OpenMed/multicare-articles huggingface dataset:
Sintilimab combined with anlotinib as first-line treatment for advanced sarcomatoid carcinoma of head and neck: a case report and literature review
Authors: Lei Wang, Yingyu Huang, Xin Sun
Journal: Front Oncol (2024)
Keywords: anlotinib, head and neck, immune checkpoint inhibitors, sarcomatoid carcinoma, sintilimab
MeSH terms: Case Reports

Sarcomatoid carcinoma (SC) is a rare, complex, aggressive tumor that spreads rapidly, is highly malignant, and has metastasized. Surgical resection is the primary treatment, and it usually occurs in the lungs and kidneys but rarely in the neck. Patients with advanced sarcomatoid carcinoma (SC) of the head and neck (HN) have a poor progonsis. In recent years, immune checkpoint inhibitors (ICIs) have been established as treatments for many solid tumors; however, the effectiveness of ICIs in treating SC of HN is still little recognized. We report a case study of a middle-aged woman with primary sarcomatoid carcinoma of the neck. She developed sarcomatoid carcinoma of the contralateral neck 7 months after the first surgical treatment. Subsequently, disease recurrence and metastasis occurred 8 months after the second surgery. The patient did not receive any treatment after both surgeries. The tumor showed high programmed death-ligand 1 (PD-L1) expression, with a combined positive score (CPS): 95. The patient's response to treatment was assessed as partial remission (PR) after 2 cycles of anlotinib combined with sintilimab. The patient has survived for over 2 years and remains in PR status, despite experiencing grade 2 hypothyroidism as an adverse event during treatment. The case highlights the efficacy and safety of anlotinib and sintilimab as a first-line treatment.
Giant stone in a urinary bladder diverticulum in a 69-year-old male: a case report
Authors: Syarif Syarif, Abdul Azis, Muhammad Ilham Fauzan Patimura, Muhammad Zulharyahya Dandy Asmara Putra, Ade Nusraya, Ahmad Shafwan Natsir
Journal: Pan Afr Med J (2023)
Keywords: bladder stone, bladder diverticulum, bladder neck stenosis, case report, transurethral resection
MeSH terms: Diverticulum / diagnosis, Diverticulum / surgery, Lower Urinary Tract Symptoms, Urinary Bladder Diseases / diagnosis, Urinary Bladder Diseases / surgery, Case Reports, Aged, Humans, Male, Urinary Bladder / surgery, Bladder Diverticulum

The stone formation could occur due to urine stasis in the bladder diverticulum. However, the stones are usually smaller in size and can pass spontaneously. However, a giant stone inside vesical diverticulum is considered a rare entity. We report a 69-year-old male, with a two-year history of lower urinary tract symptoms along with a recurrence of urinary tract infection. An abdominal computed tomography scan revealed the presence of a giant bladder diverticulum and a large bladder stone. The patient underwent a transurethral bladder neck incision followed by diverticulectomy with stone extraction. The diverticulum size measures 6x4x3.8 cm and diverticulum stone size of 4x3x3 cm. Fortunately, the patient recovered well after the operation. In conclusion, giant stones inside large vesical diverticulum are a rare occurrence and should be considered in patients with lower urinary tract symptoms. Early diagnosis and optimal management of the obstruction are the principles to prevent long-term complications.
Case Report: Minocycline-induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report and literature review
Authors: Zhe Zhao, Ming Lu, Yingqiu Ying
Journal: Front Pharmacol (2024)
Keywords: adverse event, case report, drug reaction with eosinophilia and systemic symptoms (dress) syndrome, literature review, minocycline
MeSH terms: Case Reports

