OpenMed/multicare-articles huggingface dataset:
Rapid death due to pulmonary epithelioid haemangioendothelioma in several weeks: A case report
Authors: Chu Qin, Jia Hua, Xingfeng Zhu, Guochu Lu, Haoda Yu, Tao Bian
Journal: Open Life Sci (2022)
Keywords: haemoptysis, lung nodules, pulmonary epithelioid haemangioendothelioma
MeSH terms: Case Reports

A 49-year-old woman was admitted to our hospital because of haemoptysis for 6 days. This patient claimed no medical history except high blood sugar. Chest computed tomography (CT) showed infection and multiple nodules on both sides of the lung. Blood tests showed no obvious abnormalities. Tracheoscopy showed haemorrhagic discharge in the left upper lobe and an old thrombus obstructing the lumen in the anterior basal segment of the right lower lobe. Then, CT-guided percutaneous lung biopsy was performed. The pathological results suggested multiple nodular-like lesions in the submitted tissues, and tumour cells were round or short fusiform, forming a solid nest structure, visible mitosis, and a vascular cavity-like structure containing red blood cells. Immunohistochemistry revealed positive staining for Vimentin, Bcl-2, CD31, and CD34; negative staining for CD68, SMA, CR, and D2-40; and 40% Ki67+ positivity. Based on the earlier data, the patient was diagnosed with pulmonary epithelioid haemangioendothelioma. This patient did not receive any treatment for several reasons. Unfortunately, the patient died 8 weeks after diagnosis. In conclusion, we present a case featuring the rapid death due to PEH.
Chronic Q Fever with Vascular Involvement: Progressive Abdominal Pain in a Patient with Aortic Aneurysm Repair in the United States
Authors: Zanthia Wiley, Sujan Reddy, Kara M Jacobs Slifka, David C Brandon, John Jernigan, Gilbert J Kersh, Paige A Armstrong
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Q fever is a zoonotic bacterial infection caused by Coxiella burnetii. Chronic Q fever comprises less than five percent of all Q fever cases and, of those, endocarditis is the most common presentation (up to 78% of cases), followed by vascular involvement. Risk factors for chronic Q fever with vascular involvement include previous vascular surgery, preexisting valvular defects, aneurysms, and vascular prostheses. The most common symptoms of chronic Q fever with vascular involvement are nonspecific, including weight loss, fatigue, and abdominal pain. Criteria for diagnosis of chronic Q fever include clinical evidence of infection and laboratory criteria (antibody detection, detection of Coxiella burnetii DNA, or growth in culture). Treatment of chronic Q fever with vascular involvement includes a prolonged course of doxycycline and hydroxychloroquine (≥18 months) as well as early surgical intervention, which has been shown to improve survival. Mortality is high in untreated chronic Q fever. We report a case of chronic Q fever with vascular involvement in a 77-year-old man with prior infrarenal aortic aneurysm repair, who lived near a livestock farm in the southeastern United States.
Persistent Anemia in the Setting of a Rare Pancreatic Pseudoaneurysm
Authors: Olivia Peralta, Christopher Chew, Matthew Newcomb
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Introduction. Pancreatic pseudoaneurysm is a rare but potentially fatal complication that can follow pancreatitis. While early detection is critical to preventing poor long-term outcomes, clinical features vary significantly. Most often, abdominal pain is the presenting complaint, but this can be complicated as classic symptoms of pancreatitis also present with abdominal pain. Herein, we present a patient with an acute on chronic gastrointestinal bleed that was finally attributed to a pancreatic pseudoaneurysm. Case Presentation. The patient was a 56-year-old male with a past medical history significant for epilepsy, alcohol abuse, and hypertension who presented as a transfer from an outside facility for a gastrointestinal bleed. Prior to presentation, the patient reported rectal bleeding over the prior 1.5 months but had not sought care until bleeding increased along with increased abdominal pain. The patient's hemoglobin was 6.3 at presentation of the outside facility and received a total of four units of packed red blood cells (PRBCs) prior to arrival. After arrival, persistent bleeding was noted, and an additional 2 units of PRBCs were transfused. A computed tomography angiography (CTA) of the abdomen was obtained to identify the source for embolization. This, however, revealed a 4 × 4 × 3.5 cm intrinsically dense or enhanced mass of the pancreatic head. Discussion. Pancreatic pseudoaneurysm is a rare but potentially fatal complication that can follow pancreatitis. In chronic pancreatitis patients who underwent imaging incidence is estimated to be up to 10%. Treatment is difficult, and coil embolization is often used, though this can lead to splenectomy due to splenic ischemia. Stent grafts can be used in the surrounding arteries to maintain the integrity of viscera but carry risk of stent-related thrombosis. Further research is needed on the optimal management of this potentially lethal complication of pancreatitis.
Case report and literature review: An intrahepatic sewing needle in a child
Authors: Hao Shi, Zhibao Lv, Weijue Xu, Qingfeng Sheng, Xiong Huang, Ting Xu
Journal: Front Pediatr (2023)
Keywords: children, foreign body, intrahepatic, needle, surgery
MeSH terms: Case Reports

