OpenMed/multicare-articles huggingface dataset:
Mycetoma: Nonvenereal perineal lesions
Authors: Shweta Gupta, Khushbu Jain, Chirag Parmar, Parul Shah, Ranjan C Raval
Journal: Indian J Sex Transm Dis AIDS (2010)
Keywords: eumycetoma, melanoid, mycetoma
MeSH terms: Case Reports

Mycetoma is a chronic, granulomatous disease of the skin, and subcutaneous tissue, which sometimes involves muscle, bones, and neighboring organs. It is characterized by tumefaction, abscess formation, and fistulae with discharge of grains from sinuses. Mycetoma can be caused by various species of fungi (eumycetoma) and aerobic actinomycetes (actinomycetoma), which occur as saprophytes in soil or plants. A tentative diagnosis sufficient to initiate treatment may be made on the basis of grain color. For instance, melanoid grains are always caused by fungi and ochroid or pale grains by actinomycetes. Although this is not the thumbrule, there are exceptional reports too. As trauma favors infection, most lesions are on the foot and lower leg but they may occur anywhere on the body mimicking actinomycosis. However, lab investigations and culture are important tool to differentiate apart from the clinical picture. We are reporting atypical case with unusual site of presentation (perineum and thigh) of mycetoma.
A wandering spleen presenting as a hypogastric mass: case report
Authors: Mahdi Bouassida, Selim Sassi, Mohamed Fadhel Chtourou, Noomen Bennani, Sonia Baccari, Fathi Chebbi, Mechaal Benali, Mohamed Mongi Mighri, Hassen Touinsi, Sadok Sassi
Journal: Pan Afr Med J (2012)
Keywords: ct scan, wandering spleen, splenectomy, splenopexy, torsion
MeSH terms: Gastrointestinal Diseases / diagnosis, Wandering Spleen / diagnosis, Case Reports, Abdominal Pain / diagnosis, Abdominal Pain / etiology, Adenoma / diagnosis, Adult, Diagnosis, Differential, Female, Gastrointestinal Diseases / complications, Gastrointestinal Diseases / surgery, Humans, Splenectomy, Stomach Neoplasms / diagnosis, Wandering Spleen / complications, Wandering Spleen / surgery

Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all of the ligaments that hold the spleen in its normal position in the left upper quadrant of the abdomen. It is an uncommon clinical entity that mainly affects children. Among adults it most frequently affects women of reproductive age, in whom acquired laxity of the splenic ligaments is usually the cause. Patients with a wandering spleen may be asymptomatic, present with a movable mass in the abdomen, or have chronic or intermittent abdominal pain because of partial torsion and spontaneous detorsion of the spleen. A 26-year-old woman was admitted to our hospital with vomiting and abdominal pain. Abdominal examination revealed a large ovoid hypogastric mass. A CT scan showed a wandering spleen in the hypogastric region. Exploratory laparotomy revealed an ischemic spleen. A total splenectomy was performed.
Pleomorphic adenoma of base of tongue: is midline mandibulotomy necessary for approaching benign base tongue lesions?
Authors: Sandeep Bansal, Gopika Kalsotra, Abdul Wadood Mohammed, Amanjit Bahl, Ashok K Gupta
Journal: Case Rep Otolaryngol (2012)

Objective. To report a rare presentation of pleomorphic adenoma, at base tongue, excised surgically by a transoral midline glossotomy technique without mandibulotomy. Case Report. Pleomorphic adenoma is a benign tumor of the salivary gland found rarely in the base of tongue. Surgery is the definitive treatment for this tumor, and different approaches have been mentioned in the literature. In our case we surgically excised the tumor by a transoral midline glossotomy technique without mandibulotomy where we combined the cosmetic advantage of transoral technique and the exposure advantage of a glossotomy technique. Discussion. We discuss the different approaches to oropharynx, their advantages and disadvantages. Primary transoral approach provides better cosmesis but less exposure whereas median labiomandibuloglossotomy approach provides more exposure but is cosmetically unacceptable. Conclusion. A transoral midline glossotomy approach without mandibulotomy provides wide exposure with acceptable cosmesis.
Multimodal Analgesia With Long-Acting Dinalbuphine Sebacate Plus Transversus Abdominis Plane Block for Perioperative Pain Management in Bariatric Surgery: A Case Report
Authors: Shih-Yuan Liu, Yi-Hong Ho, Chih-Shung Wong
Journal: Front Pharmacol (2021)
Keywords: mma, tap, bariatric surgery, long-acting dinalbuphine sebacate (naldebain®), opioid-sparing
MeSH terms: Case Reports

