OpenMed/multicare-articles huggingface dataset:
Why is preventing antibiotic resistance so hard? Analysis of failed resistance management
Authors: Shiwei Zhou, Camilo Barbosa, Robert J Woods
Journal: Evol Med Public Health (2020)
Keywords: antibiotic resistance, antibiotic stewardship, clinical decision making, translational evolutionary medicine
MeSH terms: Case Reports

We describe the case of a patient with pancreatitis followed by intra-abdominal infection in which source control was not achieved. Antimicrobial therapy led to the emergence of resistance in multiple organisms through multiple population dynamics processes. While the initial insult was not due to infection, subsequent infections with resistant organisms contributed to a poor outcome for the patient. Though resistance evolution was a known risk, it was difficult to predict the next organism that would arise in the setting of antibiotic pressure and its resistance profile. This case illustrates the clinical challenge of antibiotic resistance that current approaches cannot readily prevent. LAY SUMMARY Why is antibiotic resistance management so complex? Distinct evolutionary processes unfold when antibiotic treatment is initiated that lead, separately and together, to the undesired outcome of antibiotic resistance. This clinical case exemplifies some of those processes and highlights the dire need for evolutionary risk assessments to be incorporated into clinical decision making.
Donor Cell Myeloid Sarcoma in an Umbilical Cord Transplant Patient: A Case Report and a Review of the Literature
Authors: Christi Hayes, Bruce Petersen, Adriana Malone
Journal: Case Rep Hematol (2015)

Donor cell leukemia (DCL) represents a rare complication of allogeneic transplantation. The precise incidence remains unclear, though it may be higher following umbilical cord blood transplants. Here, we present an unusual case of a patient with B-ALL who presented with a donor derived myeloid sarcoma of the heart following a double cord blood transplant. To our knowledge, it is the first case of sarcomatous or chloromatous presentation of DCL following a UCBT.
Hyperuricemic renal failure in nonhematologic solid tumors: a case report and review of the literature
Authors: Neeraj Saini, Kyeong Pyo Lee, Smita Jha, Sanket Patel, Neelima Bonthu, Ankit Kansagra, Ashmeet Bhatia, Sandra E Martinez, Jaymin Patel, Sarah Altamimi, Sara Ghotb
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Tumor lysis syndrome (TLS) is an oncologic emergency that is caused by massive tumor cell lysis. It is commonly associated with hematological cancers like leukemia and lymphoma and uncommonly with solid nonhematologic tumors as well. However, spontaneous tumor lysis syndrome (STLS) without any cytotoxic chemotherapy rarely occurs in solid tumors. We describe a case of STLS in a metastatic adenocarcinoma of unknown primary and review the literature of STLS in solid non-hematologic tumors to identify various risk factors for pathogenesis of this entity.
Cushing Syndrome Secondary to Primary Neuroendocrine Lung Carcinoma
Authors: A Zainal, O Akinsola, K Rajamani
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Cushing syndrome (CS) is a disorder characterized by a result of chronic exposure to excessive glucocorticoids. This article describes a case of a 30-year-old female presenting with fatigue, abdominal striae, unintentional weight gain, and lipodystrophy. A rare diagnosis of ectopic adrenocorticotropic-dependent CS was determined and a neuroendocrine lung tumor (NET) was discovered on chest x-ray. After surgical resection, pathology confirmed lung NET that stained positive for adrenocorticotropic hormone (ACTH). The patient's symptoms fully resolved. The authors aim to urge clinicians to maintain a high index of suspicion for ectopic ACTH secretion (EAS) through a multimodal approach when caring for patients with CS.
Diagnostic Workup and Treatment of a Rare Apocrine Hidrocystoma Affecting the Oral Mucosa: A Clinical and Histological Case Report
Authors: Pier Paolo Poli, Luca Creminelli, Valeria Moramarco, Alessandro Del Gobbo, Franco Ferrante, Carlo Maiorana
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Apocrine hidrocystomas are rare benign cystic tumors originating from the secretory portion of apocrine sweat glands. To the best of our knowledge, there is no evidence currently available reporting the presence of apocrine hidrocystomas in the oral cavity. Therefore, this case report aims to describe the clinical and histological features of an apocrine hidrocystoma affecting the oral mucosa. A 69-year-old male patient presented with a 1-year history of a solitary, well-circumscribed, submucosal mass in the left posterior buccal mucosa. The clinical examination revealed a yellowish soft, fluctuant, and painless lesion with no clinical signs of erythema or ulcerations of the overlying epithelium. The entire lesion was excised and histopathological analysis confirmed the diagnosis of apocrine hidrocystoma. No recurrence was observed after a 1-year follow-up.
A case of hydrocele stone with its composition analysis
Authors: Masayoshi Zaitsu, Koji Mikami, Yuta Takeshima, Takumi Takeuchi
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Hydrocele stones are freely mobile calcified bodies lying between the tunica vaginalis layers, and they are relatively rare. We present here another case of hydrocele stone incidentally discovered when castration was being undergone for the endocrine treatment of prostate cancer. A 71-year-old man was diagnosed as stage D2 prostate cancer with his prostate-specific antigen 387 ng/ml. A white smooth stone of 11 mm in diameter was incidentally found moving freely in the right hydrocele space during castration. The hydrocele stone was of yellow hard center with white materials around it. Crystallographical analysis of the hydrocele stone by a infrared spectrophotometer showed that the center was composed of 64% calcium carbonate and 36% calcium phosphate, while the outer portion was protein. Our case is the fourth where crystallographical analysis was reported for hydrocele stones.
Tumor Flare Reaction in a Classic Hodgkin Lymphoma Patient Treated With Brentuximab Vedotin and Tislelizumab: A Case Report
Authors: Chunting Zhu, Yi Zhao, Fang Yu, Weijia Huang, Wenjun Wu, Jingsong He, Zhen Cai, Donghua He
Journal: Front Immunol (2022)
Keywords: brentuximab vedotin, classic hodgkin lymphoma, immune related adverse event, tislelizumab, tumor flare reaction
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Antineoplastic Agents, Immunological / therapeutic use, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Brentuximab Vedotin / therapeutic use, Hodgkin Disease / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Humans, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, tislelizumab, Brentuximab Vedotin

