OpenMed/multicare-articles huggingface dataset:
Chylothorax in a child with rifampicin-resistant tuberculosis
Authors: B McLaren, X Song, E Mate, C Jardine, T Mabaso, V Mammen, S Lala, Z Dangor, C Verwey
Journal: Afr J Thorac Crit Care Med (2019)
Keywords: chylothorax, drug resistant tuberculosis, endobronchial tuberculosis, paediatric tuberculosis, tuberculosis
MeSH terms: Case Reports

Chylothorax is rare in children. Only a few cases of tuberculosis (TB)-associated chylothorax have been reported. We present a child on standard four-drug TB treatment who presented with wheezing and a chylothorax. Bronchoscopy showed caseating lymph nodes, and rifampicin-resistant TB was identified from the bronchoalveolar lavage specimen. There was marked clinical and radiological improvement 1 month after starting multidrug-resistant (MDR) TB treatment and steroids. The association of chylothorax and MDR-TB has not been described in children. MDR-TB should be considered in children who fail adherent, empirically started drug-susceptible TB treatment.
Rapid symptom control in neuroleptic malignant syndrome with electroconvulsive therapy: A case report
Authors: Lauren Katzell, Emily Beydler, Amílcar Silva Dos Santos, Richa Vijayvargiya, Brent R Carr
Journal: Front Psychiatry (2023)
Keywords: amantadine, case reports, catatonia, electroconvulsive therapy, neuroleptic malignant syndrome, schizoaffective disorder
MeSH terms: Case Reports

Introduction:
Neuroleptic malignant syndrome (NMS), thought to arise through dopamine antagonism, is life-threatening. While prompt diagnosis of NMS is critical, it may be obscured by other diagnoses, such as malignant catatonia, with overlapping, life-threatening symptoms. Initiation of dopamine-blocking agents such as antipsychotics and abrupt cessation of dopaminergic medications such as amantadine can precipitate NMS. Once NMS is suspected, deft medical management should ensue. Multiple case reports detail electroconvulsive therapy's (ECT's) effectiveness in the treatment of NMS. While this relationship is well-documented, there is less literature regarding comparative efficacy of ECT in the acute treatment of NMS-like states precipitated by withdrawal of dopamine agonists, such as amantadine.
Case:
We present a 52-year-old female with schizoaffective disorder bipolar type, with a history of a lorazepam-resistant catatonic episode the prior year that had responded to amantadine. She presented febrile with altered mental status, lead pipe rigidity, mutism, grasp reflex, stereotypy, autonomic instability, and a Bush-Francis Catatonia Rating Scale (BFCRS) of 24, suggesting malignant catatonia versus NMS. There was concern over a potentially abrupt cessation of her amantadine of which she had been prescribed for the past year.
Interventions:
Organic etiologies were ruled out, and a presumptive diagnosis of NMS was made with central dopaminergic depletion from abrupt dopamine agonist (amantadine) withdrawal as the suspected underlying etiology. After intravenous lorazepam and reinduction of amantadine failed to alleviate her symptoms, urgent ECT was initiated. Our patient received an index series of ECT of seven treatments. After ECT #1 she was no longer obtunded, after treatment #2 her symptoms of mutism, rigidity, stereotypy, and agitation showed improvement, and by ECT #3, the NMS had rapidly dissipated as evidenced by stable vital signs, lack of rigidity, and coherent conversation.
Conclusion:
Brisk identification of potentially life-threatening NMS and NMS-like states, including malignant catatonia, warrants a trial of ECT. ECT's theoretical mechanisms of action coincide with the theoretical pathophysiology of the conditions. It is a viable and safe treatment option for reducing mortality. With prompt initiation of ECT, we obtained rapid control of a condition with a potentially high mortality.
Simultaneous Rupture of the Bladder and Pelvicaliceal System Because of Blunt Abdominal Trauma: A Rare Case
Authors: Sarosh Janardanan, Ravindra Kulkarni, Nimalan Arumainayagam
Journal: J Endourol Case Rep (2019)
Keywords: bladder rupture, blunt trauma, pelvicaliceal injury, rendezvous stenting
MeSH terms: Case Reports