Laparoscopic bariatric surgery is increasingly performed in morbidly obese patients. However, post-surgical pain is common and is usually managed with classical opioids such as morphine and fentanyl. Further, morbidly obese patients are predisposed to opioid-related side effects, especially post-operative nausea and vomiting (PONV), and respiratory depression. Obstructive sleep apnea in morbidly obese patients even predisposes them to respiratory depression. Thus, reducing opioid consumption is important. Multimodal analgesia (MMA) provides optimal perioperative analgesia while minimizing opioid consumption. Studies have shown that MMA strategy can provide sufficient pain relief in bariatric surgery with enhanced recovery. There are very few reports on the use of dinalbuphine sebacate (DS), a newly introduced non-controlled opioid medication with long-lasting analgesic effects. DS has a different mechanism of action from that of morphine or fentanyl and is non-addictive, with minimal side effects. It has been successfully used in laparoscopic cholecystectomy in our previous study. We present a case of a new MMA protocol with DS on a 46-year-old morbidly obese female patient who underwent laparoscopic sleeve gastrectomy. The MMA protocol included ultrasound-guided intramuscular DS injection plus transversus abdominis plane (TAP) block and other analgesics; it achieved good perioperative analgesia with opioid-sparing effect and enhanced patient's recovery with no pain in the following 4 months.
Acute liver abscess after non-operative management of blunt liver injury: A rare case managed with laparoscopic drainage
Authors: Mu-Yun Lin, Ching-Yun Liao, Being-Chuan Lin
Journal: Int J Surg Case Rep (2020)
Keywords: blunt liver injury, laparoscopic drainage, liver abscess, non-operative management
MeSH terms: Case Reports

Introduction:
Liver abscess may develop as a rare complication of the non-operative management (NOM) of blunt liver injury.
Presentation:
A 36-year-old male was injured in a motorcycle accident on November 28, 2017. First aid was performed at the local hospital, then he was transferred to our trauma center for further management. The abdominal computed tomography (CT) revealed a segment 7/8 liver laceration, and the liver injury was of grade III according to the American Association for the Surgery of Trauma-Organ Injury Scale for liver injury. Intermittent high fever was observed for the first 3 days after NOM, and repeat abdominal CT showed an abscess with rupture at the previously injured liver parenchyma. He underwent laparoscopic drainage of the liver abscess, and culture revealed the presence of Salmonella enterica, serogroup D. After laparoscopic drainage, the patient recovered well, with a 21-day hospital stay.
Discussion:
Liver abscess as a complication after NOM of blunt liver injury is a rare entity, with an incidence rate of 1.5%. It is usually seen in major liver injuries (grade III and above) and the abscesses take a median of 6 days (range, 1-12 days) to form and be diagnosed. The management of liver abscess may be by surgical drainage (laparotomy or laparoscopy) or percutaneous drainage.
Conclusion:
This report reminds us the liver abscess complication after NOM of blunt liver injury, although it is a rare entity. Results of this patient support drainage of the liver abscess can be safely and effectively performed by laparoscopy.
Acute Liver Failure due to Disseminated Varicella Zoster Infection
Authors: Elizabeth Caitlin Brewer, Leigh Hunter
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

Acute liver failure (ALF) can be due to numerous causes and result in fatality or necessitate liver transplantation if left untreated. Possible etiologies of ALF include ischemia, venous obstruction, medications, toxins, autoimmune hepatitis, metabolic and infectious causes including hepatitis A-E, varicella-zoster virus (VZV), cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV), and adenovirus with VZV being the most rarely reported. Pathognomonic skin lesions facilitate diagnosis of VZV hepatitis, but definitive diagnosis is secured with liver biopsy, tissue histopathology, culture, and specific VZV polymerase chain reaction (PCR). Antiviral treatment with intravenous acyclovir can be effective if initiated in a timely manner; however, comorbidities and complications frequently result in high mortality, especially in immunocompromised hosts as exemplified in this case presentation.
Image of the Month: Enterocolitis Following a Pull-through for Total Colonic Hirschsprung Disease in a 2-Year-Old Boy
Authors: Anisha Apte, Elise McKenna, Marc A Levitt
Journal: European J Pediatr Surg Rep (2020)
Keywords: hirschsprung disease, enterocolitis, pull-through
MeSH terms: Case Reports