Background:
The presence of intrahepatic foreign bodies is a rare occurrence at the emergency department. Normally, foreign bodies reach the liver through migration. Incidence is lower among children than among adults, and the circumstances of children are often different. We report a 19-month-old boy with a sewing needle in the liver and review the previous reports of intrahepatic sewing needle in the PubMed database from the last three decades.
Case presentation:
A 19-month-old boy was transferred to our center from a local hospital presenting intermittent cough and rhinorrhea. A chest radiograph to exclude pulmonary disease revealed an incidental finding of a high-density shadow in the hepatic region. On admission, the boy had no gastrointestinal symptoms. Abdominal physical examinations were unremarkable. His mother, a worker in a textile factory, denied any history of trauma. Abuse was excluded based on investigation. Preoperative routine test results were normal. Contrast-enhanced computed tomography (CT) revealed that the sewing needle was located in hepatic segment IV and the tip had close relationship with intrahepatic portal vein. Initially, laparoscopy was performed without success. We eventually converted to laparotomy to completely remove the rusty sewing needle. The patient resumed feeding soon after the operation and was discharged in a few days.
Conclusions:
Intrahepatic sewing needle has high incidence among boys and developing countries. Combined with contrast-enhanced CT, knowledge of the pediatric patient's family background and medical history would help judge the route of entry and determine the management and surgical strategy. Laparoscopic procedure is not suitable for rusty sewing needles.
Bouveret Syndrome: A Rare Case of Instance and Treatment in a Younger Patient
Authors: Kevin J Yang, C K Chang
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Bouveret syndrome, a specific form of gallstone ileus, is the obstruction of the gastric outlet by a gallstone, which can enter the duodenum through a fistula. While the average age of individuals with Bouveret syndrome is 74 years, our patient was 42 years of age at the time of operation, significantly younger than the average patient afflicted with this condition. In the treatment of our patient's condition, the operation conducted entailed a partial duodenectomy, gastrojejunostomy, cholecystectomy, common bile duct exploration, extraction of bile duct stones, and insertion of a t-tube in the bile duct. The patient was found to be in healthy condition upon check-up six months after the operation. The outcome of our case suggests that younger Bouveret patients can safely undergo multiple surgical procedures in the treatment of Bouveret syndrome. Our case also suggests that a cholecystectomy and the removal of the obstructing gallstone can both be carried out within one operation, although coupling these two procedures in one operation might be riskier for patients within the normal age range of Bouveret syndrome. We also suggest that fistula repair be carried out for younger Bouveret patients in particular and that the patient be subjected to a CT scan in the diagnosis of Bouveret syndrome when this condition is suspected.
Interscalene Block in an Anesthetized Adult with Hypertrophic Obstructive Cardiomyopathy Undergoing Clavicle Fracture Reduction
Authors: Anthony M-H Ho, Joel Parlow, Rene Allard, Michael McMullen, Glenio B Mizubuti
Journal: POCUS J (2020)
Keywords: general anesthesia, hypertrophic obstructive cardiomyopathy, interscalene block, postoperative analgesia, regional anesthesia
MeSH terms: Case Reports

Whether regional anesthesia procedures should be performed in heavily sedated/anesthetized adults remains controversial. One of the purported advantages of performing regional nerve blocks in conversant patients is early warning against major nerve injury and, arguably, early detection of local anesthetic systemic toxicity. A 60-year-old man with hypertrophic obstructive cardiomyopathy (HOCM) underwent a clavicle fracture repair under general anesthesia. Intraoperative transesophageal echocardiography revealed dynamic left ventricular outflow track obstruction and systolic anterior motion of the posterior mitral valve leaflet. In part based on such echo findings, he received an ultrasound-guided interscalene plus a superficial cervical plexus block for postoperative analgesia prior to emergence from general anesthesia. Given the lack of robust data on the safety of ultrasound-guided regional techniques in heavily sedated/anesthetized adults, we use the example of echographic evidence of significant HOCM to argue for a pragmatic and individualized approach when faced with unusual situations in which the pros of such an approach may outweigh the cons - in this case for performing an interscalene block on an anesthetized adult.
Zanubrutinib Treatment of Central Nervous System Posttransplant Lymphoproliferative Disorder After Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report
Authors: Ting-Ting Yang, Wei-Hao Chen, Yan-Min Zhao, Hua-Rui Fu, He Huang, Ji-Min Shi
Journal: Front Oncol (2021)
Keywords: ebv-negative, hematopoietic stem cell transplantation, lymphoma, posttransplant lymphoproliferative disorder, zanubrutinib
MeSH terms: Case Reports