We present a unique case of simultaneous rupture of the bladder and left renal pelvis after blunt trauma to the lower abdomen. To the best of our knowledge, this has not yet been reported in the literature. Another unusual aspect of this case was that the bladder rupture was bilateral, with both an extra- and intraperitoneal component. The management of this case was challenging. This involved an emergency laparotomy to repair the bladder tear, followed by a nephrostomy. This was followed by left ureteral stent insertion using a rendezvous technique. The case also highlights the role of expectant conservative management relating to the concurrent left renal pelvic rupture.
Digitalization of relational space in the service triangle: The case study of retail banking
Authors: Anna Carreri, Giorgio Gosetti, Nicoletta Masiero
Journal: Front Sociol (2023)
Keywords: algorithm, banking, digitalization, quality of work, service triangle, surveillance, work identity, working relationships

Introduction:
The article aims to shed light on the process of shaping the relational space of work in the service triangle through the progressive digitalization of work in retail banking industry. It addresses the following research question: how do technological shifts affect the relationships and interactions (a) between employees and supervisors, and (b) between employees and customers? Through a close examination of the redesign of the interpersonal relationships from the subjective viewpoint of front-line workers across these two levels, the paper contributes to advancing the understanding of the impact of technologies on surveillance practices, work identity and professional ethics in a key working sector with regard to digitalization and changes in professional requirements.
Methods:
The question is addressed through a qualitative case study of retail banking in Italy. In the (retail) banking sector, the redesign of the relations between supply and demand for services is more sensitive to the changes afforded by digitalization and learning algorithms. The study was conducted with the involvement of workers and trade unionists, with whom we embarked on a constant work of re-articulation through data collection, analysis, and conceptualization. We collected a multiplicity of data for triangulation: interviews, focus groups, documents, and ethnographic notes.
Results:
Data analysis shows how work processes and interpersonal relationships start to be redesigned across the two levels. At (a) level, two main aspects are found: the measurement of individual performance within the logic of quantification, which reduces employees to a set of measured dimensions, pushing workers into conditions of stress and competition; new surveillance practices and forms of organizational control enabled by technologies and learning algorithms. At (b) level, from being an expert with specific knowledge in the financial sector the bank employee turns into a kind of seller of any product that the algorithm decides to sell, thus ignoring the value of situated experience held by embedded, embodied social actors. Moreover, algorithms enter jurisdictional spaces traditionally controlled by knowledge workers and produce unknown outcomes concerning to whom to sell which products that cannot be clearly understood by workers.
Discussion:
Technology contributes to engendering complex identity constructions to maintain, protect, and revise professional identity.
Epstein-barr virus encephalitis: a case report
Authors: Somayh Hashemian, Farah Ashrafzadeh, Javad Akhondian, Mehran Beiraghi Toosi
Journal: Iran J Child Neurol (2015)
Keywords: basal ganglia, encephalitis, epstein-barr virus
MeSH terms: Case Reports

Many neurologic manifestations of Epstein-Barr virus (EBV) infection have been documented, including encephalitis, aseptic meningitis, transverse myelitis, and Guillain-Barre syndrome. These manifestations can occur alone or coincidentally with the clinical picture of infectious mononucleosis. EBV encephalitis is rare and is indicated as a wide range of clinical manifestations. We report a 10-year-old girl presented with fever, gait disturbance, and bizarre behavior for one week. The results of the physical examination were unremarkable. The diagnosis of EBV encephalitis was made by changes in titers of EBV specific antibodies and MRI findings. A cranial MRI demonstrated abnormal high signal intensities in the basal ganglia and the striatal body, especially in the putamen and caudate nucleus. EBV infection should be considered when lesions are localized to the basal ganglia.
Giant cystic lymphangioma of the mesentery: varied clinical presentation of 3 cases
Authors: Mohamed Rami, Abdelhalim Mahmoudi, Aziz El Madi, Khalid, Khattala, Moulay Abderrahmane Afifi, Youssef Bouabdallah
Journal: Pan Afr Med J (2012)
Keywords: lymphangioma, cyst, mesentery
MeSH terms: Lymphangioma, Cystic / pathology, Mesentery, Peritoneal Neoplasms / pathology, Case Reports, Child, Female, Humans, Lymphangioma, Cystic / surgery, Male, Peritoneal Neoplasms / surgery

