OpenMed/multicare-articles huggingface dataset:
Tuberculosis Presenting as Ruptured Liver Abscess and Inferior Vena Cava Thrombosis in a Pediatric Patient
Authors: Nadia Nazir Jatoi, Marium Ashraf, Varisha Fatima Shaikh, Sharmeen Nasir, Hafsa Nazir Jatoi
Journal: Ochsner J (2023)
Keywords: antitubercular agents, mycobacterium tuberculosis, liver abscess, thrombosis, tuberculosis, vena cava–inferior
MeSH terms: Case Reports

Background: Tuberculosis is a leading cause of mortality and morbidity in many countries across the world, including Pakistan. While systemic tuberculosis can involve any organ of the body, tubercular liver abscess is a rare presentation. Case Report: We report the case of an 8-year-old female from a developing country where tuberculosis poses a significant burden on the health care system. The patient presented with fever and weight loss for 6 months and abdominal pain for 14 days. On examination, she had tenderness and guarding over the right hypochondrium. Investigations revealed neutrophilic predominance in the complete blood count and elevated C-reactive protein. Imaging of the abdomen revealed ruptured liver abscess, extensive abdominal lymphadenopathy, and thrombus in the inferior vena cava. Gastric secretions were positive for Mycobacterium tuberculosis. Treatment included antitubercular and antithrombotic therapy. The patient was closely followed until she had completed the 1-year course of antitubercular therapy and was symptom-free. Conclusion: In tuberculosis-endemic countries, physicians should keep a high index of suspicion for tuberculosis in children who present with liver abscess and multisystem involvement.
An acute presentation of Chronic Thromboembolic Pulmonary Hypertension complicated by cerebellar infarction
Authors: M Gleeson, J Murray, S Gaine
Journal: Respir Med Case Rep (2023)
MeSH terms: Case Reports

Persistent symptoms and features of pulmonary hypertension in a patient with pulmonary embolism suggests chronic thromboembolic pulmonary hypertension (CTEPH) which can be associated with significant morbidity and mortality. A high level of clinical suspicion, including addressing risk factors for recurrent or cgronic thromboemboli and appropriate anticoagulation is required. We present a rare case of a young man presenting late with pulmonary embolism and features consistent with CTEPH complicated by a cerebrovascular event.
Chronic Isolated Fallopian Tube Torsion in a Sexually Inactive Adolescent Female Diagnosed Peroperatively
Authors: Yuhya Hirahara, Koichi Nagai, Kazunori Mukaida
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

Introduction:
Isolated fallopian tube torsion (IFTT) has rarely been confirmed in sexually inactive adolescents, and preoperative diagnosis of IFTT is difficult because of the absence of specific symptoms. Therefore, pediatric patients with IFTT tend to be misdiagnosed before the surgery.
Case:
A 15-year-old female patient with no history of abdominal surgery or sexual intercourse presented with acute left lower abdominal pain and purpura. MRI revealed hydrosalpinx in the left adnexal region. Her abdominal pain had completely resolved at our examination; she was followed up as an outpatient. One month after the initial presentation, she experienced a large volume of watery discharge. Magnetic resonance imaging, which was performed every three months, showed a gradual decrease in the size of the hydrosalpinx; however, it persisted in the left adnexal region. She was counseled to receive laparoscopy to treat the hydrosalpinx, which was the most likely cause of the watery discharge. IFTT was detected during the laparoscopy, and left salpingectomy was performed for pathological evaluation of the persistent hydrosalpinx. Following laparoscopy, the patient's watery discharge was resolved. Pathological findings confirmed no signs of malignancy.
Conclusion:
Our current report highlighted watery discharge as an indicative symptom of IFTT. It is unclear whether IFTT induced the hydrosalpinx or vice versa. We presumed that the patient's hydrosalpinx occurred due to IFTT, because the patient complained watery discharge one month after the initial appearance, and noncongenital hydrosalpinx in adolescents, especially without a history of sexual intercourse, is a rare event. Clinicians should consider IFTT in patients presenting with unremitting watery discharge and hydrosalpinx, because IFTT may persist even after the pain disappears.
Sarcomatoid Carcinoma Metastasis to the Colon from a Small Renal Mass: Case Report with Review of Literature
Authors: Shailesh Patidar, Arun Ramdas Menon, Shirley Sundersingh, Ramakrishnan Ayloor Seshadri, Anand Raja
Journal: J Kidney Cancer VHL (2023)
Keywords: metastasis from small renal mass, renal cell carcinoma, sarcomatoid differentiation, solitary metastasis, synchronous metastasis in rcc
MeSH terms: Case Reports