We present a case of a 2-year-old boy with total colonic Hirschsprung disease (HD) who underwent an ileostomy as a newborn, and then colectomy and pull-through at 10 months of age. Since then he has presented four times with enterocolitis. The case is presented with a focus on evaluating patients with HD who present with obstructive symptoms following corrective surgery. A key image is presented along with questions formatted as a quiz to guide readers through critically evaluating the case.
Management of a hopeless mandibular molar: a case report
Authors: Saeed Asgary
Journal: Iran Endod J (2011)
Keywords: cem cement, endodontics, tooth reimplantation, treatment outcome
MeSH terms: Case Reports

Intentional tooth reimplantation can be an alternative treatment option for teeth with poor or hopeless prognosis where coronal and surgical endodontic treatment(s) are not possible. This technique may help to restore a natural tooth to function in preference to prosthesis/implant replacements. A 38-years old male was referred to private practice with persistent chronic apical periodontitis of a previously root canal treated mandibular left first molar. A furcal perforation and distolingual cusp fracture was previously repaired and treated with amalgam (~5 years ago). In view of the patient/tooth's limitations, intentional reimplantation was planned using CEM cement retrograde filling. Clinical and radiographic follow-up during 2 years postoperatively revealed no sign/symptoms of infection or inflammation. Moreover, periradicular healing was evident on radiographs.
Utility of stellate ganglion block in atypical facial pain: a case report and consideration of its possible mechanisms
Authors: Harsha Shanthanna
Journal: Case Rep Med (2013)

We present this report of a young patient with chronic severe atypical facial pain who was successfully controlled with stellate ganglion block under ultrasound guidance. The patient had a history of severe disabling, unilateral, facial neuropathic pain with minimal response to analgesic medications. Upon assessment the patient had features suggestive of trigeminal neuralgia, although postherpetic neuralgia could not be ruled out. As a diagnostic test intervention, stellate ganglion block was tried under ultrasound guidance. The patient showed significant improvement in pain control and functional disability lasting beyond 10 weeks. Subsequent blocks reinforced the analgesia. Atypical facial pain has several differential diagnoses. The involvement of sympathetic system in its causation or sustenance is uncertain. Stellate ganglion block achieves sympathetic block of cervicofacial structures, and its blockade has been shown to affect chronic pain conditions. Although its mechanism is not clear, one has to consider its possible role in conditions of stress apart from directly controlling the sympathetic activity. There is certainly a role in exploring the potential benefits of stellate ganglion block in such clinical conditions. The technique of stellate block under ultrasound is also described, as it influences the safety and precision of the block.
Cardiac Fibroelastoma versus Thrombus: Echocardiographic Evidence Can Be Misleading
Authors: John P O'Laughlin, Gautam Verma, Iosif Gulkarov
Journal: Case Rep Cardiol (2016)

We present a case of a young female with stroke symptoms who underwent valve sparing resection of a presumed fibroelastoma based on echocardiographic findings. After confirming embolic stroke, she underwent excision of the lesion, which on pathology revealed a nonbacterial thrombus. Ultimately, this led to a more extensive work-up leading to the discovery of a papillary serous ovarian carcinoma, the underlying cause of her hypercoagulable state. The initial echocardiographic findings painted the clear picture of a papillary tumor on the aortic valve which was likely the source of the emboli resulting in ischemic stroke. This unique case presentation illustrates that imaging, including echocardiography, may not always coincide with the clinical diagnosis. Thus, understanding the differential diagnoses of cardiac masses is of vital clinical significance. The distinction of fibroelastoma versus the much less common finding of aortic thrombus may lead to early diagnosis of malignancy and prevention of life threatening events due to stroke or undiagnosed disease.
Map syndrome (MYH Associated Polyposis) colorectal cancer, etiopathological connections
Authors: A Bolocan, D Ion, R V Stoian, M B Serban
Journal: J Med Life (2011)
Keywords: genetics, hereditary, recessive
MeSH terms: Adenomatous Polyposis Coli / diagnosis, Case Reports, Adenomatous Polyposis Coli / genetics, Female, Gene Silencing, Humans, Middle Aged