Giant cystic lymphangioma is an uncommon mesenteric tumor which is usually reported in children. In this paper, we describe 3 cases, that was admitted in our department, two with abdominal distension, pain, and an abdominopelvic mass; the other present an acute abdomen. Preoperative studies including abdominal ultrasonography and computed tomography failed to determine the cause of the pain for the female patients. The laparotomy found a giant cystic tumor of the small bowel mesentery. The histological study showed a tumor that was diagnosed as a cystic lymphangioma. Based on those three cases a review of the literature is suggested.
Goodpasture's Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association
Authors: Amanjit Bal, Ashim Das, Dheeraj Gupta, Mandeep Garg
Journal: Case Rep Pulmonol (2014)

Introduction. Goodpasture's syndrome is a rare clinical entity and is characterized by circulating autoantibodies which are principally directed against the glomerular/alveolar basement membrane. The etiology of Goodpasture's syndrome is still unknown. Lung involvement occurs as a result of lung injury and the exposure of new epitopes to the immune system. Recently, several studies have suggested the role of silica as one of etiological factors in ANCA associated vasculitis and glomerulonephritis. Materials and Methods. We present a case of a 40-year-old welder with silicosiderosis, who developed anti-GBM disease with p-ANCA positivity. Case Report. Patient presented to an emergency with gradually increasing breathlessness along with renal failure and died after short hospital stay. Autopsy pathology findings revealed crescentic glomerulonephritis with linear glomerular basement membrane antibody deposition, splenic vasculitis, pulmonary haemorrhage, and pulmonary silicosiderosis. Conclusion. This case reinforces the role of environmental triggers like exposure to silica, metal dust, and tobacco in pathogenesis of Goodpasture's syndrome and p-ANCA associated vasculitis.
Pancreatic groove cancer
Authors: Yuan-Hao Ku, Shih-Chin Chen, Bor-Uei Shyr, Rheun-Chuan Lee, Yi-Ming Shyr, Shin-E Wang
Journal: Medicine (Baltimore) (2017)
MeSH terms: Pancreas / pathology, Pancreatic Neoplasms / pathology, Case Reports, Observational Study, Aged, Female, Humans, Male, Middle Aged

Pancreatic groove cancer is very rare and can be indistinguishable from groove pancreatitis. This study is to clarify the characteristics, clinical features, managements, and survival outcomes of this rare tumor.Brief descriptions were made for each case of pancreatic groove cancer encountered at our institute. Individualized data of pancreatic groove cancer cases described in the literature were extracted and added to our database to expand the study sample size for a more complete analysis.A total of 33 patients with pancreatic groove cancer were included for analysis, including 4 cases from our institute. The median tumor size was 2.7 cm. The most common symptom was nausea or vomiting (89%), followed by jaundice (67%). Duodenal stenosis was noted by endoscopy in 96% of patients. The histopathological examination revealed well differentiated tumor in 43%. Perineural invasion was noted in 90%, and lymphovascular invasion and lymph node involvement in 83%. Overall 1-year survival rate was 93.3%, and 3- or 5-year survival rate was 62.2%, with a median survival of 11.0 months. Survival outcome for the well-differentiated tumors was better than those of the moderate/poorly differentiated ones.Early involvement of duodenum causing vomiting is often the initial presentation, but obstructive jaundice does not always happen until the disease progresses. Tumor differentiation is a prognostic factor for survival outcome. The possibility of pancreatic groove cancer should be carefully excluded before making the diagnosis of groove pancreatitis for any questionable case.
Case report: A giant lung leiomyosarcoma: From an accurate diagnosis to a successful surgery. A rare case and brief literature review
Authors: Elisa Sicolo, Maria Giovanna Mastromarino, Giacomo Rabazzi, Diana Bacchin, Greta Ali, Vittorio Aprile, Marco Lucchi
Journal: Front Surg (2022)
Keywords: lung cancer, pneumonectomy, primary lung leiomyosarcoma, sterno-thoracotomy, thoracic surgery, transcatheter arterial embolization
MeSH terms: Case Reports