Background:
Tumor flare reaction (TFR) is a clinical syndrome, which is mainly associated with painful and swollen lymph nodes or splenomegaly, slight fever, bone pain, and skin rash during treatment with immune-related drugs, causing difficulty in distinguishing TFR from disease progression. Brentuximab vedotin (BV) and programmed death 1 (PD-1) inhibitor are two ideal drugs used for the treatment of classic Hodgkin lymphoma, but few studies have reported their adverse effects in association with TFR. The efficacy and safety of monotherapy or combination therapy with these drugs needs to be further evaluated. It is essential to determine whether treated patients can develop TFR, thus enabling more accurate diagnosis and treatment.
Case presentation:
A 26-year-old female patient, diagnosed with classic Hodgkin lymphoma, had received 2 + 3 cycles of ABVD chemotherapy (a combination of adriamycin, bleomycin, vinblastine, and dacarbazine) and 4 cycles of PD-1 inhibitor (tislelizumab) therapy but exhibited poor efficacy. Subsequently, she was given combination therapy of BV (100 mg) + tislelizumab (200 mg). However, a slight fever, painful and swollen axillary lymph nodes, multiple skin rashes with pruritus, joint pain, and fatigue with poor appetite appeared during the treatment. Ultrasound (US) scans revealed that multiple lymph nodes were significantly enlarged. After treatment with low-dose dexamethasone and cetirizine, the symptoms were alleviated. A biopsy of the left axillary lymph node revealed that lymphoid tissue exhibited proliferative changes, without tumor cell infiltration. These findings were consistent with the clinical and pathological manifestations of TFR.
Conclusion:
Combination therapy with BV and PD-1 inhibitor was effective in the treatment of relapsed or refractory classic Hodgkin lymphoma. The results suggest that the combination therapy may cause TFR, and biopsy and also continuous imaging observation are important to determine the disease stage. This approach allows clinicians to decide whether to continue the current treatment plan, and alerts them to the occurrence of excessive activation of the immune system.
Prosthetic Joint Infection of a Revision Knee Arthroplasty with Candida parapsilosis
Authors: Martine Christine Keuning, Aziz Al Moujahid, Wierd Pieter Zijlstra
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We report a case of an infected total knee arthroplasty with Candida parapsilosis. The patient was successfully treated with a two-stage exchange arthroplasty, local antifungal treatment, and systemic antifungal treatment. This specific combination therapy to treat C. parapsilosis joint infection has not been previously reported.
Annular Rupture Due to Calcified Nodule Located in Left Ventricular Outflow Tract (LVOT) During Transcatheter Aortic Valve Replacement (TAVR) Managed by Protamine Sulfate
Authors: Sukhjinder Chauhan, Mina Bhatnagar, Talha N Jilani, Jeffrey Levisman
Journal: Cureus (2023)
Keywords: annular rupture, aortic rupture, aortic stenosis (as), balloon-expandable, left ventricular outflow obstruction (lvot), lvot, self-expanding, tavi, transcatheter aortic valve repair
MeSH terms: Case Reports

