OpenMed/multicare-articles huggingface dataset:
Case Report: Takotsubo Cardiomyopathy After Traumatic Brain Injury
Authors: Fajun Wang, Joseph Darby
Journal: Front Neurol (2021)
Keywords: tbi, takotsubo cardiomyopathy, case report, diagnosis, stress cardiomyopathy, traumatic brain injury
MeSH terms: Case Reports

Introduction: Takotsubo cardiomyopathy (TCM) or "stress cardiomyopathy" is an uncommon condition characterized by transient cardiac dysfunction with left ventricular apical ballooning in an appropriate clinical context. TCM has been observed in a variety of acute neurological conditions most prominently in patients with aneurysmal subarachnoid hemorrhage and status epilepticus. TCM has only been reported infrequently in association with traumatic brain injury (TBI). Herein we present a patient who developed TCM 3 days after hospital admission with severe TBI. Case Presentation: A 30-year-old male presented to the hospital with an acute subdural hematoma, anisocoria, declining consciousness and CT evidence of uncal herniation after being found down in a hotel room. The patient was taken emergently to the operating room for decompressive hemicraniectomy and hematoma evacuation. On the post-trauma day (PTD) 3, the patient developed acute dyspnea with increased oxygen requirements that improved with diuresis. On PTD 4, nursing staff noted T waive inversions (TWI) on the bedside monitor prompting an electrocardiogram (ECG) that showed a prolonged QTc interval and worsening TWI in leads I, II, aVL, and V2-6. Troponin I level was mildly elevated at 0.63ng/mL. Transthoracic echocardiography (TTE) was subsequently performed and showed a low ejection fraction (EF 26%) with apical hypokinesis and basal hyperkinesis, consistent with TCM. A diagnosis of TCM was confirmed by Cardiology consultation and he was started on a beta-blocker and an ACE inhibitor. Follow-up TTE on PTD 20 showed a normal left ventricular EF. Conclusion: While rarely reported in patients with TBI, TCM developed in an otherwise healthy young male following severe TBI necessitating decompressive hemicraniectomy. TTE should be considered in patients with TBI who have cardio-pulmonary symptoms or unexplained ECG abnormalities.
Bifocal Presentation of Primary Testicular Extranasal NK/T-Cell Lymphoma: A Case Report and Review of the Literature
Authors: Ali Naboush, Firas Farhat, Selim M Nasser, Francois G Kamar
Journal: Case Rep Oncol Med (2013)

Introduction. Testicular lymphoma is an aggressive disease with a very poor prognosis. Nasal-type natural killer/T-cell lymphoma (NKTCL-N) in particular is very uncommon and has a rapidly progressive, fatal course. Case Report. We report a case of primary NKTCL-N of the testis in a 38-years-old Middle Eastern man. The patient had a history of primary right testicular tumor diagnosed at an outside institution as a seminoma and treated with orchiectomy followed by chemo/radiation. On admission, the patient had an enormous nasal granuloma with blood workup showing pancytopenia and elevated liver function tests due to active hepatitis B infection. CT scan of the sinuses showed a very large soft tissue mass, and PET scan showed splenomegaly with multiple lymph node masses in the pelvis and the chest areas. Bone marrow and nasal tumor biopsies as well as review of the slides from the initial orchiectomy were all in favor of NKTCL-N lymphoma. The patient was treated with CHOD based combination chemotherapy and responded dramatically to the first two cycles but passed away from fulminant hepatitis B infection. Conclusion. Despite all known treatments of NKTCL-N lymphoma of the testes, this disease has a very poor prognosis and invariably follows an aggressive clinical course.
Totally endoscopic atrial septal defect repair using transthoracic aortic cannulation in a 10.5-kg-boy
Authors: Huy Q Dang, Huong T Le, Linh T H Ngo
Journal: Int J Surg Case Rep (2018)
Keywords: atrial septal defect, co(2) insufflation, direct aortic cannulation, minimally invasive cardiac surgery, totally endoscopic surgery

