OpenMed/multicare-articles huggingface dataset:
Delayed Presentation of Shoulder Tuberculosis
Authors: Majid Darraj
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Infections caused by Mycobacterium tuberculosis (MTb) have a global distribution, with infections occurring most frequently in persons residing in or who have resided in developing nations. Pulmonary tuberculosis (Tb) is the most common form of infection caused by MTb. Osteoarticular Tb is a far less common condition than pulmonary Tb and is frequently overlooked in the differential diagnosis of persons with joint pathology. Osteoarticular Tb infections are far less common than pulmonary Tb and are usually not considered in the differential diagnosis. We describe a case of a 57-year-old immigrant African male who presented with 5 years of right shoulder pain and a restricted range of movement. Magnetic resonance imaging (MRI) concluded right shoulder septic arthritis, for which he underwent operative drainage and debridement was undertaken. The thick purulent joint fluid subsequently yielded MTb, establishing the diagnosis of osteoarticular Tb. We conclude that Tb should be suspected in cases of long-standing joint pain and stiffness, particularly in persons from endemic areas with Tb as well as patients with a previous history of Tb exposure.
Coronary-cameral fistula with angina pectoris
Authors: Mehmet Akif Cakar, Ersan Tatli
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Coronary-cameral fistula (CCF) is an anomalous connection between a coronary artery and cardiac chamber. Most of CCFs are discovered incidentally during angiographic evaluation for coronary vascular disorder. We report a case of CCF with angina pectoris. Selective coronary arteriography revealed diffuse CCF involving the left anterior descending artery (LAD) emptying into left ventricle (LV) and showed significant two-vessel coronary artery stenosis.
Case report: Video-assisted minimally invasive mitral and pulmonary valve replacement as reoperation in patient with situs inversus totalis
Authors: Saad Salamate, Ali El-Sayed Ahmad, Ali Bayram, Sami Sirat, Farhad Bakhtiary
Journal: Front Cardiovasc Med (2023)
Keywords: dextrocardia situs inversus totalis, minimally invasive surgery, mitral valve, pulmonary valve, reoperation
MeSH terms: Case Reports

Dextrocardia with situs inversus totalis is a rare congenital condition. We report herein a first experience of video-assisted minimally invasive mitral and pulmonary valve replacement through right anterior mini-thoracotomy as reoperation in patient with this complex anomaly. The good clinical and cosmetic results demonstrate that this innovative technique can be safely performed even in difficult anatomical conditions.
Case report: Heart failure secondary to myocardial infarction in a fertile woman with woven coronary artery
Authors: Jiayi Hu, Qian Wang, Mei Dong, Huixia Lu
Journal: Front Cardiovasc Med (2022)
Keywords: coronary angiography, coronary artery bypass grafting, heart failure, ischemic heart disease, woven coronary artery
MeSH terms: Case Reports

A 42-year-old female was hospitalized with 2-day history of fever, dyspnea, and chest tightness. Four years ago, she had similar symptoms at the eighth week of gestation. Computed tomography coronary angiography only suggested moderate stenosis, but cardiac MRI indicated myocardial infarction. The coronary angiography demonstrated a woven coronary artery. She underwent successful coronary artery bypass grafting surgery and took medication regularly. Finally, the prognosis was favorable. Cardiovascular events seldom happen in fertile women because of the protection of estrogen, but once it occurs, the potential cause, such as coronary anomaly and other risk factors, should not be overlooked.
Case study: auditory brain responses in a minimally verbal child with autism and cerebral palsy
Authors: Shu H Yau, Genevieve McArthur, Nicholas A Badcock, Jon Brock
Journal: Front Neurosci (2015)
Keywords: autistic disorder, auditory processing, autism, autism spectrum disorder, cerebral palsy, event-related potentials, language impairment, magnetoencephalography
MeSH terms: Case Reports

