OpenMed/multicare-articles huggingface dataset:
Cholesterol Granuloma in the Maxillary Sinus: Are Endodontically Treated Teeth Involved in Its Etiopathogenesis?
Authors: Silas Antonio Juvencio de Freitas Filho, Gilberto Gallo Esteves, Denise Tostes Oliveira
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Cholesterol granuloma (CG) is a tissue reaction in response to the accumulation of cholesterol crystals rarely found in the maxillary sinus. The etiopathogenesis of maxillary sinus CG remains unclear. We reviewed the literature and added two new reports of cholesterol granuloma in maxillary sinus related to endodontically treated maxillary posterior teeth. The first report refers to a 45-year-old woman diagnosed with rhinitis, who was submitted to endodontic retreatment of maxillary molar, and subsequently showed maxillary sinus opacity with cystic appearance. The second case describes a young adult woman, who presented a cystic mass in maxillary sinus after endodontic treatment, in close association with the apex of the maxillary right second premolar. Both patients were treated by a classic Caldwell-Luc surgery and the microscopic analyses revealed maxillary sinus CG. In the following, the authors discuss the probable involvement of endodontically treated maxillary posterior teeth in the etiopathogenesis of maxillary sinus CG.
Response to Modified Antitubercular Drug Regime and Antiretroviral Therapy in a Case of HIV Infection with Disseminated Tuberculosis with Isoniazid Induced Toxic Epidermal Necrolysis
Authors: Abhijit Swami, Bhaskar Gupta, Prithwiraj Bhattacharjee
Journal: Case Rep Infect Dis (2012)

Toxic epidermal necrolysis (TEN) is a potentially life-threatening disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes. Without proper management,TEN can cause sepsis leading to death of the patient. Though TEN is commonly drug induced, Isoniazid (INH) has been uncommonly associated with TEN. As INH is one of the first line drugs in treatment of tuberculosis, TEN induced INH needs modification of antitubercular therapy (ATT) with withdrawal of INH from the treatment regime along with other supportive treatments. Patients with HIV infection and disseminated tuberculosis need to be urgently initiated on an effective ATT on diagnosis of tuberculosis. However, if the patient develops potential life-threatening toxicity to first line antitubercular drugs like INH, an alternative effective ATT combination needs to be started as soon as the condition of the patient stabilizes as most of these patients present in advanced stage of HIV infection and this is to be followed by antiretroviral therapy (ART) as per guidelines. The present case reports the effectiveness of an ATT regime comprising Rifampicin, Pyrazinamide, Ethambutol, and Levofloxacin along with ART in situations where INH cannot be given in disseminated tuberculosis in HIV patients.
The Role of Point-of-Care Ultrasound in Pilonidal Sinus Disease
Authors: Hadiel Kaiyasah, Lamis Abufool, Labib Al Ozaibi
Journal: POCUS J (2022)
Keywords: pilonidal sinus, pits, recurrence, surgical excision, ultrasound
MeSH terms: Case Reports

Pilonidal sinus is a common problem encountered in proctology clinics. It has a wide spectrum of clinical picture ranging from a single asymptomatic pit to a more complex disease with multiple sinuses and secondary openings. Hence, the treatment options could range from observation or simple excision to a more radical approach like flap surgeries. Ultrasonographic assessment could help in mapping the extent of the pilonidal sinus. It can also identify whether the sinus is infected or has formed an abscess. With the above-mentioned information provided by the point of care ultrasound, the surgeon can tailor the surgical approach to each individual case and improve the overall outcome. In this article, we are highlighting some examples of cases managed in our proctology unit where ultrasound was done preoperatively and guided the management.
Targeted management of evolving and established chronic lung disease of prematurity assisted by cardiopulmonary ultrasound: A case report of four patients
Authors: Guglielmo Bruno, Roberto Chioma, Enrico Storti, Giovanni De Luca, Margherita Fantinato, Patrizio Antonazzo, Maria Pierro
Journal: Front Pediatr (2023)
Keywords: bronchopulmonary dysplasia (bpd), case report, endotype, lung ultrasonography (lus), phenotype (mesh), targeted neonatal echocardiography
MeSH terms: Case Reports