A third of patients with renal cell carcinoma (RCC) present with metastatic disease. Metastasis in RCC from small renal mass (SRM) (≤4 cm) is rare. We report a case of stage cT1a clear-cell RCC with low-risk features on pathology presenting with disproportionately large synchronous solitary metastasis to the transverse colon. He underwent resection of the mass with the involved transverse colon and adjoining mesocolon. Intestinal continuity was restored, following which partial nephrectomy was performed for the right renal tumor. Final pathology of the right renal mass confirmed clear-cell RCC. The large mass after immunohistochemistry profile confirmed metastasis from the renal tumor.
Hysterosalpingography and Ultrasonography Features of Herlyn-Werner-Wunderlich Syndrome Detected during Infertility Workup
Authors: Hidayatullah Hamidi, Bibi Hosai Balkhi
Journal: Case Rep Radiol (2024)
MeSH terms: Case Reports

The Herlyn-Werner-Wunderlich syndrome (HWWS) is a very rare congenital anomaly of the urogenital tract. It is characterized by a combination of didelphys uterus, unilateral vaginal obstruction, and ipsilateral renal agenesis. MRI imaging is usually used for diagnosis; however, the authors present a case of HWWS diagnosed by ultrasonography (HSG) and hysterosalpingography (HSG) in a 22-year-old lady who has undergone an imaging workup of infertility.
Community-acquired multidrug-resistant Enterobacter cloacae sepsis in a 25-month-old child in rural Gambia: A case report
Authors: Baleng Mahama Wutor, Williams Oluwatosin Adefila, Keita Modou Lamin, Yusuf Abdulsalam O, Ilias Hossain, Minteh Molfa, Ousman Barjo, Rasheed Salaudeen, Isaac Osei, Grant Mackenzie
Journal: IDCases (2024)
Keywords: case report, community-acquired, enterobacter cloacae, enterobacter sepsis, mortality, multidrug-resistant
MeSH terms: Case Reports

Enterobacter cloacae is the leading cause of morbidity and mortality in the genus Enterobacter. It mostly causes nosocomial infections, especially in children, the elderly and those with underlying diseases. However, cases of community-acquired bacteraemia caused by E. cloacae have been reported. The increasing inclination of E. cloacae to cause multidrug-resistant infections has made it particularly challenging to treat. A 25-month-old male child presented to a rural hospital in The Gambia with a one-week history of persistent high-grade fever, dyspnoea, and anorexia. Two days before presentation, he began to have generalized tonic-clonic seizures. On examination, he was found to be febrile, dyspnoeic, pale, and tachycardic. He had a modified Glasgow Coma Scale score of 9/15. Investigations revealed an elevated C-reactive protein, low haemoglobin, and elevated white blood cell count. Cerebrospinal fluid culture did not yield any growth. E. cloacae was isolated from a blood culture taken on the day of admission. The pathogen was resistant to all available antibiotics. He was transfused with whole blood and initially treated empirically with amoxicillin-clavulanic acid and gentamicin. The former was changed to cefuroxime because the child had not improved. The child died nine days after admission. Although E. cloacae is primarily known for causing nosocomial infections, fatal community-acquired infections also occur. This case report demonstrates the difficulty in treating multidrug-resistant E. cloacae in a low-resource setting and its propensity to cause fatal infections.
A Cytomegalovirus (CMV) Case Study to Promote Interprofessional Learning (IPL) Between Audiology and Biomedical Science Students in Higher Education
Authors: Amreen Bashir, Ross Pallett, Karan Singh Rana, Saira Hussain
Journal: Br J Biomed Sci (2023)
Keywords: audiology, biomedical science, higher education, interprofessional learning, patient care
MeSH terms: Audiology, Cytomegalovirus Infections / diagnosis, Cytomegalovirus, Humans, Interprofessional Relations, Students