An estimated 30% of individuals with autism spectrum disorders (ASD) remain minimally verbal into late childhood, but research on cognition and brain function in ASD focuses almost exclusively on those with good or only moderately impaired language. Here we present a case study investigating auditory processing of GM, a nonverbal child with ASD and cerebral palsy. At the age of 8 years, GM was tested using magnetoencephalography (MEG) whilst passively listening to speech sounds and complex tones. Where typically developing children and verbal autistic children all demonstrated similar brain responses to speech and nonspeech sounds, GM produced much stronger responses to nonspeech than speech, particularly in the 65-165 ms (M50/M100) time window post-stimulus onset. GM was retested aged 10 years using electroencephalography (EEG) whilst passively listening to pure tone stimuli. Consistent with her MEG response to complex tones, GM showed an unusually early and strong response to pure tones in her EEG responses. The consistency of the MEG and EEG data in this single case study demonstrate both the potential and the feasibility of these methods in the study of minimally verbal children with ASD. Further research is required to determine whether GM's atypical auditory responses are characteristic of other minimally verbal children with ASD or of other individuals with cerebral palsy.
Mesenteric Ischemia and Its Need for Timely Recognition and Management
Authors: Anish Kumar Shrestha, Anisha Shrestha, Bikal Ghimire, Prajwal Ram Ghimire, Simin Kunwar, Prajjwol Luitel, Niranjan Adhikari
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Mesenteric ischemia is a fatal vascular emergency of the small intestine which, if not diagnosed and treated in time, has a very high mortality rate. Presenting with nonspecific symptoms such as abdominal pain, nausea, constipation, tachycardia, and gastrointestinal bleeds, it can masquerade as other causes of acute abdomen, particularly bowel obstruction. Ideal laboratory tests and markers are still lacking due to complexity in bowel's anatomy, physiology, blood supply, and drainage. We report 10 cases of mesenteric ischemia presented in our center with their demography, laboratory findings, approach to diagnosis, and treatment along with their outcomes at discharge. Out of the ten cases, six cases presented with signs and symptoms of acute bowel obstruction without passage of stool and one with passage of black stool. These seven patients underwent laparotomy, while the remaining three cases who either presented with milder symptoms or refused surgical interventions were managed conservatively. All patients were diagnosed with either acute or chronic mesenteric ischemia based on their operative and/or radiographic findings.
Insufficiency fracture in the para-acetabulum, with features mimicking those of a malignant bone tumor
Authors: Akio Sakamoto, Takuaki Yamamoto, Kazuhiro Tanaka, Shuichi Matsuda, Tatsuya Yoshida, Yukihide Iwamoto
Journal: Clin Med Case Rep (2008)
Keywords: ct, mri, insufficiency fracture, para-acetabulum, plain radiograph
MeSH terms: Case Reports

Para-acetabular insufficiency fractures are rare and exceedingly difficult to diagnose without a high index of suspicion, since the images mimic those of bone tumors. We herein present the case of a 55-year-old woman who suffered from hip pain with subacute onset. She had undergone a hysterectomy-ovariectomy due to endometriosis when she was 41 years old. Her bone mineral density was normal due to supplemental treatment with female hormones. About 3 months after onset, she was referred to our institute with a diagnosis of pelvic bone tumor. Plain radiographs and computed tomography showed irregular osteosclerosis in the para-acetabulum. Bone scintigraphy demonstrated uptake in the para-acetabulum. Magnetic resonance imaging showed abnormal signal with low-signal intensity on T1-weighted images and high-signal intensity on T2-weighted images throughout the entire hemipelvic bone. Since the pain continued for more than 3 months, open biopsy was undertaken and the lesion was found to be non-neoplastic. Six months after onset, the pain disappeared. The clinical course suggested a diagnosis of insufficiency fracture in the para-acetabulum. Para-acetabular insufficiency fractures should always be considered in cases of hip pain, even in patients with prolonged symptoms.
Localized candidiasis in kidney presented as a mass mimicking renal cell carcinoma
Authors: Zhao Song, Nicholas Papanicolaou, Stephanie Dean, Zhanyong Bing
Journal: Case Rep Infect Dis (2012)
MeSH terms: Case Reports