Bronchopulmonary dysplasia (BPD) is one of the most common complications of premature birth. The current definition of BPD is based on the duration of oxygen therapy and/or respiratory support. Among the pitfalls of all the diagnostic definitions, the lack of a proper pathophysiologic classification makes it difficult to choose an appropriate drug strategy for BPD. In this case report, we describe the clinical course of four premature infants, admitted to the neonatal intensive care unit, for whom the use of lung and cardiac ultrasound was an integral part of the diagnostic and therapeutic process. We describe, for the first time to our knowledge, four different cardiopulmonary ultrasound patterns of evolving and established chronic lung disease of prematurity and the consequent therapeutic choices. This approach, if confirmed in prospective studies, may guide the personalized management of infants suffering from evolving and established BPD, optimizing the chances of success of the therapies and at the same time reducing the risk of exposure to inadequate and potentially harmful drugs.
Posttransurethral Resection of Prostate Recurrent Life Threatening Hematuria: A Rare Cause
Authors: M C Arya, Lalit Kumar, Ruchi Mittal, Rajeev Kumar, Mayank Baid
Journal: Case Rep Urol (2016)

Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-year-old male presented with recurrent massive hematuria following TURP done elsewhere 15 days before. His hemoglobin was 4 gm/dL after 13 units of blood transfusion and repeated clot evacuations. His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed intravesical aneurysm. CT angiography showed pseudoaneurysm of a branch of internal iliac artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria. But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to cardiomorbidities.
The superinfection of a dermoid cyst
Authors: Janelle Luk, Alexander Quaas, Elizabeth Garner
Journal: Infect Dis Obstet Gynecol (2007)
MeSH terms: Dermoid Cyst / microbiology, Ovarian Neoplasms / microbiology, Superinfection / complications, Superinfection / drug therapy, Case Reports, Abortion, Induced / adverse effects, Adult, Chlamydia / isolation & purification, Chlamydia Infections / drug therapy, Chlamydia Infections / surgery, Dermoid Cyst / surgery, Doxycycline / therapeutic use, Female, Humans, Ovarian Neoplasms / surgery, Pregnancy, Doxycycline

Mature cystic teratoma may be complicated by torsion, rupture, and malignant change, but is rarely complicated by infection. Here we report the case of a patient who presented with a tubo-ovarian abscess following a dilation and curettage (D&C) procedure in the setting of an ovarian dermoid cyst.
Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter
Authors: Cédric Nesti, Benny Wohlfarth, Yves M Borbély, Reto M Kaderli
Journal: Front Surg (2021)
Keywords: case report, minimally-invasive surgery, retrosternal goiter, thoracoscopic, thyroidectomy
MeSH terms: Case Reports

Introduction: The treatment of choice for retrosternal goiters (RSG) is surgical resection to relieve symptoms and rule out malignancy. Although the majority of RSG can be removed by a cervical approach only, an extracervical approach (e.g., sternotomy, thoracotomy or thoracoscopy) may be required. Herein, we describe a refined thoracoscopic-assisted cervical two-team RSG resection without thoracoscopic mediastinal dissection. Technique: A 57-year-old man presented with a large RSG with posterior mediastinal extension (PME) and extensive peritumoral vascularization. Due to its extension below the aortic arch and its small connection with the right thyroid lobe, a combined cervical and thoracoscopic approach was intended. The endocrine surgery unit performed the cervical mobilization of the right thyroid lobe, while the thoracic surgery unit gently pushed the mediastinal tumor through the thoracic inlet without performing mediastinal dissection. This allowed a safe visualization of the inserting vessels by the endocrine surgery team at the neck, followed by a stepwise division of the vessels and resection of the retrosternal nodule through the cervical access. Comment: The described approach is indicated for RSG with posterior mediastinal extension, anteroposterior dimension smaller than the thoracic inlet and inaccessibility from a cervical approach only. This minimally invasive approach is associated with a faster recovery, decreased morbidity and postoperative pain, shorter hospital stay and better cosmetic results.
Exome sequencing is an efficient tool for variant late-infantile neuronal ceroid lipofuscinosis molecular diagnosis
Authors: Liliana Catherine Patiño, Rajani Battu, Oscar Ortega-Recalde, Jeyabalan Nallathambi, Venkata Ramana Anandula, Umashankar Renukaradhya, Paul Laissue
Journal: PLoS One (2014)
MeSH terms: Exome, Neuronal Ceroid-Lipofuscinoses / diagnosis, Pathology, Molecular / methods, Sequence Analysis, DNA / methods, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Child, Child, Preschool, Female, High-Throughput Nucleotide Sequencing, Humans, Male, Mutation, Neuronal Ceroid-Lipofuscinoses / genetics