Annular rupture is a rare yet fatal complication of transcatheter aortic valve replacement (TAVR). The likelihood of annular rupture is increased by the presence of extensive subannular calcification, excessive balloon dilatation for valve expansion or aggressive valve oversizing to prevent paravalvular leakage during TAVR. Although extensive annular or aortic root calcification increases the likelihood of annular rupture, rupture due to the presence of a calcified nodule in the left ventricular outflow tract (LVOT) is not commonly reported. We present the case of an 84-year-old man who developed an annular rupture during TAVR, likely due to the presence of a calcified nodule located in LVOT, which was noted on a pre-procedural computed tomography (CT) scan. The rupture was identified early and was successfully reversed with the administration of protamine sulfate during the procedure.
Rituximab in steroid-refractory immune-related pancreatitis: a case report
Authors: Armando Santoro, Silvia Masini, Raffaele Cavina, Maria Chiara Tronconi, Fabio De Vincenzo
Journal: Front Oncol (2023)
Keywords: atezolizumab, immune checkpoint inhibitors, immune-related adverse event, rituximab, steroid-refractory pancreatitis
MeSH terms: Case Reports

The use of immune checkpoint inhibitors (ICIs) for treating several types of cancer is increasing, but they may be associated with immune-related adverse events (irAEs). Pancreatitis is a rare irAE, mostly responsive to steroid treatment. There are no published data on the management of steroid-refractory ICI-induced pancreatitis. Rituximab has shown efficacy in the setting of relapsing non-ICI-induced autoimmune pancreatitis. However, its use has not been tested for treating immunotherapy-related pancreatitis. Here, we present the case of a patient with steroid-refractory immune-related pancreatitis successfully treated with rituximab as a potential strategy for irAE management.
Hyperspectral Imaging-A Novel Tool to Assess Tissue Perfusion and Oxygenation in Esophageal Anastomoses
Authors: Duarte Vaz Pimentel, Larissa Merten, Jan-Hendrik Gosemann, Ines Gockel, Boris Jansen-Winkeln, Steffi Mayer, Martin Lacher
Journal: European J Pediatr Surg Rep (2023)
Keywords: anastomotic leakage, anastomotic stricture, esophageal atresia, hyperspectral imaging, perfusion
MeSH terms: Case Reports

Anastomotic stricture and leakage are common complications after repair of esophageal atresia (EA). A compromised perfusion of the anastomosis is a contributing factor. Hyperspectral imaging (HSI) is an ultrashort noninvasive method to measure tissue perfusion. We present two cases of with tracheoesophageal fistula (TEF)/EA repair, in whom we applied HSI: the first patient was a newborn with EA type C who underwent open TEF repair. The second one had an EA type A and cervical esophagostomy, in whom we performed gastric transposition. In both patients, HSI confirmed a good tissue perfusion of the later anastomosis. The postoperative course was uneventful and both patients are on full enteral feeds. We conclude that HSI is a safe and noninvasive tool that allows near real-time assessment of tissue perfusion and can contribute to the identification of the optimal anastomotic region during pediatric esophageal surgery.
Calcifying Odontogenic Cyst with Extensive Areas of Dentinoid: Uncommon Case Report and Update of Main Findings
Authors: Hellen Bandeira de Pontes Santos, Everton Freitas de Morais, Deborah Gondim Lambert Moreira, Luis Ferreira de Almeida Neto, Petrus Pereira Gomes, Roseana de Almeida Freitas
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

The calcifying odontogenic cyst (COC) is a benign odontogenic cyst that occurs in the gnathic bones. This cyst is part of a spectrum of lesions characterized by odontogenic epithelium containing "ghost cells," which may undergo calcification. Areas of an eosinophilic matrix material compatible dentinoid also may present adjacent to the epithelial component. However, these areas of dentinoid commonly do not appear so abundant in COCs. In this study, we report a case of intraosseous COC with extensive areas of dentinoid and perform an update regarding the clinical, radiographical, histopathological, and differential diagnosis, treatment, and prognosis of this cystic lesion.
Facilitating heart transplantability in an end-stage heart failure patient with brain abscess and infected left ventricle assist device-A unique case report
Authors: Mohamad Ibrahim, Shawqi Arafat, Sebastian V Rojas, René Schramm, Jan F Gummert, Michiel Morshuis, Henrik Fox
Journal: Int J Surg Case Rep (2020)
Keywords: antibiotic therapy, brain abscess, case report, heart transplantation, left ventricular assist device
MeSH terms: Case Reports