Candida albicans is a ubiquitous fungus and infection of urinary tract by C. albicans can be originated from blood or retrograde infection. We reported a case of localized candidiasis in the kidney presenting as a mass. The patient was a 61-year-old male with a history of type 2 diabetes mellitus and urinary bladder urothelial carcinoma status post radical cystoprostatectomy with a neobladder three years ago. Pathology at that time also showed a prostatic adenocarcinoma (Gleason score 3 + 4) in addition to the high-grade urothelial carcinoma. Three month ago the patient presented with flank pain, chill, and increased white cell counts. Imaging study showed a large renal mass suspicious for a renal cell carcinoma. Radical nephrectomy was performed and found that there was a large pocket of pus in the retroperitoneum around the right kidney during the surgery. Intraoperative abscess cultures were positive for C. albicans. Pathology showed a 13.5 cm necrotic renal mass extending to the perinephric fat. Histologically the tumor showed necrotic granulomatous inflammation. Grocott stain in the surgical specimen was positive for pseudohyphae and yeast forms. The patient was initiated a course of fluconazole postoperatively and was feeling well.
Low-Dose Fluoxetine in Four Children with Autistic Spectrum Disorder Improves Self-Injurious Behavior, ADHD-Like Symptoms, and Irritability
Authors: Juan Pablo Lucchelli, Gilles Bertschy
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Autism Spectrum Disorder (ASD) is defined by the copresence of two core symptoms: alteration in social communication and repetitive behaviors and/or restricted interests. In ASD children and adults, irritability, self-injurious behavior (SIB), and Attention Deficit and Hyperactivity Disorders- (ADHD-) like symptoms are regularly observed. In these situations, pharmacological treatments are sometimes used. Selective Serotonin Reuptake Inhibitors- (SSRI-) based treatments have been the subject of several publications: case reports and controlled studies, both of which demonstrate efficacy on the symptoms mentioned above, even if no consensus has been reached concerning their usage. In this article four clinical cases of children diagnosed with ASD and who also present ADHD-like symptoms and/or SIB and/or other heteroaggressive behaviors or irritability and impulsivity treated with low doses of fluoxetine are presented.
Fatal aortic dissection in a patient with giant cell arteritis: a case report and review of the literature
Authors: Anjeli K Nayar, Michael Casciello, Jennifer N Slim, Ahmad M Slim
Journal: Case Rep Vasc Med (2013)

Giant cell arteritis may lead to catastrophic, large-vessel complications from chronic vascular wall inflammation without prompt diagnosis and treatment. We describe a rare case of acute aortic dissection without preceding aneurysm secondary to histologically confirmed giant cell arteritis (GCA) in an 85-year-old female with a four-year history of polymyalgia rheumatica and temporal arteritis diagnosed per biopsy six months prior to presentation. The literature is reviewed and the clinical implications of this case are discussed.
Biliary atresia with an unusual abdominal orientation: A case report
Authors: Jawad Allarakia, Taher Felemban, Waleed Khayyat, Ahmed Alawi, Abdurrahaman Mirza, Batool Alkhazal, Yasmin Yousef
Journal: Int J Surg Case Rep (2019)
Keywords: biliary atresia, case report, congenital abnormalities, heterotaxy, situs anomalies

Introduction:
Biliary atresia (BA) is a rare condition where the hepatic or common bile ducts get obliterated by fibrous tissue for unknown causes. It is diagnosed in 5-10 per 100,000 live births worldwide in whom liver injury and death are definite if untreated.
Presentation:
We report a case of BA with associated malrotation and situs ambiguous discovered incidentally during Kasai procedure. The small intestine was found to be malrotated with the duodenojejunal junction to the right of the vertebral column. The liver, stomach, and spleen were in the center, right side, and left side of the abdomen respectively. The malrotation was corrected by performing a Ladd's procedure in addition to the Kasai. She had an uneventful postoperative course. At follow-up on the second, sixth and 12th weeks postoperatively, she had normal stool color and liver function.
Discussion:
BA patients with associated structural anomalies might have a worse outcome after the Kasai procedure. Several studies demonstrated that the coexistence of malrotation with BA to be in the range of 0.3%-9.4% among BA patients. Also, the presence of situs abnormalities with BA has been reported in some studies to be present in 0.01-0.045% of BA cases. However, the presentation of BA with both situs inversus and intestinal malrotation has seldom been reported.
Conclusion:
The diagnosis of BA should prompt further investigation for other anatomical abnormalities as the presence of which might affect the management plan.
Propionibacterium acnes Is an Unusual Cause of Acute Scrotal Abscess in a Preterm Infant
Authors: Naoto Nishizaki, Tadaharu Okazaki, Yu Adachi, Kaoru Obinata, Hiromichi Shoji, Toshiaki Shimizu
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Acute scrotal abscess is an extremely rare condition in neonates and may mimic testicular torsion. Most of these abscesses have reportedly been due to Staphylococcus and Salmonella spp. infections. We herein report a unilateral acute scrotal abscess in a preterm infant born at 26 weeks in whom Propionibacterium acnes was isolated from the collected scrotal fluid culture. To our knowledge, this is the first case report implicating P. acnes as a causative agent of neonatal scrotal abscess. Based on such findings, P. acnes infection should be considered in differential diagnosis of acute scrotal abscess in neonates, particularly in preterm infants.
A Novel Homozygous JAK3 Mutation Leading to T-B+NK- SCID in Two Brazilian Patients
Authors: Lucila A Barreiros, Gesmar R S Segundo, Anete S Grumach, Pérsio Roxo-Júnior, Troy R Torgerson, Hans D Ochs, Antonio Condino-Neto
Journal: Front Pediatr (2018)
Keywords: jak3, scid, newborn screening, primary immunodeficiency, severe combined immunodeficiency
MeSH terms: Case Reports