Introduction:
Although totally endoscopic surgery (TES) has been widely applied for the treatment of atrial septal defect (ASD), small children receive few benefits from this technique due to risks of the femoral cannulation.
Case presentation:
A 23-month-old boy, weighing 10.5 kg, with the diagnosis of sinus venosus ASD underwent successful repair by TES. We performed this surgery through 4 small trocars (one 12 mm trocar and three 5 mm trocars), without robotic assistance. In this case, we inserted the arterial cannula directly into the ascending aorta instead of the femoral artery (FA). The defects were repaired on the beating heart with CO2 insufflation.
Discussion:
Femoral cannulation in small children pose some risks, such as increased arterial line pressure, critical lower limb ischaemia, and post-operative iliac or femoral arterial stenosis. Putting the arterial cannula directly into the ascending aorta is a good solution but is difficult to be performed through TES, especially in small children. The major concern of operating on the beating heart is the air embolism, which requires special preventative methods.
Conclusion:
Transthoracic aortic cannulation may facilitate TES in small children. However, the safety and efficacy of this approach needs to be validated by larger studies preferably randomised controlled trials.
Urethral rhinosporidiosis: Prolapsing mass from urethra in a Bangladeshi farmer
Authors: B M Saiduzzaman, Saumitra Chakravarty, Md Shafiqur Rahman, Mominul Haider, Md Mominul Islam, Md Shaleh Mahmud
Journal: IDCases (2023)
Keywords: endospores, prolapsing urethral mass, rhinosporidiosis, sporangia, urethra
MeSH terms: Case Reports

Rhinosporidiosis is a chronic granulomatous fungal infection caused by Rhinosporidium seeberi. Usual site of infection is the nasal mucosa & nasopharynx. Male urethra is extremely rare site involving this disease. Here we are reporting a rare case where rhinosporidiosis presented as a prolapsing mass from urethra during voiding.
A Fetus with Imperforate Anus Developing Pulmonary Hypoplasia Triggered by Transient Urethral Obstruction
Authors: Masatake Toshimitsu, Takayuki Iriyama, Seisuke Sayama, Kan Suzuki, Satsuki Kakiuchi, Mari Ichinose, Takahiro Seyama, Kenbun Sone, Keiichi Kumasawa, Takeshi Nagamatsu, Tomoyuki Fujii, Yutaka Osuga
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Pulmonary hypoplasia is a rare entity in a fetus with imperforate anus. The fetus was diagnosed with high-type imperforate anus with rectourethral fistula based on the dilated fetal bowel and the presence of bowel calcification at 19 weeks of gestation. As gestation advanced, fetal ultrasonography demonstrated development of pulmonary hypoplasia, progressive bowel dilation, and persistent oligohydramnios from 28 weeks of gestation despite a fluid-filled bladder without hydroureter or hydronephrosis. To prevent further worsening of pulmonary hypoplasia caused by thoracic compression due to bowel dilation and oligohydramnios, a male neonate was delivered by cesarean section at 32 weeks of gestation. The neonate showed respiratory failure requiring full respiratory support. Although a catheter did not pass through the urethra into the bladder at birth, cystourethrography revealed the patency of fistula and stenosed lower urinary tract. Prenatal and postnatal findings strongly suggested that the meconium in the colon might have passed into the urethra in the penis, resulting in the physical blockage of urine outflow to the amniotic space which leads urine flow from the bladder to the colon through the fistula, which resulted in subsequent oligohydramnios and bowel dilation. To the best of our knowledge, this is the first case report of a fetus with imperforate anus developing pulmonary hypoplasia possibly due to urethral obstruction.
Spectacularly successful microsurgical penile replantation in an assaulted patient: one case report
Authors: Mohammed Fadl Tazi, Youness Ahallal, Abdelhak Khallouk, Mohammed Jamal Elfassi, Moulay Hassan Farih
Journal: Case Rep Urol (2011)
MeSH terms: Case Reports

Penile amputation is a rare condition for which immediate surgical replantation is warranted. We present herein one case of a 27-year-old male who presented to the Emergency Department after his wife cut his penis. The penis was replanted microsurgically. The deep dorsal penile veins and superficial veins were anastomosed. Although we could not reanastomose the arteries, wound healing occurred without any problem one week postoperatively and the patient regained erectile function 4 weeks after surgery. At 1-year follow-up examinations he reported on restored erectile function and a normal urinary function.
Use of reverse angle guide catheter with trans-radial approach in patients undergoing middle meningeal artery embolization
Authors: Neeharika Krothapalli, Mohamad Fayad, Smit Patel, Ahmed Elmashad, Eric Sussman, Charles Bruno, Andrew Grande, Bharathi Jagadeesan, Brendan Killory, Mark Alberts, Inam Kureshi, Martin Ollenschleger, Ramachandra Tummala, Tapan Mehta
Journal: Front Neurol (2022)
Keywords: embolization, middle meningeal artery, reverse angle guide catheter, subdural hematoma, trans-radial approach