Modern and effective patient care requires specialist healthcare professionals working together. Interprofessional learning (IPL) seeks to provide opportunities for different healthcare disciplines to learn with, from and about each other. This study focused on the delivery and evaluation of a cytomegalovirus (CMV) case study workshop to facilitate IPL between two Health and Care Professions Council (HCPC) regulated courses: Biomedical Science and Audiology. The 2 h online workshop consisted of 1) defining the roles, responsibilities and skills of the two healthcare professions, 2) the structure of the Biomedical Science and Audiology departments, 3) routes to HCPC registration, 4) core curriculum of both degree programmes and 5) interpreting interdisciplinary data related to a CMV patient case. The workshop was interactive, with the virtual learning environment promoting peer discussions and the use of online polling. Student responses were collected through an online questionnaire. A total of 108 respondents completed a post-event survey and Mann-Whitney U tests revealed there were no significant differences in the responses between the two student cohorts in response to each of the survey statements (p > 0.05). A total of 82.4% of students agreed that they need to know the role of other healthcare professionals for their future practice, whilst 84.2% agreed that the CMV case study was a good format to facilitate effective IPL. A total of 93.5% of respondents recognised the importance of both professions in diagnosing a patient with CMV. Thematic analysis identified four common themes, including appreciation of shared roles, recognition of similarities in registration pathways, working together to provide holistic patient care and the role of clinicians in the patient journey. This novel collaboration between Biomedical Science and Audiology facilitated effective IPL whilst meeting the interprofessional education HCPC requirements. Collaborative working is an essential component of delivering effective patient care and allied healthcare degrees need to provide opportunities within their curriculum to foster this. We hope this study encourages other higher education institutes to expand and develop their current IPL activities to include a broader spectrum of healthcare courses.
Case report: A novel COL3A1 variant in a Colombian patient with isolated cerebrovascular involvement in vascular Ehlers-Danlos syndrome
Authors: Valeria Valencia-Cifuentes, Stiven Ernesto Sinisterra-Díaz, Valentina Quintana-Peña, Edgar Folleco, José A Nastasi-Catanese, Harry Pachajoa, Juan P Fernández-Cubillos
Journal: Front Med (Lausanne) (2024)
Keywords: col3a1, colombia, case report, intracranial aneurysm, rare disease, vascular ehlers–danlos syndrome
MeSH terms: Case Reports

Introduction:
To date, approximately 600 unique pathogenic variants have been reported in COL3A1 associated with vascular Ehlers-Danlos syndrome (vEDS). The objective of this study was to describe a patient with a novel variant in COL3A1 associated with vEDS.
Case report:
We describe the clinical history and thorough phenotyping of a patient with brain aneurysms and identified a novel pathogenic variant in COL3A1. This male patient reported transient focal neurologic symptoms. Physical examination showed abnormal atrophic scarring, horizontal stretch marks under the arms, and an acrogeric appearance of the skin of the hands and feet. Brain imaging revealed extensive dilation of both internal carotids and the vertebrobasilar system. Molecular analysis identified a variant in COL3A1 (NM_000090.4):c.3058G>T p.(Gly1020Cys), which was classified as likely pathogenic. Currently, the patient has never had an event concerning dissection/rupture of tissues that could be affected in this condition.
Conclusion:
This report demonstrates that exhaustive evaluation with clinical and genetic approaches should be considered in patients with vascular abnormalities. vEDS has a variable clinical presentation and often goes unrecognized, even though it is related to life-threatening complications and a shortened life expectancy. Diagnosis confirmed by genetic testing is crucial to determining appropriate surveillance, prevention, treatment, and genetic counseling.
Benzodiazepine and Zolpidem-Induced Bradycardia: A Case Report
Authors: Ivan Ivanov, Rachel Kirzhner, Brenda Sokup, Yan Sun
Journal: Cureus (2024)
Keywords: alprazolam, benzodiazepine, bradycardia, clonazepam, suicide, toxicology, zolpidem
MeSH terms: Case Reports

Benzodiazepines and zolpidem are commonly used in suicide attempts. They have previously been thought to have very few side effects outside of central nervous system depression, and are considered relatively safe even in overdoses. Cardiovascular manifestations of these overdoses are exceedingly rare. We depict a case where an unknown woman appearing to be in her 50s presented to our emergency department somnolent after a large ingestion of alprazolam, clonazepam, and zolpidem. During the evaluation, the patient became bradycardic to 35 beats per minute on the monitor, which responded to atropine administration. Therefore, it is important for an emergency medicine provider to be aware that both benzodiazepine and zolpidem overdoses can cause profound sinus bradycardia, which can respond to atropine.
Case Report: Kounis syndrome due to cryptopteran bite
Authors: Rui Liao, Shengjie Cheng, Nan Xu
Journal: Front Cardiovasc Med (2024)
Keywords: acute coronary syndrome (acs), allergic reaction, case report, cryptopteran, kounis syndrome
MeSH terms: Case Reports

