OpenMed/multicare-articles huggingface dataset:
An Unusual Case of Brucella abortus Prosthetic Joint Infection
Authors: Jennifer Walsh, Anne Gilleece, Lynda Fenelon, David Cogley, Kirsten Schaffer
Journal: J Bone Jt Infect (2019)
MeSH terms: Case Reports

Brucellosis is a systemic infection caused by brucella species. Prosthetic joint infection due to brucella species is rare. We report the case of a prosthetic joint infection presenting fourteen years post treatment for systemic brucellosis.
Primary malignant fibrous histiocytoma: a rare case
Authors: Anastasios Katsourakis, George Noussios, Iosif Hadjis, Neofitos Evangelou, Efthimios Chatzitheoklitos
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Malignant fibrous histiocytoma (MFH) of the small intestine is an extremely rare condition. It occurs most commonly in the extremities and the trunk. We report a case of a 67-year-old woman who admitted with fever, myalgia, and altered status. After thorough investigation, a tumor of the jejunum was found. The patient underwent complete surgical removal of the tumor. A diagnosis of MFN (undifferentiated high-grade pleomorphic sarcoma) was made. The patient received adjuvant chemotherapy with Gemcitabine. Two years after the operation, the patient died due to recurrence of the disease. MFH of the small intestine is an extremely rare neoplasm with an aggressive biological behaviour. In this paper, pathogenesis, natural history, and treatment are reviewed.
Esophageal Lichen Planus: Understanding a Potentially Severe Stricturing Disease
Authors: Bharat Rao, Abhishek Gulati, Blair Jobe, Shyam Thakkar
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

A 67-year-old woman with a long-standing history of recurrent dysphagia and esophageal strictures failed to respond to aggressive antireflux management. She required multiple dilations for symptomatic strictures that were discovered throughout the esophagus. Intralesional, topical, and systemic glucocorticoid therapies were utilized without resolution in symptoms. Several years after initial presentation, histopathology ultimately demonstrated lichenoid features and a diagnosis of esophageal lichen planus (ELP) was confirmed. However, as her symptoms had already become significantly disabling with severe strictures that carried an increased risk of endoscopic complications with dilation, she ultimately decided to undergo an esophagectomy for definitive treatment. Moreover, ELP may often go unrecognized for several years. Clinicians should consider ELP in the differential for dysphagia in middle- to elderly-aged women with or without a known history of lichen planus (LP) especially for those with findings of multiple or proximal strictures.
Mandibular facial talon cusp: case report
Authors: Folakemi A Oredugba
Journal: BMC Oral Health (2005)

Background:
Talon cusp is a supernumerary structure projecting from the dento-enamel junction to a variable distance towards the incisal edge of an anterior tooth. Studies have shown that it consists of enamel, dentine and a variable amount of pulp tissue. Hyperactivity of the enamel organ during morphodifferentiation has been attributed to its formation. Most previous reports have been made concerning the occurrence of this structure on primary and permanent teeth and mostly on the palatal aspect. Only few have been reported on the facial aspect of the teeth. When it occurs, the effects are mainly aesthetic and functional and so early detection and treatment is essential in its management to avoid complications.
Case presentation:
An unusual case of talon cusp on the facial aspect of a mandibular central incisor is reported. Its presence resulted in attrition of the opposing tooth. Reduction of the cusp and topical application of fluoride gel was initiated.
Conclusion:
The management and treatment outcome of talon cusp depends on the size, presenting complications and patient cooperation.
Psychological impacts of intervention to improve a therapeutic garden for older adults with dementia: a case study conducted at a care facility
Authors: Chiara Meneghetti, Veronica Murroni, Erika Borella, Andrea Melendugno, Elena Carbone, Giulia Goldin, Raffaele Cavalli, Andrea Basso, Francesca Pazzaglia
Journal: Front Psychiatry (2023)
Keywords: behavior mapping, dementia, exposure to nature, intervention, therapeutic garden