We report a novel homozygous JAK3 mutation in two female Brazilian SCID infants from two unrelated kindreds. Patient 1 was referred at 2 months of age due to a family history of immunodeficiency and the appearance of a facial rash. The infant was screened for TRECs (T-cell receptor excision circles) and KRECs (kappa-deleting recombination excision circles) for the assessment of newly formed naïve T and B cells respectively, which showed undetectable TRECs and normal numbers of KRECs. Lymphocyte immunophenotyping by flow cytometry confirmed the screening results, revealing a T-B+NK- SCID. The patient underwent successful HSCT. Patient 2 was admitted to an intensive care unit at 8 months of age with severe pneumonia, BCGosis, and oral moniliasis; she also had a positive family history for SCID but newborn screening was not performed at birth. At 10 months of age she was diagnosed as a T-B+NK- SCID and underwent successful HSCT. JAK3 sequencing revealed the same homozygous missense mutation (c.2350G>A) in both patients. This mutation affects the last nucleotide of exon 17 and it is predicted to disrupt the donor splice site. cDNA sequencing revealed skipping of exon 17 missing in both patients, confirming the predicted effect on mRNA splicing. Skipping of exon 17 leads to an out of frame deletion of 151 nucleotides, frameshift and creation of a new stop codon 60 amino acids downstream of the mutation resulting in a truncated protein which is likely nonfunctional.
Embryonal Rhabdomyosarcoma with Posttherapy Cytodifferentiation and Aggressive Clinical Course
Authors: Maniraj Jeyaraju, Regina Ann Macatangay, Ashley Taylor-King Munchel, Teresa Anne York, Elizabeth A Montgomery, Michael E Kallen
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Rhabdomyosarcoma is the most common soft tissue sarcoma in children and adolescents. Embryonal rhabdomyosarcoma (ERMS), its most common subtype, is a malignant soft tissue tumor with morphologic and immunophenotypic features of embryonic skeletal muscle. The histologic findings in ERMS typically include a range of differentiation in rhabdomyoblasts from primitive to terminally differentiated forms, and the latter become more prominent after chemotherapy-induced cytodifferentiation. Several reports have shown therapy-related cytodifferentiation to portend a good prognosis in ERMS. We discuss the case of a pediatric patient who presented with ERMS of the orbit. Although her tumor showed extensive posttreatment cytodifferentiation and several other good prognostic clinicopathologic factors, it pursued an aggressive course, resulting in early metastasis and death. This case represents an unusual course and may be instructive as to the clinicopathologic features impacting prognostication, and ultimately the biology, of this aggressive family of tumors.
Zipper repair of 3 cm iatrogenic colonic perforation with dual-channel endoscope and twin grasper-assisted titanium clip
Authors: Wei Yang, Wei Wen, Xiaoli Ren, Qi Zhai, Shupei Li, Ji Xuan
Journal: DEN Open (2023)
Keywords: clips, colonoscopy, intestinal perforation, tantalum
MeSH terms: Case Reports