The neuronal ceroid-lipofuscinoses (NCL) is a group of neurodegenerative disorders characterized by epilepsy, visual failure, progressive mental and motor deterioration, myoclonus, dementia and reduced life expectancy. Classically, NCL-affected individuals have been classified into six categories, which have been mainly defined regarding the clinical onset of symptoms. However, some patients cannot be easily included in a specific group because of significant variation in the age of onset and disease progression. Molecular genetics has emerged in recent years as a useful tool for enhancing NCL subtype classification. Fourteen NCL genetic forms (CLN1 to CLN14) have been described to date. The variant late-infantile form of the disease has been linked to CLN5, CLN6, CLN7 (MFSD8) and CLN8 mutations. Despite advances in the diagnosis of neurodegenerative disorders mutations in these genes may cause similar phenotypes, which rends difficult accurate candidate gene selection for direct sequencing. Three siblings who were affected by variant late-infantile NCL are reported in the present study. We used whole-exome sequencing, direct sequencing and in silico approaches to identify the molecular basis of the disease. We identified the novel c.1219T>C (p.Trp407Arg) and c.1361T>C (p.Met454Thr) MFSD8 pathogenic mutations. Our results highlighted next generation sequencing as a novel and powerful methodological approach for the rapid determination of the molecular diagnosis of NCL. They also provide information regarding the phenotypic and molecular spectrum of CLN7 disease.
Dual ankyrinG and subpial autoantibodies in a man with well-controlled HIV infection with steroid-responsive meningoencephalitis: A case report
Authors: Christopher M Bartley, Thomas T Ngo, Cathryn R Cadwell, Adil Harroud, Ryan D Schubert, Bonny D Alvarenga, Isobel A Hawes, Kelsey C Zorn, Trung Hunyh, Lindsay H Teliska, Andrew F Kung, Shailee Shah, Jeffrey M Gelfand, Felicia C Chow, Matthew N Rasband, Divyanshu Dubey, Sean J Pittock, Joseph L DeRisi, Michael R Wilson, Samuel J Pleasure
Journal: Front Neurol (2023)
Keywords: ank3, ankyring, autoantibody, autoimmune, axon initial segment (ais), human immunodeficiency virus (hiv), meningoencephalitis, node of ranvier
MeSH terms: Case Reports

Neuroinvasive infection is the most common cause of meningoencephalitis in people living with human immunodeficiency virus (HIV), but autoimmune etiologies have been reported. We present the case of a 51-year-old man living with HIV infection with steroid-responsive meningoencephalitis whose comprehensive pathogen testing was non-diagnostic. Subsequent tissue-based immunofluorescence with acute-phase cerebrospinal fluid revealed anti-neural antibodies localizing to the axon initial segment (AIS), the node of Ranvier (NoR), and the subpial space. Phage display immunoprecipitation sequencing identified ankyrinG (AnkG) as the leading candidate autoantigen. A synthetic blocking peptide encoding the PhIP-Seq-identified AnkG epitope neutralized CSF IgG binding to the AIS and NoR, thereby confirming a monoepitopic AnkG antibody response. However, subpial immunostaining persisted, indicating the presence of additional autoantibodies. Review of archival tissue-based staining identified candidate AnkG autoantibodies in a 60-year-old woman with metastatic ovarian cancer and seizures that were subsequently validated by cell-based assay. AnkG antibodies were not detected by tissue-based assay and/or PhIP-Seq in control CSF (N = 39), HIV CSF (N = 79), or other suspected and confirmed neuroinflammatory CSF cases (N = 1,236). Therefore, AnkG autoantibodies in CSF are rare but extend the catalog of AIS and NoR autoantibodies associated with neurological autoimmunity.
A fetal hemolytic anemia in a child with cytomegalovirus infection
Authors: S Hosseeini, Sh Ansari, E Kalantar, M Sabzechian, A Alibeik, A Dorgalaleh
Journal: Iran J Ped Hematol Oncol (2014)
Keywords: autoimmune hemolytic anemia, cytomegalovirus, direct anti globulin test, viral load
MeSH terms: Case Reports