Minocycline is a tetracycline commonly used for several dermatological diseases. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but severe adverse event which can be caused by minocycline. An 18-year-old male patient developed fever, acute rash, pharyngeal pain, lymphadenopathy, hematologic abnormalities, increased creatinine level, elevated liver enzyme levels, and splenomegaly 4 weeks after the oral treatment of minocycline, 100 mg daily, for acne. Once diagnosed with DRESS syndrome, intravenous methylprednisolone was applied and his clinical manifestations and laboratory results remarkably improved. Then, a total of 13 DRESS syndrome cases induced by minocycline were reviewed and their clinical characteristics were summarized. In these cases, only two patient (15.4%) was present with pharynx involved. In conclusion, we reported a rare minocycline-induced DRESS syndrome who developed fever, eosinophilia, acute rash, pharyngitis, lymphadenopathy, acute kidney injury, hepatitis, and splenomegaly. Our report provides detailed clinical features of minocycline-induced DRESS syndrome, which helps us further understand this severe adverse event.
Bilateral Posterior Fracture-Dislocation of the Shoulders Secondary to Uremic Encephalopathy
Authors: Marlon M Mencia, Raakesh Goalan
Journal: J Am Acad Orthop Surg Glob Res Rev (2023)
MeSH terms: Epilepsy, Tonic-Clonic / complications, Fracture Dislocation / complications, Joint Dislocations / complications, Shoulder Dislocation / diagnosis, Shoulder Dislocation / etiology, Shoulder Dislocation / surgery, Shoulder Fractures / complications, Shoulder Fractures / diagnostic imaging, Case Reports, Humans, Male, Middle Aged, Seizures / complications, Shoulder

Bilateral posterior fracture-dislocation of the shoulder is an uncommon injury pattern usually caused by epileptic seizures. The cause of the seizure activity remains unknown in most cases, although the injury has been associated with several conditions. A 59-year-old man with uncontrolled hypertension presented with new-onset generalized tonic-clonic seizures. He was diagnosed with uremic encephalopathy and bilateral posterior fracture-dislocation of his shoulders. His medical condition required stabilization leading to a delay in definitive surgery and a subsequent poor outcome. This case highlights the previously unknown association between bilateral fracture-dislocation of the shoulders and seizures caused by uremic encephalopathy. In these complex situations with competing clinical priorities, it is important to initiate prompt treatment of the cause in any new-onset seizures, to facilitate expedient surgical management of the orthopaedic injury.
Case report: Isolated brainstem-cerebellar symptoms in a patient with anti-NMDA receptor encephalitis
Authors: Yongfeng Xu, Qingqing Tao, Yi Dong, Yinxi Zhang
Journal: Front Immunol (2024)
Keywords: isolated brainstem-cerebellar symptoms, anti-nmdar encephalitis, ataxia, brainstem symptoms, encephalitis
MeSH terms: Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis, Autoantibodies / blood, Autoantibodies / cerebrospinal fluid, Autoantibodies / immunology, Brain Stem / pathology, Case Reports, Adult, Cerebellar Ataxia / diagnosis, Cerebellar Ataxia / etiology, Cerebellar Ataxia / immunology, Cerebellum / diagnostic imaging, Cerebellum / pathology, Female, Humans, Immunotherapy, Magnetic Resonance Imaging, Male, Receptors, N-Methyl-D-Aspartate / immunology, Autoantibodies, Receptors, N-Methyl-D-Aspartate

Cerebellar ataxia is an uncommon and atypical manifestation of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, often accompanied by seizures, psychiatric symptoms, and cognitive deficits. Previous cases of isolated brainstem-cerebellar symptoms in patients with anti-NMDAR encephalitis have not been documented. This report presents a case of anti-NMDAR encephalitis in which the patient exhibited cerebellar ataxia, nystagmus, diplopia, positive bilateral pathological signs, and hemiparesthesia with no other accompanying symptoms or signs. The presence of positive CSF anti-NMDAR antibodies further supports the diagnosis. Other autoantibodies were excluded through the use of cell-based assays. Immunotherapy was subsequently administered, leading to a gradual recovery of the patient.
Approach to a cerebral hernia caused by an intratumoral hemorrhage of a cystic oligodendroglioma: a case report
Authors: Jiahua Zhou, Yingxi Wu, Huaizhou Qin, Shoujie Wang, Dayun Feng, Di Yang
Journal: Front Oncol (2024)
Keywords: cerebral hernia, cystic oligodendroglioma (cod), diagnosis, intratumoral hemorrhage (ith), treatment
MeSH terms: Case Reports