Introduction:
Exposure to nature is known to support psychological wellbeing, and can support People with Dementia (PwD). Here we describe a case study conducted at a care facility for PwD to examine the effect of their exposure to nature after intervention to renovate an existing Therapeutic Garden (TG). Changes in frequency of attendance and behavior in the TG were examined. A single case was also considered to assess individual benefits.
Materials and methods:
Twenty-one PwD participated in the study. Their behavior in the TG was observed for 4 weeks before and after the intervention (using behavioral mapping), and measures of individual characteristics (general cognitive functioning, behavioral/neuropsychiatric symptoms, depression, and quality of life) were administered.
Results:
Ten of the 21 PwD visited the TG more often after the intervention, their social behaviors (e.g., talking to others) increased, and their active isolated behavior in the garden (e.g., smelling, touching flowers) tended to increase. The increase in social behavior related to less severe baseline depressive symptoms. Passive isolated behaviors related to more impaired baseline cognitive functioning. The case of Mrs. A extended the findings for the whole sample: although her dementia symptoms (apathy, motor disturbances) worsened, she visited the TG more often after the intervention, her social exchanges and active isolated actions increased, and her agitation and wandering decreased.
Discussion:
These results support the benefits of exposure to nature for PwD, and underscore the importance of considering users' profiles to optimize their use of a TG.
A total laparoscopic treatment strategy for Amyand's hernia complicated with appendicitis: A case report
Authors: Shen-Hung Han, Ming-Yi Li, Hung-Fei Lai
Journal: Int J Surg Case Rep (2019)
Keywords: acute appendicitis, amyand’s hernia, case report, laparoscopic appendectomy, laparoscopic hernioplasty

Introduction:
The presence of a vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. It is even rarer with complicated appendicitis. Formerly it was treated via an open groin approach; recently there are new trends involving the use of laparoscopy for reduction and management of appendix. Conversely the role of laparoscopy in the following hernia repair was less discussed, with no standard care. We reported a case of Amyand's hernia complicated with appendix which was managed via a total laparoscopic strategy.
Presentation of case:
A 49-year-old male presented with right groin mass with progressive pain for 3 days. Physical exams revealed incarcerated right inguinal hernia. Amyand's hernia with acute appendicitis was diagnosed preoperatively via computed tomography (CT). Emergent diagnostic laparoscopy was performed. Appendix was reduced, with appendectomy justified for signs of appendicitis. An interval total extraperitoneal (TEP) hernioplasty was performed 3 month later, with no adverse events postoperatively.
Discussion:
In virtue of previous literature, we proposed a total laparoscopic strategy for Amyand's hernia which consists of transabdominal diagnostic laparoscopy, management of appendix, and either immediate or elective laparoscopic hernioplasty, based on status of appendix.
Conclusion:
This laparoscopic treatment strategy is feasible for Amyand's hernia, with minimized risk of surgical site infection (SSI), fair recovery and cosmesis.
Novel NtA and LG1 Mutations in Agrin in a Single Patient Causes Congenital Myasthenic Syndrome
Authors: Aiping Wang, Yangyang Xiao, Peng Huang, Lingjuan Liu, Jie Xiong, Jian Li, Ding'an Mao, Liqun Liu
Journal: Front Neurol (2020)
Keywords: agrn, agrin, congenital myasthenic syndrome, missense mutation, whole-exome sequencing
MeSH terms: Case Reports

Congenital myasthenic syndrome (CMS) is a group of genetic disorders of neuromuscular transmission that is characterized by muscle weakness. A mutation in the gene encoding agrin (AGRN) is a rare cause of CMS, and only a few families or isolated cases have been reported. We reported a pediatric proband exhibiting muscle weakness in the trunk and limbs with skeletal malformation and intellectual disability and performed whole-exome sequencing (WES) of the proband parent-offspring trio. Results revealed a new compound heterozygous mutation in AGRN: c.125A>C (p.Glu42Ala) in the N-terminal agrin domain (NtA) and c.4516G>A (p.Ala1506Thr) in the laminin G1 domain (LG1). Bioinformatic analysis predicted the mutation as possibly pathogenic. The new compound heterozygous mutation in AGRN may disrupt agrin's known function of bridging laminin and α-dystroglycan and undermine the formation and maintenance of the neuromuscular junction (NMJ) via both muscular and neural agrin pathways. It may also induce secondary peripheral neuropathy and skeletal malformation.
Management of a swallowed denture: our experience with 34 patients
Authors: Vaishnevy Ganesh, Sara Drever, Joshua Agilinko, Vamsidhar Vallamkondu, Samit Majumdar, Muhammad Shakeel
Journal: Ger Med Sci (2021)
Keywords: management, swallowed dentures
MeSH terms: Deglutition, Esophagus, Case Reports, Review, Adolescent, Adult, Aged, Aged, 80 and over, Dentures, Esophagoscopy, Female, Humans, Male, Middle Aged, Retrospective Studies, Young Adult