Background:
Kounis syndrome is an acute coronary syndrome (ACS) caused by allergic reactions, including coronary artery spasm (type I) caused by allergies without coronary predisposing factors, pre-existing coronary atherosclerosis, and coronary artery disease. Anaphylaxis leads to plaque rupture or erosion leading to acute myocardial infarction (type II) and acute coronary stent thrombosis (type III). Here we share a case of Kounis syndrome type I caused by an allergy caused by a Cryptopteran bite.
Case presentation:
A 47-year-old woman was admitted to the hospital due to an insect bite for 2 days and chest distress for more than 3 h. Outside the hospital, electrocardiogram(ECG) showed sinus rhythm, ST-segment elevation in leads V1-V3, high-sensitivity troponin 2.54 ng/ml(0-0.5 ng/ml). One hour later, the ECG of the patient showed that the ST segment elevation of lead V1-V4 was 0.10-0.20 mV. Emergency coronary angiography showed coronary spasm and moderate lumen stenosis in the middle segment of left anterior descending artery (LAD). After treatment, the patient's symptoms were relieved, and the ST segment of lead V1-V4 of electrocardiogram returned to normal.
Conclusion:
Kunis syndrome is a life-threatening condition that can also cause myocardial ischemic injury in patients with or without coronary artery disease. Timely identification and anti-allergic treatment can achieve a good prognosis.
VKORC1 polymorphisms and complete resistance to vitamin K antagonists: About two cases
Authors: Ilham Benyamna, Houda El Fissi, Fadoua Bouzid, Abdelhamid El Mousadik, Najat Alif
Journal: Biomedicine (Taipei) (2024)
Keywords: mutations, resistance to vitamin k antagonists, vkorc1
MeSH terms: Case Reports

Complete resistance to vitamin K antagonists is a rare but serious condition. It can complicate therapeutic management, especially when direct oral anticoagulants cannot be used. Some single mutations in the VKORC1 gene have been identified in patients partially or completely resistant to vitamin K antagonists. We report the cases of two women in their fifties who presented an unexplained peripheral venous thrombosis. The aetiological assessment did not show any abnormalities. Genetic testing showed that both patients had the VKORC1 5417 GG genotype. The VKORC1 3673 genotype was GG in case 1 and GA in case 2. The two patients showed complete resistance to vitamin K antagonists which required a change in treatment with favourable outcomes. Our goal is to offer optimal care guided by a literature review.
Case report: Fibroadenomas associated with atypical ductal hyperplasia and infiltrating epitheliosis mimicking invasive carcinoma
Authors: Li Wang, Wei Zhao, Jue Zhou, Rong Ge
Journal: Front Oncol (2024)
Keywords: mec, breast, carcinoma, fibroadenoma, infiltrating epitheliosis
MeSH terms: Case Reports

Infiltrating epitheliosis (IE) is an uncommon type of complex sclerosing lesion in the breast. This condition is characterized by the infiltration of ducts into a scleroelastotic stroma, along with the presence of cells that display architectural and cytological patterns similar to those observed in usual ductal hyperplasia. We herein report a case of a 24-year-old woman who presented with bilateral breast nodules, which were initially identified as multiple fibroadenomas based on ultrasound findings. The patient underwent Mammotome system and regional mastectomy procedures, and subsequent pathological analysis confirmed the presence of multiple fibroadenomas with atypical ductal hyperplasia and infiltrating epitheliosis. This case discusses the challenges faced in diagnosing malignancy in a patient with multiple fibroadenomas accompanied by atypical ductal hyperplasia and infiltrating epitheliosis.
Case report: Endoscopic retrieval of a proximally migrated pancreatic stent using the basket-through- the-sphincterotome technique
Authors: Hang Yi, Qin Liu, Song He, Li Zhong, Xiaodong Guo, Suhua Wu, Bo Ning
Journal: Front Med (Lausanne) (2023)
Keywords: endoscopy, migration, pancreatic stent, retrieval, sphincterotome
MeSH terms: Case Reports