The incidence of cerebral herniation caused by intratumoral hemorrhage (ITH) in cystic oligodendroglioma (COD) is exceedingly rare. This study presents a case of cerebral herniation subsequent to cystic oligodendroglioma (COD) and sudden intratumoral hemorrhage. Following initial emergency treatment and evaluation, we successfully circumvented the solid component of the tumor and proceeded with cystic puncture and external drainage to prevent the incidence of brain herniation and mitigate the severity of associated symptoms. Based on preoperative examination results, the cystic glioma was successfully resected, and the patient experienced an uneventful recovery. According to the pathological findings, the oligodendroglioma was classified as World Health Organization (WHO) grade III. The treatment efficacy was comparable to cases of the same pathological grade, in which neither intratumoral hemorrhage nor cerebral hernia was observed.
Accidental Cut-Throat Injury by a Broken Glass: Bloodstain Pattern Analyses and Autopsy Findings
Authors: Biliana Mileva, Metodi Goshev, Mihaela Georgieva, Ivan I Tsranchev, Alexandar Alexandrov
Journal: Cureus (2024)
Keywords: accidental cut-throat injury, bloodstain pattern, crime scene investigation, cut-throat injury, death scene investigation, forensic autopsy, neck injury, neck vascular injury, neck zones
MeSH terms: Case Reports

Injuries in the neck region are rarely observed in forensic practice, especially of accidental origin. Primarily, such cases are associated with homicide or suicide. The neck region comprises different and vital anatomical structures, and even minor trauma could be lethal. In the absence of witnesses to the accident, each finding is of utmost importance, from the death/crime scene investigation - bloodstain patterns and trace evidence - to careful examination of the deceased body. The forensic pathologist has the challenging task of analyzing all the findings to make a statement concerning the cause and manner of death and, if there is something suspicious about the current case, to inform the relevant authorities.
Acute Lung Injury As Severe Acute Respiratory Distress Syndrome After Fentanyl Overdose
Authors: Asha Bansari, Han Li, Sai Chunduru, Naveen Baskaran
Journal: Cureus (2024)
Keywords: acute respiratory distress syndrome (ards), drug intoxication, drug overdose, illicit fentanyl, lung-injury, opioid side effects
MeSH terms: Case Reports

Acute lung injury following fentanyl overdose is an unusual presentation. Pulmonary edema has been associated with opioid and naloxone use. However, to our knowledge, there have been no previous reports of inhaled fentanyl-associated acute lung injury presenting with acute hypoxic respiratory failure secondary to severe acute respiratory distress syndrome. We report a case of inhaled fentanyl-related severe acute respiratory distress syndrome which presented immediately after snorting fentanyl. This patient developed hypoxia requiring 100% oxygen on non-rebreather mask, and acute respiratory distress syndrome was confirmed on chest X-ray and computed tomography on admission. He was successfully treated with steroids with recovery in 48 hours. Naloxone was used in this patient, which has been associated with pulmonary edema in case reports and series, but clinical findings were more consistent with acute respiratory distress syndrome rather than pulmonary edema. The mechanism for this clinical presentation is not well known. Proposed mechanisms include lung injury from inhalation against an obstruction in a manner similar to post-obstructive pulmonary edema. Although our patient rapidly responded to symptomatic treatment and steroid course, our case also highlights the need for further study to elucidate the various clinical presentations associated with fentanyl use-related lung toxicity including acute respiratory distress syndrome.
The Management of Inflatable Penile Prosthesis Erosion and Infection following Iatrogenic Aspiration
Authors: Ali Baydoun, Alexander Benben, Matthew Skalak, Jordan Bilbrew, Mazen Abdelhady
Journal: Case Rep Urol (2024)
MeSH terms: Case Reports

This case report presents a unique and previously unreported case of malfunction, infection, and erosion of an inflatable penile prosthesis (IPP) resulting from iatrogenic injury during a priapism aspiration procedure performed by an emergency medicine physician. The patient, a 75-year-old male with a history of IPP placement for erectile dysfunction, presented with urinary retention and priapism, leading to inadvertent deflation of the IPP during aspiration. Subsequent evaluation revealed a pinhole opening on the scrotum, indicating infection and erosion of the prosthesis tubing. The patient underwent emergent explantation of the infected IPP, washout, cystoscopy, and insertion of a suprapubic tube. Intraoperative cultures identified Escherichia cloacae as the causative pathogen. This case highlights the importance of thorough chart review to identify patients with IPPs before aspiration procedures and emphasizes the need for healthcare provider education regarding potential complications in this patient population. Early recognition and management of such complications are crucial for optimal patient outcomes. While IPP placement remains a highly satisfactory treatment for erectile dysfunction, this case highlights the importance of vigilance to ensure the best care for patients with penile prostheses. It is noteworthy that ultimately, a new IPP was not placed in this patient due to the patient's significant medical comorbidities.
Pulmonary involvement in primary Sjögren's syndrome: contribution of the different means in the systematic investigation
Authors: Maysam Jridi, Yosra Cherif, Samar Derbal, Fatma Ben Dahmen, Meya Abdallah
Journal: Pan Afr Med J (2023)
Keywords: sjögren's syndrome, interstitial lung disease
MeSH terms: Asthma, Pulmonary Disease, Chronic Obstructive, Sjogren's Syndrome / complications, Sjogren's Syndrome / diagnosis, Sjogren's Syndrome / epidemiology, Case Reports, Adult, Aged, Cough, Female, Humans, Male, Middle Aged, Retrospective Studies