The case presented raised our scientific curiosity and it is worthy of being brought in front of the medical audience because of several reasons presented below. Presently, there are 3 hereditary syndromes that have a demonstrated etiological relationship with the colorectal cancer: Familiar Adenomatous Polyposis (FAP syndrome), HNPCC syndrome (Hereditary Nonpoliposis Colorectal Cancer) and MAP syndrome.Discovered only in 2002, the MAP syndrome (MYH associated polyposis) is the first hereditary syndrome that has autosomal recessive transmission. The APC gene can be mutated in several ways during the colonic oncogenesis: congenital in the FAP syndrome, somatic in sporadic colorectal cancers and secondary to the MYH gene inactivation in MAP syndrome. MAP phenotype is similar to the FAP phenotype because of the somatic mutations to the APC gene. Colonic polyposis is lower than FAP syndrome and appeared later, in the 40's and 50's. Colorectal cancers are frequent and discovered in the same moment as the colonic polyposis. Patients are diagnosed mostly in cancer stages. Colonoscopy shows polyps disseminated around the entire colic frame. Treatment in these cases is total rectocolectomy with ileoanal anastomosis. When working in a general emergency surgery clinic, physicians are often faced with colorectal cancers in different evolutive stages, and mostly they are faced with their complications.
Metastatic Urachal Carcinoma Treated With Several Different Combined Regimens: A Case Report
Authors: Han Zheng, Wei Song, Xiemin Feng, Hong Zhao
Journal: Front Oncol (2021)
Keywords: combination chemotherapy, immunity therapy, serum marker, targeted therapy, urachal carcinoma
MeSH terms: Case Reports

Urachal carcinoma is a rare bladder malignance. This study presents a case of an elderly patient with urachal carcinoma who was found to have pulmonary metastases 1 year after 5 recurrent resections. The patient was treated with up to 7 different chemotherapy regimens, including a VEGF monoclonal antibody and anti-PD-1 antibody. This is the first report of PD-1 antibody being used in patients with urachus, although the disease progressed after only four cycles of the application. The patient's disease was controlled by the FOLFIRI combined with the VEGF monoclonal antibody regimen. The most prominent issues at present are the difficulty of obtaining drugs for rare cancers and the lack of late-stage clinical trials to guide therapeutic decisions.
Hepatic Rupture Induced by Spontaneous Intrahepatic Hematoma
Authors: Jin-Bao Zhou, Wei-Bo Chen, Feng Zhu
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

The etiology of hepatic rupture is usually secondary to trauma, and hepatic rupture induced by spontaneous intrahepatic hematoma is clinically rare. We describe here a 61-year-old female patient who was transferred to our hospital with hepatic rupture induced by spontaneous intrahepatic hematoma. The patient had no history of trauma and had a history of systemic lupus erythematosus for five years, taking a daily dose of 5 mg prednisone for treatment. The patients experienced durative blunt acute right upper abdominal pain one day after satiation, which aggravated in two hours, accompanied by dizziness and sweating. Preoperative diagnosis was rupture of the liver mass. Laparotomy revealed 2500 mL fluid consisting of a mixture of blood and clot in the peritoneal cavity. A 3.5 cm × 2.5 cm rupture was discovered on the hepatic caudate lobe near the vena cava with active arterial bleeding, and a 5 × 6 cm hematoma was reached on the right posterior lobe of the liver. Abdominal computed tomography (CT) and laparotomy revealed spontaneous rupture of intrahepatic hematoma with hemorrhagic shock. The patient was successfully managed by suturing the rupture of the hepatic caudate lobe and clearing part of the hematoma. The postoperative course was uneventful, and the patient was discharged after two weeks of hospitalization.
Four cases of cytokine storm after COVID-19 vaccination: Case report
Authors: Kazuhiro Murata, Naoki Nakao, Naoki Ishiuchi, Takafumi Fukui, Narutaka Katsuya, Wataru Fukumoto, Hiroko Oka, Naotaka Yoshikawa, Takafumi Nagao, Akira Namera, Naoya Kakimoto, Naohide Oue, Kazuo Awai, Kanji Yoshimoto, Masataka Nagao
Journal: Front Immunol (2022)
Keywords: covid-19, rna sequencing, immunology, side effects, vaccination
MeSH terms: COVID-19, Case Reports, COVID-19 Vaccines / adverse effects, Cytokine Release Syndrome, Humans, Pandemics / prevention & control, Vaccination / adverse effects, Vaccination / methods, COVID-19 Vaccines

The global coronavirus disease 2019 (COVID-19) pandemic has led to the rapid development of vaccines against this disease. Despite the success of the international vaccination program, adverse events following vaccination, and the mechanisms behind them, remain poorly understood. Here we present four cases of death following receipt of a second dose of COVID-19 vaccine, with no obvious cause identified at autopsy. Using RNA sequencing, we identified genes that were differentially expressed between our post-vaccination cases and a control group that died of blood loss and strangulation. Three hundred and ninety genes were found to be upregulated and 115 genes were downregulated in post-vaccination cases compared with controls. Importantly, genes involved in neutrophil degranulation and cytokine signaling were upregulated. Our results suggest that immune dysregulation occurred following vaccination. Careful observation and care may be necessary if an abnormally high fever exceeding 40°C occurs after vaccination, even with antipyretic drugs.
Laparoscopic cholecystectomy in a patient with situs inversus totalis after videolaparoscopic sleeve-Case report
Authors: Fernando Ponce Leon, Mariana H Fiorencio, Camilla P Leal, André R Santos
Journal: Int J Surg Case Rep (2020)
Keywords: cholecystectomy, cholelithiasis, obesity, situs inversus, videolaparoscopy
MeSH terms: Case Reports