Background:
Trans-radial access (TRA) for MMA embolization has grown due to lower access site complications and greater patient satisfaction. Here, we describe the feasibility of utilizing a 6F Envoy Simmons 2 (6F-SIM2) as a guide catheter with TRA and compare outcomes with trans-femoral approach (TFA) in a single center case series.
Methods:
We performed a retrospective review of patients who underwent MMA embolization for management of chronic subdural hematoma (cSDH). TRA was performed by utilizing a combination of 6F 90cm Envoy (Codman & Shurtleff, Inc., Rayham, MA) Simmons 2 guide catheter and 5F 125cm Sofia (Microvention, Aliso Viejo, CA) intermediate catheter. Outcomes measured are Modified Rankin Score (mRS) at 90 days, inpatient mortality, post-embolization recurrence, fluoroscopy time and radiation exposure.
Results:
A total of 71 patients underwent 97 MMA embolization overall with 65 (67%) in trans-femoral access group, 11 (11.3%) in trans-radial access without use of Simmons 2 Guide catheter group and 21 (21.6%) in trans-radial access with use of Simmons 2 Guide catheter group. There were no direct access-related complications in either group. One patient had thromboembolic stroke in trans-femoral group. There was no difference in average procedure-related total fluro time or radiation dose among all three groups.
Conclusion:
Trans-radial approach using 6F-SIM2 guide catheter coupled with 5F Sofia intermediate catheter is safe and effective. It provides an alternative approach to access distal branches of bilateral anterior circulation in elderly patients with difficult anatomy undergoing MMA embolization.
Steroid-responsive encephalopathy associated with autoimmune thyroiditis presenting as confusion, dysphasia, and myoclonus
Authors: S A Ryan, C Kennedy, H J Harrington
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Steroid response encephalopathy associated with autoimmune thyroiditis (SREAT), or Hashimoto's encephalopathy, is a rare disorder believed to be immune-mediated. It is most often characterized by a subacute onset of confusion with altered level of consciousness, seizures, and myoclonus. We describe the case of a 48-year-old gentleman who presented with confusion and dysphasia. Specific clinical features and laboratory results led to a diagnosis of Hashimoto's encephalopathy. This case highlights the core features of this condition and the potential for complete response to steroid therapy.
Lymphoma in HIV patients: Varied presentations
Authors: Dattatray G Saple, Ira Shah, Amar U Surjushe, Anuradha Murthy, Priya Chudgar, Prashant D Gote
Journal: Indian J Med Paediatr Oncol (2010)
Keywords: hiv, lymphoma, non-hodgkins lymphoma
MeSH terms: Case Reports

Although lymphomas have been reported in patients with acquired immunodeficiency syndrome, it has rarely been reported from the Indian subcontinent. We present three human immunodeficiency virus-infected patients (two adults and one child) who had non-Hodgkin's lymphoma - plasmablastic variety, Hodgkin's lymphoma - nodular sclerosis type II and B cell lymphoma, respectively.
Advances in Cardiopulmonary Life-Support Change the Meaning of What It Means to be Resuscitated
Authors: Leslie C Avant, Carolyn E Kezar, Keith M Swetz
Journal: Palliat Med Rep (2020)
Keywords: end of life, palliative care, patient–physician relationship, withdrawing, withholding
MeSH terms: Case Reports

As options for advanced cardiopulmonary support proliferate, the use of mechanical circulatory support, such as left ventricular assist device as destination therapy (LVAD-DT), is becoming increasingly commonplace. In the current case, a patient was hospitalized for complications related to his LVAD-DT requests "full code" status, despite a clinician's warning that performing chest compressions may damage the LVAD device or vascular structures leading to poor outcome. This discussion explores the ethical and legal considerations regarding a patient request for cardiopulmonary resuscitation when limited options for survival or further treatment are available.
Rotationplasty Salvage Procedure as an Effective Alternative to Femoral Amputation in an Adult With a History of Osteosarcoma: A Case Report and Review
Authors: Jean Gaillard, Alban Fouasson-Chailloux, Dominique Eveno, Guillaume Bokobza, Marta Da Costa, Romain Heidar, Marie Pouedras, Christophe Nich, François Gouin, Vincent Crenn
Journal: Front Surg (2022)
Keywords: borggreve-van ness surgery, femur, osteosarcoma, rotationplasty, septic nonunion
MeSH terms: Review