Background:
Autoimmune hemolytic anemia is a hematologic disorder that is rarely observed in infants and young children. Most of the cases are associated with viral or bacterial infections. In some cases, AIHA can be characterized by a chronic course and an unsatisfactory control of hemolysis, thus requiring prolonged immunosuppressive therapy.
Case report:
Especially in children younger than 2 years of age, the clinical course of the disease may show either resistance to steroids or dependence on high-dose steroids. We report here an infant fatal autoimmune.
Conclusion:
This case suggests that investigation for the presence of CMV infection in infantile AIHA should be considered. Severe hemolysis is rare but could be a potentially life-threatening complication of CMV infection described mostly in immune compromised adults and children.
Brugada Syndrome Caused by Autonomic Dysfunction in Multiple Sclerosis
Authors: Michel Ibrahim, Garly Saint-Croix, Rosario Colombo
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Only one case report has previously described a patient with multiple sclerosis and a type 1 Brugada pattern on the electrocardiogram. Patients with multiple sclerosis have several neurological deficits including sensory symptoms, acute or subacute motor weakness, gait disturbance, and balance problems that may lead to an increased risk of falls. Concurrent autonomic dysfunction and neurologic consequences of multiple sclerosis may precipitate both mechanical falls and falls with loss of consciousness. While mechanistically different, the type 1 Brugada pattern presents similarly with syncope due to an insufficient cardiac output during dysrhythmia. In such patients, intracardiac defibrillators have shown to prevent sudden cardiac death in patients with the Brugada syndrome. In light of these similarly presenting but unique clinical entities, MS patients who develop a syncopal event in the setting of a spontaneous type I Brugada pattern pose a diagnostic and therapeutic dilemma. This case illustrates an approach to the risks and benefits of an ICD placement in an MS patient with the type 1 Brugada pattern.
Vulva fibroadenoma associated with lactating adenoma in a 26-year-old nigerian female
Authors: C C Anunobi, F J N Obiajulu, A A F Banjo, A O E Okonkwo
Journal: Case Rep Pathol (2013)

Background. Vulva lactating adenoma is rare and may be misdiagnosed as adenocarcinoma in frozen section and aspiration cytology if breast tissue is not anticipated. Objective. To raise the awareness of lactating vulva ectopic breast lesion among clinicians and pathologists. Case Report. We present a case of vulva fibroadenoma associated with lactating adenoma in a 26-year-old Nigerian female. Conclusion. The rarity of vulva ectopic breast tissue can present a diagnostic challenge for both the clinician and the anatomical pathologist. Once excisional biopsy is done and the lesion confirmed histologically, the anxious patient can be reassured.
Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion
Authors: Koshiro Shimasaki, Tomokazu Yoshioka, Akihiro Kanamori, Masashi Yamazaki
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. We report a rare case of a patient diagnosed with bilateral mucoid degeneration of the ACL with AKP and no limited joint range of motion (ROM). A 59-year-old man with spontaneous right AKP was admitted to our hospital. He first underwent arthroscopic resection of the thickened medial plica protruding far into the medial patellofemoral joint (PFJ) but felt little effectiveness thereafter. He then had an arthroscopic release of the lateral patellar retinaculum because of valgus knee and patellar instability, which resulted in only temporary improvement. Then, the AKP relapsed, this time with limitations in the ROM. Magnetic resonance imaging (MRI0 showed a diffuse, thickened ACL with a high inhomogeneous intensity in the T2-weighted and proton density weighted images and which looked similar to a celery stalk. Based on the patient's history and MRI findings, we suspected mucoid degeneration of the ACL and subsequently performed arthroscopic excision. At the same time, AKP appeared on the other side. Since the MRI demonstrated a similar celery stalk image as before, the same operation was performed on this side, as well. Finally, AKP and the limitation of the ROM were relieved approximately one month after surgery. Due to the patient only suffering from AKP with a preserved ROM, it took about 14 months to diagnose this disease. It should, therefore, always be considered in cases of AKP alone.
Necrotizing fasciitis complicating pregnancy: a case report and literature review
Authors: Marinos Nikolaou, Petros Zampakis, Vasiliki Vervita, Konstantinos Almaloglou, Georgios Adonakis, Markos Marangos, Georgios Decavalas
Journal: Case Rep Obstet Gynecol (2014)

Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. A 15-year-old primigravid woman, at 28 weeks of gestation with no significant previous medical history, was admitted to our hospital complaining of severe left lower extremity pain and high fever the last 72 hours. During clinical examination, she had a swollen, erythematous and tender to palpation inflamed skin over the medial aspect of the upper thigh without any evidence of injury. Incision drainage was performed immediately and she received broad spectrum antibiotics. During initial laboratory examinations, diabetes mellitus was diagnosed. There was no clinical improvement over the following days. Magnetic resonance imaging (MRI) revealed subcutaneous tissue inflammation and edema of infected tissues confirming the disease entity. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intensive care monitoring was performed successfully. The patient's postoperative course was uncomplicated and skin defect was closed with split thickness skin grafting. Our case emphasized the potential immunosuppressive role of pregnancy state in conjunction with diabetes mellitus in the development of severe necrotizing soft tissue infections.
Electroconvulsive therapy (ECT) with ketamine induction for catatonia in an HIV positive patient
Authors: Yvette Nel, Craig A Bracken
Journal: S Afr J Psychiatr (2023)
Keywords: ect, hiv, ketamine, case report, catatonia
MeSH terms: Case Reports

Introduction:
The successful use of ECT as treatment for catatonia, in the context of HIV (human immunodeficiency virus) infection, has been described previously. Ketamine has been used as an anaesthetic induction agent for ECT, although not considered the induction agent of choice. There are also case reports suggesting that ketamine may be an alternative treatment specifically for catatonia.
Patient presentation:
This case report describes the management of a female patient who presented with catatonia, evidenced by stupor, waxy flexibility, mutism, negativism, and stereotypy, as well as stage four HIV infection, with poor response to previous psychotherapeutic interventions.
Management and outcome:
We describe the course of management of this patient with ECT, following poor initial clinical response to ECT with propofol induction, the subsequent use of ketamine as an anaesthetic induction agent for ECT, with associated improvement in seizure quality, and good overall clinical response to ECT demonstrated thereafter.
Conclusion and contributions:
This case report suggests that ketamine may be a viable induction agent for ECT in this clinical setting.
Novel Phenotype in Unbalanced 7;9 Translocation with Critical Incidental Finding
Authors: Julie Fischer, Luis Rohena
Journal: Case Rep Genet (2022)
MeSH terms: Case Reports

This case discusses a now 13-year-old boy who underwent chromosome analysis and fluorescence in situ hybridization (FISH) for subtelomeric rearrangements due to dysmorphic features at birth. This testing revealed a diagnosis of an unbalanced 7;9 translocation resulting in monosomy for 7q34-qter and trisomy for 9pter-p21, which resulted in a very complex medical course. At the age of 12, due to persistent complex neurodevelopmental concerns, the patient was referred by neurology for whole-exome sequencing. This testing revealed an incidental pathogenic heterozygous KCNH2 deletion, which is associated with long QT-syndrome type II. Prior to this point, the patient had no symptoms of long QT syndrome and had multiple EKGs with normal QT intervals. However, due to this association, the patient underwent Holter monitoring, which revealed clinical evidence of long-QT syndrome type II. Preventative treatment was then initiated and the patient remains asymptomatic. This case expands on the phenotype of this patient's unbalanced 7;9 translocation as well as highlights the importance of secondary findings in genetic testing.