Primary pulmonary leiomyosarcomas (PPLs) are incredibly rare tumors, characterized by an often-aggressive clinical behavior. Diagnosis is frequently incidental. Whenever present, symptoms are nonspecific, thus PPLs are usually misdiagnosed as other more common respiratory diseases or lung cancer subtypes. Surgery is the best treatment choice and in the therapeutic strategy, timeliness and radicality are of major importance. We report the case of a huge left PPL, successfully treated with salvage surgery after a careful multidisciplinary preoperative assessment, which permitted a prompt diagnostic path and surgery.
Successful conversion from butorphanol nasal spray to buprenorphine/naloxone using a low-dose regimen to assist with opioid tapering in the setting of chronic pain and migraine management in an older adult patient: A case report
Authors: Joshua MacAusland-Berg, Amy Wiebe, Radhika Marwah, Katelyn Halpape
Journal: Can J Pain (2022)
Keywords: buprenorphine/naloxone, butorphanol, chronic pain, micro-dosing, older adult
MeSH terms: Case Reports

Background:
Butorphanol is marketed as a treatment for migraines; however, evidence suggests that the harms of its use exceed the benefits. The short half-life of butorphanol places patients at high risk for opioid dependence and makes tapering a challenge. Buprenorphine/naloxone has unique pharmacological properties that are beneficial in chronic pain treatment. At this time there is limited published data on the use of micro-dosing initiation regimens in patients with chronic pain, especially in older adult patients.
Aims:
This article presents the case of an older adult patient for whom a buprenorphine/naloxone micro-dosing regimen was successfully utilized to aid discontinuation of butorphanol nasal spray, assist with opioid tapering, and manage chronic pain.
Methods:
This case took place in an outpatient setting while the patient was receiving care from an interprofessional chronic pain service. The electronic medical record was reviewed to obtain a summary of the case data. Informed patient consent was obtained.
Results:
We present a case of an older adult patient who had been using butorphanol nasal spray for migraine and general pain management for over 20 years. The risks of ongoing use of butorphanol (i.e., inter-dose-related pain, opioid dependence, possible opioid-induced hyperalgesia, and fall risk) no longer exceeded any perceived benefit. The patient was successfully transitioned onto sublingual buprenorphine/naloxone using a micro-dosing regimen.
Conclusions:
This case provides an example of the potential benefit buprenorphine/naloxone can have for patients with chronic pain and previous opioid exposure, especially older adults at risk of central adverse effects of opioids.
A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin
Authors: Fabrice Akpadjan, Hugues Adégbidi, Cossi Angelo Attinsounon, Christiane Koudoukpo, Bérénice Dégboé, Nadège Agbessi, Félix Atadokpèdé
Journal: Pan Afr Med J (2017)
Keywords: benin, giant condyloma, west africa, electrocoagulation, infant
MeSH terms: Buschke-Lowenstein Tumor / diagnosis, Electrocoagulation / methods, Vulvar Neoplasms / diagnosis, Case Reports, Benin, Buschke-Lowenstein Tumor / pathology, Buschke-Lowenstein Tumor / therapy, Child, Preschool, Combined Modality Therapy, Female, Humans, Recurrence, Vulvar Neoplasms / pathology, Vulvar Neoplasms / therapy

We report here a case of giant vulval condyloma in a two-year-old infant infected by her "baby sitter" without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient.
An atypical case of febrile infection-related epilepsy syndrome following acute encephalitis: impact of physiotherapy in regaining locomotor abilities in a patient with neuroregression
Authors: Chanan Goyal, Waqar M Naqvi, Arti Sahu
Journal: Pan Afr Med J (2020)
Keywords: post encephalitis sequelae, neurodevelopmental treatment, sensory integration
MeSH terms: Encephalitis / therapy, Epileptic Syndromes / therapy, Physical Therapy Modalities, Seizures, Febrile / therapy, Case Reports, Acute Disease, Child, Preschool, Electroencephalography, Encephalitis / complications, Epileptic Syndromes / etiology, Humans, Locomotion / physiology, Male, Status Epilepticus / etiology, Status Epilepticus / therapy, Syndrome, Treatment Outcome