Rotationplasty or Borggreve-Van Ness surgery is lower limb salvage surgery, indicated mainly in the management of femoral bone sarcoma and congenital femur malformations in children. It can also be an interesting surgery option for managing chronic osteoarticular infections, or in cases of non union when curative therapy is no longer an option, as an alternative to femoral amputation. The principle of this surgery is to remove the affected knee and to apply a rotation of 180° to the distal part of the lower limb in order to give the ankle the function of a neo-knee. With the help of an adapted prosthesis, the aim is to allow patients to resume their social and professional activities by keeping most of their lower limb, thus avoiding the known complications of amputation (ghost limb pain, proprioceptive deficit, psychological disorders). Nevertheless, this surgery is complex and exceptional, with vascular, infectious, and psychological risks - the chimeric aspect of the lower limb may cause significant ill-being for the patient. This article reports the case of a 38-year-old patient consulting for management of a complex septic distal femoral non-union following osteosarcoma considered as being in remission. The patient underwent rotationplasty surgery on his left lower limb, with very good functional results and no surgical revision to date. In light of this particular case, we propose a didactic overview of the literature data concerning this surgery, especially in adulthood.
Hemoglobin Sunshine Seth: A Case Report of Low-Oxygen-Affinity Hemoglobinopathy
Authors: Leah S Heidenreich, Jennifer L Oliveira, Peter J Holmberg, Vilmarie Rodriguez
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Pulse oximetry is routinely used in the newborn nursery for clinical monitoring and to detect critical congenital heart disease. The differential diagnoses for reduced peripheral oxygen saturation in an infant include congenital heart disease, respiratory distress syndrome, transient tachypnea of the newborn, persistent pulmonary hypertension of the newborn, meconium aspiration syndrome, pneumonia, pneumothorax, and sepsis. The diagnostic evaluation for neonatal hypoxemia can be invasive and expensive. When this evaluation is unrevealing, other interventions may be tried without clear benefit to the patient, including, but not limited to, supplemental oxygen. Therefore, it is important to consider alternative, albeit rare, diagnoses, including hemoglobinopathies with abnormal oxygen binding properties. Mutations in the structure of alpha- and beta-globin chains can alter the affinity of hemoglobin for oxygen, and changes in oxygen affinity may result in changes in the oxygen saturation detected by pulse oximetry. These changes may or may not be of clinical significance. This case report describes Hemoglobin Sunshine Seth, a rare low-oxygen-affinity hemoglobin variant presenting as reduced peripheral oxygen saturation in an otherwise well-appearing infant male.
Successful endoscopic sclerotherapy for anastomotic tumor hemorrhage: A case report
Authors: Jinfeng Ren, Tianyu Liu, Yunzhi Zhang, Ying Bi, Zhengying Yang, Xihui Yuan
Journal: DEN Open (2023)
Keywords: anastomotic tumor, endoscopic sclerotherapy, hemostasis, lauromacrogol, tumor bleeding
MeSH terms: Case Reports

A 71-year-old male developed anastomotic tumor bleeding after subtotal gastrectomy (Billroth II), and the surgery was refused due to coronary atherosclerotic heart disease. Endoscopic sclerotherapy (ES) in the treatment of esophagogastric variceal bleeding has been commonly reported, but few in non-variceal upper gastrointestinal bleeding. As far as we know, endoscopic sclerotherapy for malignant tumor hemorrhage has not been reported. Here a valuable case is presented: endoscopic sclerotherapy was performed on the anastomotic tumor bleeding, which is an effective try in a particular period.
Decisive diagnostic clue for infectious abdominal aortic aneurysm caused by Arthrobacter russicus in a diabetic elderly woman with renal dysfunction: A case report and literature review
Authors: Hiroyuki Yamamoto, Yasuto Fukushima, Yoshihiko Ikeda, Tomoyuki Suda, Mieko Goto, Jun Isogai, Toru Hashimoto, Takashi Takahashi, Hidemitsu Ogino
Journal: Front Cardiovasc Med (2022)
Keywords: 16s rrna, arthrobacter russicus, mra, abdominal aorta, infectious aortic aneurysm, renal dysfunction
MeSH terms: Case Reports