Introduction:
Heart transplantation is the desired therapy in end-stage heart failure (HF) and in patients with left-ventricular assist devices (LVAD) suffering from life-threatening complications on device. Comorbidities are frequent in end-stage HF and may refrain the patient from being listed for heart transplantation such as infections making surgery impossible.
Presentation of case:
We report the first case of a patient with proven LVAD system infection who additionally suffers from a brain abscess that made listing for heart transplantation impossible, leaving this patient no apparent treatment option.
Conclusion:
Our extraordinary treatment strategy finally resolved both the brain abscess and LVAD system infection through extensive conservative long-term treatment facilitating this patient to be finally listed for regular heart transplantation and sustained relieve of systemic infection.
Potential association between membranous nephropathy and sargramostim therapy for pulmonary alveolar proteinosis
Authors: Kamal Sewaralthahab, Helmut Rennke, Sarah Sewaralthahab, Nicolaos E Madias, Bertrand L Jaber
Journal: Clin Nephrol Case Stud (2014)
Keywords: granulocyte-macrophage colony-stimulating factor, membranous nephropathy, pulmonary alveolar proteinosis, sargramostim
MeSH terms: Case Reports

We present the case of a 43-year-old woman with a diagnosis of pulmonary alveolar proteinosis, on chronic treatment with sargramostim, a recombinant granulocyte-macrophage colony-stimulating factor, who presented with the nephrotic syndrome secondary to biopsy-proven membranous nephropathy. We discuss potential underlying mechanisms, including speculated effects of sargramostim on mesangial cells and the kidney resident macrophages, and review the existing literature on the potential association between these two disorders.
Tourette syndrome and klippel-feil anomaly in a child with chromosome 22q11 duplication
Authors: Raymond A Clarke, Zhi Ming Fang, Ashish D Diwan, Donald L Gilbert
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

This is the first case description of the association of Klippel-Feil Syndrome (KFS), Tourette Syndrome (TS), Motor Stereotypies, and Obsessive Compulsive Behavior, with chromosome 22q11.2 Duplication Syndrome (22q11DupS). Neuropsychiatric symptoms in persons with 22q11.2 deletion, including obsessive compulsiveness, anxiety, hyperactivity, and one prior case report of TS, have been attributed to low copy number effects on Catechol-O-Methyltransferase (COMT). However, the present unique case of 22q11DupS and TS suggests a more complex relationship, either for low- or high-COMT activity, or for other genes at this locus.
Profound Sinoatrial Arrest Associated with Ibrutinib
Authors: Kanupriya Mathur, Aditya Saini, Kenneth A Ellenbogen, Richard K Shepard
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Background:
Ibrutinib is a Bruton's tyrosine kinase (BTK) inhibitor approved for second-line treatment for mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and Waldenström macroglobulinemia. Ibrutinib use has been linked to increased incidence of atrial fibrillation and hypertension in multiple studies. Other forms of cardiac toxicities have also been reported in isolated case reports. Bradycardia and asystole have not been associated with ibrutinib use in the past.
Case report:
We present a case of a 76-year-old female with no prior cardiac history, who initiated treatment with ibrutinib for relapsing mantle cell lymphoma and was noted to have symptomatic bradycardia, greater than 20 second long pauses on her cardiac monitor requiring placement of a permanent pacemaker.
Conclusion:
This is the first case associating bradycardia and asystole with tyrosine kinase inhibitor use. Irreversible inhibition of certain cardioprotective tyrosine kinases has been a growing topic of research in oncology therapeutics.
CT and MR Imaging Findings in Methanol Intoxication Manifesting with BI Lateral Severe Basal Ganglia and Cerebral Involvement
Authors: Eyup Camurcuoglu, Ahmet Mesrur Halefoglu
Journal: J Belg Soc Radiol (2022)
Keywords: diffusion-weighted imaging, magnetic resonance imaging, metabolic acidosis, methanol intoxication, putaminal necrosis
MeSH terms: Case Reports