A 53-year-old man undergoing painless colonoscopy for long-term diarrhea. After colonoscopy withdrawing to the sigmoid colon, a local perforation was found, about 3 cm in size, oval in shape. We used a two-channel endoscope and grip to pull the edges of the intestinal wall on both sides of the perforation site to close together, and then repair the 3 cm oval perforation of the colon through multiple ordinary titanium clips. The patient had no obvious infection after surgery and recovered well after 1 month of follow-up. Preliminary experience has shown that using multiple titanium clips under dual-channel endoscope to zipper suture can effectively repair 3 cm iatrogenic colonic perforations.
A sclerosing angiomatoid nodular transformation (SANT) mimicking a metachronous splenic metastasis from endometrioid cancer and ovarian cancer
Authors: Ryota Koyama, Nozomi Minagawa, Yoshiaki Maeda, Toshiki Shinohara, Tomonori Hamada
Journal: Int J Surg Case Rep (2019)
Keywords: laparoscopic splenectomy, sclerosing angiomatoid nodular transformation, splenic metastasis

Introduction:
Sclerosing angiomatoid nodular transformation (SANT) of the spleen has been considered a differential diagnosis of splenic lesions since it was originally reported. However, preoperative diagnosis of SANT is often difficult and histopathological examination by surgical resection is required.
Case presentation:
Because of a new splenic lesion, a 48-year-old woman was suspected of having metachronous solitary splenic metastasis during her postoperative follow-up for endometrioid and ovarian cancer that occurred 3 years previously. Because there was no metastasis to other sites, laparoscopic splenectomy was successfully performed for diagnosis and treatment. Histopathological examination revealed that the splenic lesion consisted of three distinct splenic vessels, thereby indicating SANT without any cancer cells or lymphoproliferative disorders.
Conclusion:
Splenectomy should be considered for the diagnosis and treatment of incidentally detected splenic lesions during follow-up for malignancy.
Management of Traumatic Cataract with Posterior Capsular Rupture: A Case Report and In Vitro Model Study
Authors: Wenjuan Wan, Ke Hu, Yan Ji, Can Li
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Purpose:
To investigate the optimal strategy for surgical management of traumatic cataract with posterior capsular rupture.
Methods:
We describe four cases of traumatic cataract with posterior capsular rupture and an in vitro model built to evaluate the optimal infusion pressure during surgery.
Results:
All patients underwent cataract surgery. By using an anterior chamber maintainer to elevate infusion pressure, we safely performed cataract extraction without phacoemulsification. At 3 days after surgery, visual acuity was greater than 20/25 in all patients, without any complications. Phacoemulsification would also be feasible under anterior chamber maintainer infusion in a similar case of traumatic cataract with posterior capsular rupture during intravitreal injection. In addition, an in vitro model that we established using pig's eyes revealed that the anterior chamber remained stable when the height of infusion bottle was 50-90 mmHg, whereas shallowing of the anterior chamber occurred when the height of infusion bottle was reduced to 40 mmHg, and corneal edema occurred when the height of infusion bottle was raised to 100 mmHg.
Conclusions:
During management of traumatic cataract with posterior capsular rupture, using an anterior chamber maintainer to maintain optimal infusion pressure may reduce the risk of anterior hyaloid membrane breakup and vitreous loss.
Acute on Chronic Heart Failure Secondary to Left Ventricular Noncompaction
Authors: Ivana Capin, Christine A Capone, Matthew D Taylor
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Left ventricular noncompaction (LVNC) is a rare cardiomyopathy characterized by hypertrabeculations and intertrabecular recesses most often seen in the left ventricle (LV). The patient may be asymptomatic or present with heart failure, arrhythmia, and sudden death. We discuss a previously healthy 7-year-old male who presented to the Emergency Department (ED) multiple times over a three-week period. His complaints evolved over the course of his illness, initially presenting with fatigue and suicidal ideation, followed by diffuse abdominal pain. Prior to his ICU admission, he had been discharged from the ED twice, due to well appearance and reassuring lab findings. He returned to the ED a final time with severe venous congestion and cardiogenic shock with acute hepatic injury. Echocardiogram revealed LV apical hypertrabeculation with a severe dilated cardiomyopathy and biventricular failure along with a large thrombus in the left ventricular cavity. Congestive heart failure and anticoagulation therapy was initiated, and the patient went on to biventricular assist device (BiVAD) placement and cardiac transplant. Although LVNC is rare, pediatric heart failure does present to the general pediatrician and has high morbidity and mortality. The presenting symptoms can be obscure and pose a challenge to pediatricians. This case report and review will assist in familiarizing the general pediatrician with pediatric heart failure presentation, treatment, and course.