Encephalitis refers to inflammation of the brain parenchyma. It is potentially life-threatening with the highest incidence and severity in younger children. Febrile infection-related epilepsy syndrome (FIRES) is a condition, in which a child develops a nonspecific febrile illness that may not persist when the initial seizure activity begins. However, an electroencephalogram (EEG) shows that the child is in status epilepticus. We report the case of a five-year-old male who presented with difficulty to maintain sitting posture, and inability to stand and walk without support, following viral encephalitis at the age of one year. He had motor, visual, speech and cognitive impairment along with a seizure disorder. The physiotherapy interventions including neurodevelopmental treatment (NDT) and sensory integration (SI) helped in regaining locomotion ability in the child. The study aims to assess the impact of physiotherapy interventions on regaining locomotor ability in a child with FIRES following infective encephalitis.
Young Male Presenting with an Acute Diarrheal Illness with Unexplained Transudative Ascites: An Atypical Presentation of Appendicular Tuberculosis
Authors: Chamara Dalugama, Achila Jayasinghe, Shamali Abeygunawardena, Manoji Pathirage, Thilak Jayalath, Udaya Ralapanawa, S S Jayasundara, Sulochana Wijetunga
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Introduction:
Appendicular tuberculosis is a rare form of extrapulmonary tuberculosis involving the gastrointestinal tract. Diagnosis of appendicular tuberculosis is difficult due to its atypical presentation. Histological confirmation remains the gold standard in diagnosis. Case Presentation. We report a 37-year-old Sri Lankan male presenting with a diarrheal illness with high fever for 8 days in the background of constitutional symptoms for 1-month duration. He was pale and had moderate amount of free fluid in the abdomen. Inflammatory markers were elevated, and CT abdomen revealed a thickened elongated appendix. Diagnostic paracentesis revealed a lymphocytic transudative ascites. A macroscopically minimally inflammed appendix removed at laparotomy and histology confirmed presence of tuberculous granulomata with caseation. He made an uneventful recovery by the anti-tuberculous therapy.
Conclusion:
High degree of suspicion is needed in diagnosis of appendicular tuberculosis due to its nonspecific presentation, and we emphasize the need of histological assessment of the appendix resected for the case of clinical appendicitis, as it may prompt the diagnosis of a rare but treatable case of tuberculosis.
Late Systemic Lupus Erythematosus-Associated Insulin Resistance Syndrome: A Rare Cause of De Novo Diabetes Mellitus
Authors: José C Alvarez-Payares, Daniel Ribero, Luis Rodríguez, Carlos E Builes, Carolina Prieto, Clara Arango, Juan G Gamboa, Cristian Alvarez-Payares
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

The association of type B insulin resistance syndrome (TBIRS) due to autoimmune diseases such as systemic lupus erythematosus (SLE) is uncommon. This is partly due to the lack of established criteria for the diagnosis of this resistance. However, some clinical aspects may suggest that the diagnosis does not necessarily have to be positive insulin receptor antibodies as such patients could respond to immunosuppressive treatment. Methods. We describe a case and have performed a literature review on PubMed/MEDLINE, EMBASE, and Google Scholar bibliographic databases to identify all case reports. All available studies from January 1975 through December 2020 were included. Data collected were tabulated, and outcomes were analyzed cumulatively. Results. Thirty-one cases of TBIRS associated with SLE have been described. These patients presented with catabolic symptoms and hyperglycemia in most cases, with an average time from the onset of symptoms of four months. In addition to that clinical characteristics related to SLE were variable, along with certain common characteristics such as acanthosis in 60% of patients. Almost all the patients had antibodies against insulin receptors. The insulin doses required by the patients ranged from 450 to 25,000 U daily. Remission was achieved in 80% of the patients with a two-year follow-up. Most patients associated with late-onset SLE, like our patient, achieved metabolic control after immunosuppressive treatment. Conclusion. High insulin resistance in patients with de novo diabetes mellitus (DM) without obesity should be considered as a possible clinical manifestation of an autoimmune disease such as SLE, with a good metabolic response to the immunosuppressive management established.
Paraneoplastic Cough and Renal Cell Carcinoma
Authors: Stephen Sullivan
Journal: Can Respir J (2016)
MeSH terms: Carcinoma, Renal Cell / complications, Cough / etiology, Kidney Neoplasms / complications, Paraneoplastic Syndromes / etiology, Case Reports, Female, Humans, Middle Aged

A case of patient with intractable cough due to renal cell carcinoma is reported. The discussion reviews the literature regarding this unusual paraneoplastic manifestation of renal malignancy.