Introduction:
Situs inversus totalis is the technical term used when there is a complete transposition of all organs to the opposite side referring to classical embryogenic orientation. Laparoscopic cholecystectomy is one of the most performed surgeries in the world.
Presentation of case:
We report the case of a 61-year-old female patient who had previously undergone videolaparoscopic gastroplasty 7 months ago, who developed refractary biliary colic and underwent videolaparoscopic cholecystectomy.
Discussion:
The surgical technique is challenging in these cases, specially because of the mirror findings in relation to the original technique. An additional challenge in this case was the fact that the patient had a previous laparoscopy due to gastroplasty performed. The presence of adhesions related to the surgery hardly interfered with the Calot triangle dissection, but the way they presented themselves required the attention of the entire surgical team.
Conclusion:
Although uncommon, laparoscopic cholecystectomy can be performed in a situs inversus patient with ease, even in the presence of a previous surgical approach.
Anti-NMDAR-Positive Small-Cell Lung Cancer Paraneoplastic Limbic Encephalitis: A Case Report and Literature Review
Authors: Raman Sohal, Steven H Adams, Vishal Phogat, Abha Harish, Carlos Ynigo D Lopez, Michael P A Williams, Kamal K Khurana, Basel Abuzuaiter, Nia Jagroop, Bhavya Narapureddy
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Introduction:
Paraneoplastic limbic encephalitis (PLE) is a rare disease that presents as rapid onset dementia characterized by short-term memory loss (STM), anxiety, and behavioral changes. Anti-NMDAR antibodies are unfrequently reported in PLE associated with small-cell lung cancer (SCLC). Given that PLE can precede the diagnosis of cancer, it is very important that once infectious, metabolic, nutritional, or structural disorders associated with short-term memory loss are ruled out that vigorous effort must be made to rule out underlying malignancy.
Case:
We report a rare case of PLE as the presenting symptom of SCLC. A 72-year-old male with history of COPD was brought to the ED by his wife after he was found to have short-term memory loss, including forgetfulness of his wedding anniversary the day before, and anxiety. Neurological exam showed impaired short-term recall on MOCA. CT head showed no evidence of infarct. Lumbar puncture was performed which showed lymphocytic pleocytosis, a nonspecific inflammatory change. CSF panel was negative for HSV, Neisseria, Hemophilus, E. coli, and HIV. Initial EEG was unremarkable, though a repeat EEG showed mild slowing of the posterior dominant rhythm consistent with mild encephalopathy. MRI showed equivocal increased FLAIR on T2-weighted images in the bilateral temporal lobes, left greater than right. CTA thorax showed bulky mediastinal and right hilar LAD. FNA of the R4 lymph node revealed SCLC. The NM bone scan showed no osteoblastic lesions. While the serum autoantibody panel was positive for anti-NMDAR, the CSF autoantibody panel returned entirely negative. Chemotherapy with etoposide and cisplatin was started on Day 4 of admission. The patient's neurological symptoms showed improvement following chemotherapy.
Conclusion:
This case highlights the importance of recognizing short-term memory loss as a feature of PLE.
Natural killer cell infusion for cytomegalovirus infection in pediatric patients with Wiskott-Aldrich syndrome following cord blood transplantation: A case report and literature review
Authors: Yongwei Yue, Lijun Meng, Jing Ling, Liyan Fan, Yanlei Zhang, Yixin Hu, Alex H Chang, Shaoyan Hu
Journal: Front Med (Lausanne) (2022)
Keywords: nk cell infusion, wiskott-aldrich syndrome, case report, cord blood transplantation, cytomegalovirus infection
MeSH terms: Case Reports

NK cells have important functions in resisting cytomegalovirus infection, as they proliferate after viral infection and have certain immunological memory. Here, we report infusion of haploid donor-derived natural killer cells to treat two pediatric patients with Wiskott-Aldrich syndrome (WAS) who were infected with cytomegalovirus after cord blood transplantation (CBT), which successfully cleared the viral infection in both patients.