Our case report describes a 54-year-old man who was admitted to our hospital complaining of visual impairment with gastrointestinal and neurological symptoms. Initial computed tomography examination showed bilateral symmetric putaminal and cerebral white matter hypodensities. Evaluation of the following magnetic resonance imaging, restricted diffusion in these corresponding areas were found to be compatible with cytotoxic edema. Teaching Point: Diffusion-weighted imaging (DWI) plays a crucial role in the diagnosis of acute methanol intoxication.
First Reported Case of Endoscopic Ultrasound-Guided Core Biopsy Yielding Diagnosis of Primary Adrenal Leiomyosarcoma
Authors: Shaunak R Mulani, Patrick Stoner, Alexander Schlachterman, Hans K Ghayee, Li Lu, Anand Gupte
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Primary adrenal leiomyosarcoma (PAL) is an extremely rare mesenchymal tumor with only a few isolated case reports in the medical literature. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or endoscopic ultrasound-guided core biopsy (EUS-CB) is a safe, effective modality for sampling lesions in the gastrointestinal tract and adjacent organs, including the adrenal glands. We describe the case of a 50-year-old male presenting with abdominal pain and unintentional weight loss over the course of one year. CT imaging revealed an 8.1 cm heterogeneous left adrenal mass with PET-confirmed metastases to the liver and lung. Pheochromocytoma was ruled out. Adrenal cortical carcinoma was the other critical differential diagnosis. As the patient was not a candidate for surgery, an EUS-FNA and CB were performed on this left adrenal mass revealing a spindle cell neoplasm with extensive necrosis confirming the diagnosis of primary leiomyosarcoma. The patient was treated with chemotherapy with palliative radiation. This case demonstrates the utility of EUS-FNA or CB as modalities that can aid in the diagnosis of adrenal lesions in specific circumstances.
Euglycemic Diabetic Ketoacidosis Secondary to Dapagliflozin in a Patient with Colon Malignancy
Authors: Eleni Papadokostaki, Evangelos Liberopoulos
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

The use of sodium-glucose cotransporter 2 (SGLT2) inhibitors for the treatment of type 2 diabetes is steadily increasing. SGLT2 inhibitors are associated with weight loss, lowering of blood pressure, and low hypoglycemia risk along with beneficial cardiovascular and renoprotective effects. In view of the increasing use of SGLT2i, physicians must be aware of their adverse effects. Euglycemic diabetic ketoacidosis (euDKA) is a well-recognized adverse effect of SGLT2i. We present here a case of euglycemic diabetic ketoacidosis secondary to dapagliflozin use in a type 2 diabetic patient with colon cancer. To the best of our knowledge, this is first report of SGLT2 inhibitor-associated euDKA in a patient with underlying colon cancer.
Novel CPLANE1 c.8948dupT (p.P2984Tfs*7) variant in a child patient with Joubert syndrome
Authors: Huiping Wang, Wensha Nie, Chunxia Wang, Zuohua Wang, Yuxia Zheng
Journal: Open Life Sci (2023)
Keywords: cplane1, joubert syndrome, ataxia, molar tooth sign, oculomotor apraxia
MeSH terms: Case Reports

Joubert syndrome (JBTS) is a class of heterogeneous ciliopathy genetically associated with CPLANE1 mutations. The characteristics of clinical phenotypes and CPLANE1 variants were analyzed in a 2-month-old patient. A 2-month-old patient with JBTS was diagnosed after clinical evaluation including family history, physical examination, cerebral MRI, ultrasonography imaging, VEGG, ocular fundus examination, and comprehensive blood and urine testing. Whole exome sequencing (WES) was performed to detect CPLANE1 variants, and Sanger sequencing was used to confirm the variants. This JBTS patient presented with oculomotor apraxia, dysregulation of breathing pattern, and ataxia. MRI revealed poor continuity of cerebelli, batwing appearance, and molar tooth sign. This patient was noted with abnormal hematology, dysregulation of hepatic function, thyroid function, immunity, and renal function, and encephalopathy. CPLANE1 (c.8948dupT (p.P2984Tfs*7) and c.247G > T (p.G83X)) variants were noticed in the patient as a pathogenic variant and caused autosomal recessive inheritance. The JBTS patient with mutations in CPLANE1 (c.8948dupT (p.P2984Tfs*7) and c.247G > T (p.G83X)) developed JBTS phenotypes. The novel CPLANE1 c.8948dupT (p.P2984Tfs*7) variant will assist clinicians and geneticists in reaching a precise diagnosis for JBTS.