his symptoms. However, these sensations only partially abated once we quit sudation therapy. Our investigation demonstrates that a Nirgudi oil massage or sudation causes the skin reaction associated with furunculosis. This case report illustrates the necessity of being aware of Panchakarma-related consequences and suggests that medical practitioners, patients, and product makers take into account the likelihood of such a reaction following Nirgudi oil massage and sudation therapy as a precaution.
Colonic Resection in an 8-Year-Old Girl with Intractable Functional Constipation and Diffuse Colonic Dysmotility and Failed Antegrade Flushes
Authors: Gabriella Danziger, Thomas O Xu, Teresa Lynn Russell, Laura Tiusaba, Jennie Yun, Marc A Levitt, Andrea Badillo
Journal: European J Pediatr Surg Rep (2024)
Keywords: antegrade continence enemas, colonic resection, diffuse colonic dysmotility, functional constipation, idiopathic constipation
MeSH terms: Case Reports

Optimal surgical management of patients with intractable constipation and diffuse colonic motility is not well defined. We present a patient with such a history, who ultimately achieved successful surgical management of constipation through a stepwise approach. An 8-year-old female presents with longstanding constipation and diffuse colonic dysmotility demonstrated with colonic manometry. She initially underwent sigmoid resection and cecostomy which failed and required diverting ileostomy. We initially proceeded with an extended resection, colonic derotation (Deloyers procedure), and neo-appendicostomy (neo-Malone) which resulted in successful spontaneous stooling for 1 year. Her constipation recurred and she subsequently underwent completion colectomy with ileorectal anastomosis given that she previously demonstrated ability to stool independently. Six months from surgery the patient continues to stool daily with assistance of fiber and loperamide. This case highlights a stepwise surgical approach to managing constipation due to diffuse colonic dysmotility and demonstrates that diffuse dysmotility may benefit from an upfront subtotal resection; however, it is crucial to assess a patient's ability to empty their rectum prior.
Exploring the influence of historical storytelling on cultural heritage tourists' revisit intention: A case study of the Mogao Grottoes in Dunhuang
Authors: Feng Yuxin, Qin Jianpeng, Lv Xiaoyu, Tian Yunxia, Meng Weilong
Journal: PLoS One (2024)
MeSH terms: Tourism, Adult, China, Culture, Female, Humans, Intention, Male, Narration

The revisit intention of tourists has long been a focal point of academic inquiry. However, there is still insufficient research on the antecedents of revisit intention from the perspectives of historical storytelling, destination image and perceived value. Taking the Mogao Grottoes in Dunhuang, a UNESCO World Heritage Site, as a case study, this paper, based on stimulus-organism-response (SOR) theory, examines the impact of historical storytelling on the destination image, perceived value, and revisit intention. Additionally, it further explores the mediating role of destination image and perceived value, as well as the moderating effect of place attachment in this chain. The research findings indicate that: (1) Historical storytelling significantly enhances tourists' perception of the tourism experience and revisit intention; (2) The study supports the mediating effect of destination image and perceived value; (3) Place attachment has a significant positive moderating effect between historical storytelling and revisit intention. Effective historical storytelling can significantly enhance destination image and perceived value, improve tourists' participation and satisfaction in tourism, stimulate revisit intention, and promote the sustainable development of tourist destinations. These findings enrich the research content of cultural heritage tourism, providing valuable suggestions for improving the management level of cultural heritage tourism attractions and increasing visitors' revisit intention.
Late-onset cobalamin C deficiency type in adult with cognitive and behavioral disturbances and significant cortical atrophy and cerebellar damage in the MRI: a case report
Authors: Miao Sun, Yingjie Dai
Journal: Front Neurol (2023)
Keywords: mmachc, bilateral cerebellar lesions, cblc, methylmalonic acidemia, reversible dwi change
MeSH terms: Case Reports

Background:
Late-onset cobalamin C (cblC) deficiency is associated with a wide range of neurological and psychiatric symptoms, hematological manifestations, anorexia, renal failure, ocular abnormalities, dermatitis, and pancreatitis. However, the neuroimaging characteristics of late-onset cblC deficiency remain insufficiently documented. Common findings include diffuse white matter swelling, varying degrees of severe leukoaraiosis, hydrocephalus, corpus callosum atrophy, and symmetric bilateral basal ganglia lesions. In this report, we present a case of late-onset cblC deficiency in adults presenting with cerebellar ataxia as the primary symptom. The MRI findings revealed bilateral lateral cerebellar hemispheres exhibiting symmetric hyperintensity, primarily observed in diffusion-weighted imaging (DWI), which is a rarely reported imaging change in this context.
Case presentation:
Our patient was a male who experienced symptoms starting at the age of 30 years, including unsteady walking, apparent cerebellar ataxia, and cognitive impairment upon nervous system examination. Brain magnetic resonance imaging (MRI) exhibited symmetric hyperintensity in the bilateral lateral cerebellar hemispheres, predominantly manifested in DWI, without any enhancement. Subsequently, significantly elevated blood total homocysteine and urinary methylmalonic acid levels were observed. Genetic analysis confirmed the presence of MMACHC compound heterozygous mutants c.482G > A and c.609G > A, thus confirming the diagnosis of cblC deficiency. These variants were classified as likely pathogenic following the guidelines of the American College of Medical Genetics and Genomics (ACMG) and were verified using Sanger sequencing. Following treatment, the patient experienced improvements in walking ability and cognition, a significant decrease in blood total homocysteine levels, and reversal of the imaging lesions.
In conclusion:
Late-onset cblC deficiency presents with diverse clinical and imaging manifestations. Early diagnosis and treatment are crucial in achieving a favorable prognosis. This case serves as a reminder to clinicians not to overlook genetic metabolic disorders, particularly those causing multisite damage, in adult patients with undiagnosed neurological disorders, especially those affecting the cerebellum. Notably, methylmalonic acidemia should be considered within the spectrum of bilateral cerebellar lesions.
De novo p.Glu61Ter mutation in GCH1 in a Moroccan patient with dopa-responsive dystonia: a case report
Authors: Ahmed Bouhouche, Leila Tamaoui, Nazha Birouk
Journal: Pan Afr Med J (2024)
Keywords: dopa-responsive dystonia, gch1 gene, case report, de novo non-sense mutation
MeSH terms: Dystonic Disorders / drug therapy, Dystonic Disorders / genetics, GTP Cyclohydrolase / genetics, Case Reports, Codon, Nonsense, Female, Humans, Male, Morocco, Mutation, GTP Cyclohydrolase, GCH1 protein, human, Codon, Nonsense, Dystonia, Dopa-responsive

Dopa-responsive dystonia (DRD) is a hereditary movement disorder due to a selective nigrostriatal dopamine deficiency. It is characterized by onset in childhood or adolescence with marked diurnal fluctuation with or without Parkinsonian features, and is caused by mutations in GCH1 gene. We report in this study the clinical and genetic features of the first DRD Moroccan patient. Using a gene panel sequencing, we identified a heterozygous nonsense variant p. Glu61Ter in GCH1. A subsequent targeted segregation analysis by Sanger sequencing validated the presence of the mutation in the patient, which was found to have occurred de novo. The objective of this study is to report the first description of DRD in Morocco, and highlights the importance of new generation sequencing technology in the reduction of medical wandering and the management of hereditary diseases.