Infectious aortic aneurysm (IAA) can be a rare but potentially fatal sequela of infectious inflammatory disease of the aortic wall with a high incidence of rupture. The definitive diagnosis is based on vascular imaging of the aneurysm using contrast-enhanced computed tomography (CE-CT) and identification of the causative microorganism from positive blood cultures (BCs). However, IAA remains extremely difficult to diagnose and treat in patients with prior antimicrobial treatment or with renal dysfunction. Here we describe a case of an 85-year-old woman with IAA caused by Arthrobacter russicus presenting with abdominal pain and fever that was initially diagnosed as a presumptive urinary tract infection and treated with empiric antimicrobial therapy. However, persistent abdominal pain with increased serological inflammation necessitated further evaluation. Unenhanced multimodality imaging considering the renal dysfunction revealed infectious aortitis of the infrarenal abdominal aorta, together with the initial culture results, leading to the tentative diagnosis of Klebsiella pneumoniae aortitis. Thereafter, serial monitoring with unenhanced magnetic resonance angiography (MRA) using thin-slab maximum intensity projection (TS-MIP) revealed acute aortic expansion strongly suggestive of a pseudoaneurysm that was successfully treated with early surgical repair under adequate infection control. Despite negative Gram staining and tissue culture results for the excised aortic wall, a definitive diagnosis of IAA secondary to A. russicus rather than K. pneumoniae was finally made by confirming the histologic findings consistent with IAA and the identification of A. russicus 16S rRNA on the resected aortic wall. The patient also developed a vascular graft infection during the postoperative course that required long-term systemic antimicrobial therapy. This case highlights the value of unenhanced MRA in the early detection of IAA in patients with renal dysfunction and the importance of a molecular diagnosis for identifying the causative microorganism in cases of culture- or tissue-negative IAA.
Successful outcome after Pancreaticodoudenectomy in an elderly cirrhotic patient: A case report
Authors: Eraj Sahaab, Nadeem Iqbal, Abu Bakar Hafeez Bhatti
Journal: Int J Surg Case Rep (2019)
Keywords: child pugh score, liver cirrhosis, morbidity, whipple's procedure

Introduction:
Cirrhosis is a risk factor for poor outcomes in non-hepatic oncological resections. There are only a handful of cases demonstrating outcomes of pancreaticoduodenectomy (PD) in patients with pancreatic cancer and underlying cirrhosis. Moreover, pushing the limits of PD to elderly cirrhotic patients and demonstrating its safety remains under reported.
Case presentation:
Here, we report successful management of a 71 year-old-lady with HCV related liver cirrhosis, obstructive jaundice and poor performance status, who was medically optimized and then underwent PD for adenocarcinoma of the head of pancreas. There was no major post-operative morbidity except minor chyle leak which resolved spontaneously. On her last follow up, she was doing well and undergoing adjuvant chemotherapy.
Discussion:
Preoperative medical optimization and careful patient selection can yield successful outcomes even after a major abdominal surgery like PD in elderly patients with underlying liver cirrhosis.
Conclusion:
Liver cirrhosis is not a contra indication to PD in elderly patients with good performance status.
Myelodysplastic syndrome with myelofibrosis transformed to a precursor B-cell acute lymphoblastic leukemia: a case report with review of the literature
Authors: Ayed A Algarni, Mojtaba Akhtari, Kai Fu
Journal: Case Rep Hematol (2012)
MeSH terms: Case Reports

Myelodysplastic syndromes (MDS) comprise a group of heterogeneous clonal hematopoietic cell disorders characterized by cytopenias, bone marrow hypercellularity, and increased risk of transformation to acute leukemias. MDS usually transformed to acute myeloid leukemia, and transformation to acute lymphoblastic leukemia (ALL) is rare. Herein, we report a unique patient who presented with MDS with myelofibrosis. Two months after the initial diagnosis, she progressed to a precursor B-cell acute lymphoblastic leukemia. She was treated with induction therapy followed by allogenic stem cell transplantation. She was alive and doing well upon last followup. We have also reviewed the literature and discussed the clinicopathologic features of 36 MDS patients who progressed to ALL reported in the literature.
Idiopathic harlequin syndrome: a case report and literature review
Authors: Khadija Elboukhari, Hanane Baybay, Sara Elloudi, Zakia Douhi, Fatima Zahra Mernissi
Journal: Pan Afr Med J (2019)
Keywords: harlequin syndrome, anidrosis, sympathetic system
MeSH terms: Autonomic Nervous System Diseases / diagnosis, Flushing / diagnosis, Hypohidrosis / diagnosis, Case Reports, Review, Autonomic Nervous System Diseases / physiopathology, Face, Flushing / physiopathology, Humans, Hypohidrosis / physiopathology, Male, Young Adult, Harlequin syndrome

Harlequin's syndrome is a rare dysautonomic syndrome of the face characterized by sweating with flush of one side and anhidrosis of the contralateral side. Mostly idiopathic although several secondary cases have been reported in the literature, the purpose of the treatment is mainly aesthetic and functional. We report the case of a patient having harlequin syndrome in its idiopathic form with a literature review.