The prevalence of pulmonary involvement in primary Sjögren´s syndrome (pSS) varies depending on investigation methods. Our study aimed to identify the contribution of the different means of investigation in the systematic screening for pulmonary involvement in pSS. This is a retrospective and descriptive study including medical records of pSS patients, who validated the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for pSS and who had undergone pulmonary assessment. We enrolled 30 patients: twenty-nine females (97%) and one male (3%). The mean age was 55±17.4. In nine patients (30%), pulmonary disease revealed the diagnosis. Dyspnoea and cough were respectively reported by 43% (N=13) and 30% (N=9) of patients. The six-minute walk test showed desaturation in four cases (14%) and the percent predicted distance was less than 70% in three cases (11%). Pulmonary function tests (PFTs) showed restrictive patterns (N=7, 26%), obstructive patterns (N=2, 7%), combined patterns (N=1, 4%), and isolated small airway disease (N=1, 4%). The prevalence of pulmonary involvement based on high-resolution computed tomography (HRCT) was 31% (N=9/29). The most frequent interstitial lung disease (ILD) was observed in five scans (56%) and usual interstitial pneumonia was the most frequently seen in three cases (60%). Bronchiolitis was observed in four cases (25%) out of 16 abnormal scans. The six-minute walk test results correlated with PFT results (P<0.05). Pulmonary involvement was noted in 50% of cases (N=15). It was clinically silent in one-third of cases (N=5). In conclusion, pulmonary involvement in Sjögren´s syndrome can be asymptomatic in 33% of cases. The six-minute walk test has a strong correlation with the results of PFT, it should be considered as an assessment tool that reflects the functional state of the patient.
Case report: Safety and efficacy of synergistic treatment using selinexor and azacitidine in patients with atypical chronic myeloid leukemia with resistance to decitabine
Authors: Lu Liu, Xiaofeng Song, Wenhao Dong, Zhao Li, Dongmei Guo
Journal: Front Oncol (2024)
Keywords: atypical chronic myeloid leukemia, azacitidine, case report, selinexor, synergism
MeSH terms: Case Reports

Background:
Atypical chronic myeloid leukemia (aCML) is a BCR::ABL1 negative myelodysplastic/myeloproliferative neoplasm with poor overall survival. Some patients can be treated by allogeneic hematopoietic stem cell transplantation (allo-HSCT) from suitable donors. The effectiveness of decitabine or azacitidine (AZA) has recently been reported; however, their combined efficacy with selinexor has not yet been reported.
Case description:
In this study, we report the case of a patient with aCML who was successfully treated with selinexor combined with AZA. A 67-year-old man with a history of gastric mucosa-associated lymphoid tissue (MALT) lymphoma was admitted to the hospital with fatigue and emaciation. He was diagnosed with aCML and no longer responded to decitabine treatment after undergoing seven cycles. The patient was subsequently administered hydroxyurea (HU), selinexor, and AZA. After four courses of combination therapy, his blood cell counts improved; he no longer required transfusions and was able to discontinue HU. The patient continued receiving selinexor and AZA without severe complications. This case is the first to show that combinatorial selinexor and AZA therapy can effectively treat aCML.
Conclusion:
Our case sheds light on the importance of selinexor and AZA combined therapy in the exploration of new treatment strategies for aCML. Moreover, this treatment approach offers the possibility of bridging with allo-HSCT.
Case Report: Multisystem inflammatory syndrome in children with associated proximal tubular injury
Authors: Silvia Maria Orsi, Carlotta Pepino, Lisa Rossoni, Margherita Serafino, Roberta Caorsi, Stefano Volpi, Serena Palmieri, Alessandro Faragli, Francesca Lugani, Carolina Bigatti, Gian Marco Ghiggeri, Enrico Eugenio Verrina, Edoardo La Porta, Andrea Angeletti
Journal: Front Nephrol (2023)
Keywords: fanconi syndrome, mis-c multisystem inflammatory syndrome in children, sars – cov – 2, bladder debris, kidney injury, proximal tubule injury
MeSH terms: Case Reports