Background: Swallowed dentures can present with upper aerodigestive tract obstruction needing urgent intervention. Removing such an ingested denture can prove challenging and needs careful planning. Aim: To share our experience of managing patients with a swallowed denture focusing on the practical aspects of denture removal along with relevant literature review. We aim to raise a public health message on the safety aspect of usage of dentures. Subjects and methods: A retrospective analysis of the patients managed by our team in the ENT department at two hospitals in Scotland, over 10 years (2009-2019), who were found to have swallowed a denture. Data on demographics, clinical history, examination findings and management of patients were collected and analysed using Microsoft Excel. Results: A total of 34 patients were admitted with a swallowed denture, of which 24 (71%) were male and 10 (29%) were female. The mean age was 60 years (range 17-83). Of the 34 patients, 2 had a feeling of something stuck in the throat but were able to eat and drink; the rest of the patients complained about dysphagia and pain in the throat, with 2 patients also showing signs of respiratory distress. Twenty-four (71%) patients required denture removal under general anaesthetic in the theatre; 20 (59%) by rigid oesophagoscopy, 1 with tracheostomy (3%), 1 with (3%) laparoscopy and gastrostomy, and 2 (6%) with external neck exploration. Seven (20%) patients were taken to the theatre and the denture was removed with Magill forceps under light sedation using intubating laryngoscope or video laryngoscope. In 1 patient (3%), the denture material was successfully removed under flexible pharyngolaryngoscopy guidance in the clinic without sedation. The final 2 (6%) patients were reassured as no foreign body was seen on flexible laryngoscopy. Conclusion: In the absence of a clear evidence of denture ingestion, a detailed history and examination are needed to identify this serious pathology. Once confirmed, the ingested denture should be removed as soon as possible to minimize the risk of serious complications.
Automatic behavior and communication due to pramipexole
Authors: Ruth H Walker
Journal: J Clin Mov Disord (2016)
Keywords: automatic behavior, dopamine agonist, parkinson’s disease
MeSH terms: Case Reports

A 45-year-old woman reported automatic behaviors and communication whilst she was being treated with pramipexole. These episodes vanished after the medication was tapered and she was started on levodopa/carbidopa. I hypothesize that the episodes were related to disordered awareness due to sleep disruption related to this medication.
Mediastinal mature teratoma perforating the right lung that was successfully resected with complete thoracoscopic surgery: A case report
Authors: Hiroyasu Matsuoka, Hirochika Matsubara, Aya Sugimura, Tsuyoshi Uchida, Tomofumi Ichihara, Hiroyuki Nakajima
Journal: Int J Surg Case Rep (2018)
Keywords: asymptomatic, mediastinal mature teratoma, perforation, thoracoscopic surgery

Introduction:
A perforating mediastinal mature teratoma can cause severe inflammation and adhesion; therefore, open surgery is usually performed. Asymptomatic perforation involving a teratoma is very rare. Complete thoracoscopic surgery is often difficult because of inflammation associated with perforation and the frequently large size of a mediastinal mature teratoma. We report a rare case of an asymptomatic perforating mediastinal mature teratoma successfully treated with complete thoracoscopic surgery.
Presentation of case:
The patient was a 15-year-old girl with an abnormal shadow at the mediastinum seen on chest radiography at a health examination performed at her junior high school; an asymptomatic mediastinal tumour was suspected. Enhanced computed tomography revealed a 6.5 × 3.5-cm tumour associated with the right upper lobe. Thoracoscopic surgery was performed using 4 access ports. Although there were inflammatory changes, hemi-thymectomy and right upper lobectomy were achieved with complete thoracoscopic surgery. The tumour included the skin, sebaceous glands, hair, and pancreatic tissue and was diagnosed as a mature teratoma perforating the right upper lobe.
Discussion:
There might be limited inflammatory changes if the patient has few or no symptoms, as in our case. In such cases, the tumour may be excised even if it is large.
Conclusion:
We report a rare case of an asymptomatic perforating mediastinal mature teratoma that was successfully treated with complete thoracoscopic surgery. Although infection, inflammatory adhesion, large tumour size, and the need for radical cure are concerns, complete thoracoscopic surgery might be helpful. In cases of few or no symptoms, thoracoscopic surgery is worth challenging.
Case Report: Clinical Features of a COVID-19 Patient With Cirrhosis
Authors: Jian Zhou, Dixuan Jiang, Wanchun Wang, Kang Huang, Fang Zheng, Yuanlin Xie, Zhiguo Zhou, Jingjing Sun
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, sars-cov-2, cirrhosis, cured patient, treatment
MeSH terms: Case Reports

Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, Hubei Province, China in December 2019. At present, COVID-19 has emerged as a global pandemic. The clinical features of this disease are not fully understood, especially the interaction of COVID-19 and preexisting comorbidities and how these together further impair the immune system. In this case study, we report a COVID-19 patient with cirrhosis. A 73-year-old woman with cirrhosis reported a fever and cough on February 6, 2020. CT of the chest indicated an infection in her bilateral lungs. She tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The woman was treated with lopinavir and ritonavir tablets and interferon alpha-2b injection, but there was no obvious effect. Although this patient was basically asymptomatic after 2 days in the hospital, the inflammation of the bilateral lungs was slow to subside as shown in CT of the chest. In addition, the white blood cell count (WBC), absolute neutrophil count, and absolute lymphocyte count remained decreased and the result of real-time reverse transcription polymerase chain reaction (PCR) (rRT-PCR) assay was still positive for SARS-CoV-2 on hospital day 28. After infusion of plasma from a recovered COVID-19 patient four times, the patient tested negative for SARS-CoV-2. She was discharged on March 13, 2020. This patient tested negative for SARS-CoV-2 after infusion of plasma from a recovered COVID-19 patient four times. Cirrhosis could impair the homeostatic role of the liver in the systemic immune response, which may affect the removal of SARS-CoV-2. This could lead to a diminished therapeutic effect of COVID-19. Thus, clinicians should pay more attention to COVID-19 patients with cirrhosis.
Mania as Debut of Cushing's Syndrome
Authors: Ricardo Álvarez Martínez, Rosa María Tomé Rodríguez, María Álvarez Ariza, Carlos Spuch, Jose M Olivares
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

This is a case of a patient affected by Cushing syndrome that was admitted at the hospital due to hormonal problems. He had presented psychiatric symptoms that were mistakenly considered not directly connected to the pathology causing the clinical condition, but a mere psychological reaction to it.
Ileocecal resection for massive rectal bleeding due to Yersinia enterocolitica: a case report and review of the literature
Authors: Ilham Azghari, Aicha Bargach, Nabil Moatassim Billah, Mohamed Amine Essaoudi, Ahmed Jahid, Nawal Kabbaj
Journal: J Med Case Rep (2016)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Cecum / surgery, Fluoroquinolones / therapeutic use, Gastrointestinal Hemorrhage / microbiology, Ileum / surgery, Laparotomy, Yersinia Infections / complications, Yersinia enterocolitica / isolation & purification, Case Reports, Review, Adult, Anemia, Iron-Deficiency / etiology, Diarrhea / microbiology, Emergency Medical Services, Female, Gastrointestinal Hemorrhage / drug therapy, Humans, Iron / therapeutic use, Tomography, X-Ray Computed, Trace Elements / therapeutic use, Treatment Outcome, Yersinia Infections / drug therapy, Yersinia Infections / microbiology, Anti-Bacterial Agents, Fluoroquinolones, Trace Elements, Iron

Introduction:
Massive gastrointestinal bleeding is an emergency that can sometimes require immediate surgery. We report the first case, to the best of our knowledge, of massive rectal bleeding due to Yersinia enterocolitica, requiring ileocecal resection.
Case presentation:
A 41-year-old North African woman was admitted to our emergency department for massive rectal bleeding. She had a history of an iron deficiency anemia of unknown cause, and diarrhea 2 months before the admission. On admission to our emergency unit, she was in a state of hemodynamic collapse. An examination showed discolored conjunctivas, massive rectal bleeding with clots and no abdominal pain. The first medical treatment included the use of noradrenaline. An upper gastrointestinal endoscopy was performed and did not show any lesions. Computed tomography of her abdomen showed significant and hypervascular wall thickening of her terminal ileum suggestive of a tumor. Because her massive rectal bleeding worsened and her collapse persisted, an exploratory laparotomy and ileocecal resection were immediately performed on the patient. Histopathological analysis showed enteritis caused by Yersinia enterocolitica. Her outcome was favorable.
Conclusion:
Enteritis due to Yersinia enterocolitica can take a pseudotumoral form and mislead the diagnosis of gastrointestinal bleeding.
Mycobacterium mucogenicum meningitis due to external ventricular drain
Authors: Salwa Moiz, Omar Rahman, Mark Morcos, Asma Siddiqui, Usman Bin Hameed
Journal: Access Microbiol (2020)
Keywords: external ventricular drain, meningitis, non-tuberculous mycobacterium
MeSH terms: Case Reports