Background:
The retrieval of a proximally migrated pancreatic duct (PD) stent via endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging, often requiring surgical intervention. We report a case with proximal migration of a pancreatic stent that was successfully removed by a basket-through-the-sphincterotome technique.
Case presentation:
A 46-year-old man with prior history of chronic pancreatitis was admitted to our hospital with 1 month history of epigastric discomfort. 9 months prior he had undergone ERCP with Endoscopic sphincterotomy (EST) and a 5 Fr × 9 cm plastic pancreatic stent placement to relieve pancreatic duct stricture and abdominal pain. Magnetic retrograde cholangiopancreatography (MRCP) done this time revealed PD dilation and a stent-shaped signal inside the PD. The subsequent endoscopic ultrasonography (EUS) verified total pancreatic stent proximal migration with no visible distal end of the stent in the papilla. ERCP was performed again with an attempt to retrieve the stent. General techniques of PD cannulation with a 0.035-in guidewire over the migrated stent and balloon extraction failed. We used a mini-basket (Endoflex Germany) to replace the guidewire, which was inserted into the PD and advanced over the proximal end of the stent through the channel of the sphincterotome. The distal end of the stent was easily caught by manipulating the tip of the sphincterotome, and the stent was then pulled out. A naso-pancreatic drainage tube was placed in the main PD, and the patient was discharged 2 days after tube withdrawal.
Conclusion:
This was a successful case of proximally migrated pancreatic stent retrieval using the unique idea of basket-through-the-sphincterotome technique, which has rarely been reported. The basket-through-the-sphincterotome technique provides the endoscopist another way to catch the distal end without difficulty. It can improve the success rate of proximally migrated pancreatic stent retrieval, especially the pig-tail pancreatic stent, of which the sticking of the proximal end into pancreatic duct branches often makes the distal end the only choice to retrieve.
Aspergillus fumigatus Epidural Abscess and Postsurgical Wound Infection in an Immunocompetent Host
Authors: Nadine Montreuil, Andres Martinez, Leon Budrie, Shriya Goyal, Tanya Quiroz, Christine Vu, Folusakin Ayoade, Candice A Sternberg
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

In this case, we present an immunocompetent patient who had a wound infection secondary to Aspergillus fumigatus after undergoing a neurosurgical procedure that was complicated by an epidural abscess. The patient was treated with voriconazole and responded favorably. We highlight the need for awareness of the possibility of an Aspergillus infection in people without any obvious immunocompromise and advocate for the inclusion of this opportunistic fungus in the workup of postneurosurgical infections and dura-based collections. A brief review of relevant literature is also included.
Case report: Severe hepatopathy following rivaroxaban administration in a dog
Authors: Allison P Mosichuk, Candace Wimbish, Kristen Poplawski, Adam Birkenheuer, Karyn Harrell, Kursten V Pierce
Journal: Front Vet Sci (2024)
Keywords: anticoagulant, canine, factor xa inhibitor, hepatopathy, rivaroxaban
MeSH terms: Case Reports

Rivaroxaban, a specific factor Xa inhibitor and commonly utilized anticoagulant, has been known to cause hepatotoxicity and liver failure in humans. Although rivaroxaban is frequently used in veterinary medicine, hepatotoxicity has not been previously reported in dogs. The current case report describes a dog that developed severe hepatopathy following rivaroxaban administration for a large right pulmonary artery thrombus. An estimated 6-year-old spayed female mixed-breed dog developed anorexia and lethargy 9 days after rivaroxaban administration began. Subsequent labwork revealed severe hepatocellular hepatopathy, and rivaroxaban was discontinued. Additional diagnostics did not reveal an underlying etiology, although hepatic cytology could be consistent with a toxic injury. The hepatopathy and clinical signs improved after rivaroxaban was discontinued. The time to onset, type of hepatopathy, and time to resolution were all similar to those reported for human cases. This case provides precedence to advocate for improved and closer monitoring of dogs receiving factor Xa inhibitors. In cases of suspected hepatotoxicity with no other identifiable cause, a risk-benefit analysis should be performed, and discontinuation of rivaroxaban administration or alternative anticoagulant medications should be considered.