Introduction:
SARS-CoV-2 infection in the pediatric population can be associated with a multiorgan inflammatory syndrome called children's multisystem inflammatory syndrome (MIS-C). The kidneys can be affected by a broad spectrum of possible injuries, whose pathogenetic mechanisms are still unclear.Case report: We report the case of a 5-year-old boy with severe cardiac involvement in the context of MIS-C. After two weeks of hospitalization, an abdominal ultrasound showed massive bladder "debris", followed by the onset of normoglycemic glycosuria. Over time, there was a progressive increase in glycosuria, and the presence of a mat of amorphous phosphate crystals was evidenced on urinary sediment. Together with the findings of hypo-uricemia, increased urinary uric acid, and globally increased urinary amino acids, a clinical picture of kidney proximal tubular damage with secondary Fanconi-like syndrome took shape.
Discussion:
This case report describes the case of a patient with MIS-C with cardiac and kidney involvement characterized by proximal tubular damage, which slowly improved but still persisted at the 8-month follow-up. The pathogenesis of the damage is unclear and probably multifactorial.
Erosive balanitis caused by Staphylococcus haemolyticus in a healthy, circumcised adult male
Authors: José Mazuecos-Blanca, José Rafael Mazuecos-Gutiérrez, Ana Jiménez-Gil
Journal: Access Microbiol (2023)
Keywords: staphylococcus haemolyticus, balanitis, balanoposthitis, circumcision, coagulase-negative staphylococci
MeSH terms: Case Reports

Introduction:
Balanitis is an inflammation of the glans penis. Balanoposthitis involves both the glans penis and prepuce and occurs only in uncircumcised males. Recurrent balanoposthitis represents a strong indication for circumcision. After Candida infections, aerobic bacteria are the second most common aetiological cause of acute infectious balanoposthitis, mainly streptococci groups B and D, and staphylococci, usually S. aureus . Their clinical manifestations are variable inflammatory changes, including diffuse erythema and oedema. Severe balanopreputial oedema with purulent exudate occurs in painful, erosive streptococcal balanoposthitis.


Coagulase-negative staphylococci (CoNS) are commensal skin bacteria, but are also recognized pathogens of the genitourinary system, mainly related to urinary tract infections. Staphylococcus haemolyticus is one of the main species of CoNS that is part of the cutaneous microflora but is also associated with nosocomial infections. In addition, S. haemolyticus also causes other infections of the male urogenital tract, such as chronic prostatitis and epididymo-orchitis, but it has not been associated with balanitis.
Case presentation:
A 45-year-old man reports having suffered several episodes of balanoposthitis in the last 3 years, which were treated with topical antifungal treatments alone or associated with corticosteroids. For this reason, he underwent a postectomy by his urologist 8 months ago to avoid further recurrences.


The patient consulted for an episode of painful, erosive and exudative lesions on the glans penis and over the post-operative scars lasting 5 days. He had no urinary discomfort or inguinal lymphadenopathy. A complete blood count, biochemical analysis, C-reactive protein (CRP), prostate-specific antigen (PSA) and urinalysis were normal. Abundant growth of S. haemolyticus was obtained in the culture on tryptone soya agar with sheep blood and chocolate agar with Vitox media. The MicroScan panel CIM 37 (PM37) was used to study the antimicrobial susceptibilities of the isolated bacteria. The fungal culture on Sabouraud dextrose agar was negative. Based on the antimicrobial susceptibility study, treatment with oral ciprofloxacin and topical mupirocin was started, and the genital infection was completely cured.
Conclusion:
We present a healthy, non-diabetic, circumcised male patient with severe, erosive and painful balanitis probably due to S. haemolyticus .