Introduction:

Mycobacterium mucogenicum is a rare non-tuberculous organism associated with catheter-related infections when pathogenic in humans. We present the first case of an external ventricular drain (EVD)-associated M. mucogenicum meningitis.
Case presentation:
A 55-year-old woman had EVD placement for obstructive hydrocephalus following traumatic subarachnoid haemorrhage. Cerebrospinal fluid (CSF) was obtained 5 days later for fever and neurological changes. M. mucogenicum was ultimately isolated from the CSF and the patient was placed on appropriate antibiotics. Her management included replacement of the EVD and a prolonged course of anti-mycobacterial antibiotics. CSF findings showed her response to therapy and neurological exam improved after 6 weeks.
Conclusion:

M. mucogenicum infections are very rare and existing reports indicate that it may be a device- or catheter-related pathogen. This microorganism has not been previously associated with an EVD. Ours may be the first documented report of EVD-related M. mucogenicum infection.
Unexpected Tension Pneumothorax-Hemothorax during Induction of General Anaesthesia
Authors: Ekaterini Amaniti, Chrysoula Provitsaki, Panagiota Papakonstantinou, George Tagarakis, Konstantinos Sapalidis, Ioannis Dalakakis, Dimitrios Gkinas, Vasilios Grosomanidis
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

Tension pneumothorax during general anaesthesia is a rare but possibly deleterious event, especially where predisposing factors are absent or unknown, making diagnosis even challenging. We describe a case of a healthy middle-aged woman, who was planned to receive general anaesthesia for total thyroidectomy. After intubation, the patient experienced marked hypoxemia (SpO2=75%), hypotension, and tachycardia. Manual positive pressure ventilation seemed to worsen hypoxemia and tachycardia, while apnoeic oxygenation through circle system with valve open slightly improved cardiorespiratory collapse. The effect of positive ventilation, along with the absence of breath sounds in the right hemithorax and cardiorespiratory collapse, established the diagnosis of tension pneumothorax, managed immediately with emergency thoracentesis and placement of a thoracostomy tube. The patient was improved and pneumothorax was confirmed with chest X-ray and CT. The latter also confirmed the presence of bilateral multiple bullae. The operation was postponed and the patient was extubated a few hours later, in good condition. After thorough evaluation for any systemic disease, which was negative, the patient underwent two-stage thoracotomy for bullectomy.
Prenatal Diagnosis of a Mosaic Paternal Uniparental Disomy for Chromosome 14: A Case Report of Kagami-Ogata Syndrome
Authors: Fenxia Li, Siping Liu, Bei Jia, Ruifeng Wu, Qingxian Chang
Journal: Front Pediatr (2021)
Keywords: kagami-ogata syndrome, mosaicism, paternal uniparental disomy, prenatal diagnosis, upd(14)pat
MeSH terms: Case Reports

The Kagami-Ogata syndrome (KOS) is a rare imprinting disorder with a distinct clinical phenotype. In KOS, polyhydramnios is associated with a small bell-shaped thorax and coat-hanger ribs. The genetic etiology of KOS includes paternal uniparental disomy 14 [upd(14)pat], epimutations, and microdeletions affecting the maternally derived imprinted region of chromosome 14q32.2. More than 77 cases of KOS have been reported; however, only one mosaic upd(14)pat case has been reported. Here we report a second mosaic upd(14)pat case. The prognosis of upd(14)pat patients is poor because of severe respiratory insufficiency. We summarized prenatal ultrasound findings of KOS to raise awareness of this condition for possible diagnosis of KOS prenatally when polyhydramnios combination with a small bell-shaped thorax and other related features are first observed. Prenatal diagnosis using methylation-specific multiplex ligation-dependent probe amplification (MLPA) or a single-nucleotide polymorphism-based microarray analysis is recommended.