Posttransplant lymphoproliferative disorder (PTLD) is a rare complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with poor prognosis. We report a patient with PTLD involved central nervous system (CNS) who treated with zanubrutinib, a second-generation Bruton tyrosine kinase (BTK) inhibitor. Our report supports the efficacy of bruton tyrosine kinase inhibitor zanubrutinib in the treatment of CNS-PTLD, which provides a new therapeutic option.
Successful pregnancy and delivery in a patient with chronic myeloid leukemia: a case report and review of the literature
Authors: Weiwei Sheng, Naitong Sun
Journal: Springerplus (2016)
Keywords: cml, ifn-α, pregnancy, tkis

Introduction:
Complications associated with chronic myeloid leukemia (CML) during pregnancy are rare, and management is challenging because very limited data are available on this patient group.
Case description:
We herein report a successful pregnancy and delivery in a patient diagnosed with CML. The patient was treated with imatinib (400 mg/day) as a first-line therapy. However, she became pregnant while she was in complete hematological remission and had a complete cytogenetic response. Because she elected to continue the pregnancy to term, imatinib treatment was stopped after 5 months of gestation and the patient was then treated with interferon-alpha for the remainder of her pregnancy. However, the CML did not relapse. She successfully gave birth to a male infant at 39 weeks by cesarean section with no adverse sequelae or malformations.
Discussion and evaluation:
The treatment of pregnant women with CML is difficult because of few available therapeutic options and limited data regarding the potential harm to the fetus. Conception should be planned and TKI therapy discontinued in female patients during pregnancy, and individual risks need to be considered when an unplanned pregnancy occurs.
Conclusions:
Our experience will be useful for counseling patients inadvertently exposed to tyrosine kinase inhibitors such as imatinib during pregnancy.
Double Vessel Coronary Angioplasty in a Patient with Anomalous Single Coronary Artery Arising from the Right Cusp and Premature Atherosclerotic Coronary Artery Disease: A Case Report and Review of the Literature
Authors: Varun Kumar, Shalini Gupta, Krishna Prasad
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

We report a rare case of a 39-year-old male who presented with acute inferior wall myocardial infarction (IWMI). Coronary angiography revealed an anomalous single coronary artery arising from the right coronary cusp. Premature atherosclerotic coronary artery disease (CAD) with critical stenosis in the mid right coronary artery (RCA), proximal posterior left ventricular (PLV) artery, and distal left circumflex (LCX) artery was detected during angiography. The patient managed successfully by percutaneous coronary interventions (PCI) with drug-eluting stents (DESs) by radial approach.
Endogenous Endophthalmitis Caused by ST66-K2 Hypervirulent Klebsiella pneumoniae, United States
Authors: Edwin Kamau, Paul R Allyn, Omer E Beaird, Kevin W Ward, Nancy Kwan, Omai B Garner, Shangxin Yang
Journal: Emerg Infect Dis (2021)
Keywords: k pneumoniae, st66-k2, united states, bacteria, endogenous endophthalmitis, hypervirulent klebsiella pneumoniae
MeSH terms: Endophthalmitis / diagnosis, Endophthalmitis / epidemiology, Klebsiella Infections / diagnosis, Case Reports, Humans, Indonesia, Klebsiella pneumoniae / genetics, United States / epidemiology, Virulence Factors, Virulence Factors

We describe a case of endogenous endophthalmitis caused by sequence type 66-K2 hypervirulent Klebsiella pneumoniae in a diabetic patient with no travel history outside the United States. Genomic analysis showed the pathogen has remained highly conserved, retaining >98% genetic similarity to the original strain described in Indonesia in 1935.
Chromosomal imbalance letter: Phenotypic consequences of combined deletion 8pter and duplication 15qter
Authors: Frenny Sheth, Joris Andrieux, Stuti Tewari, Harsh Sheth, Manisha Desai, Pritti Kumari, Nidhish Nanavaty, Jayesh Sheth
Journal: Mol Cytogenet (2013)
Keywords: 15q23 duplication, 8p23 deletion, chromosomal imbalance, gata4, igf1r, mcph1
MeSH terms: Case Reports

Exact breakpoint determination by oligonucleotide array-CGH has improved the analysis of genotype-phenotype correlations in cases with chromosome aberrations allowing a more accurate definition of relevant genes, particularly their isolated or combined impact on the phenotype in an unbalanced state. Chromosomal imbalances have been identified as one of the major causes of mental retardation and/or malformation syndromes and they are observed in ~2-5% of the cases. Here we report a female child born to non-consanguineous parents and having multiple congenital anomalies such as atrial septal defect and multiple ventricular septal defects, convergent strabismus, micropthalmia, seizures and mental retardation, with her head circumference and stature normal for her age. Cytogenetic study suggested 46,XX,add(8)(p23). Further analysis by array-CGH using 44K oligonucleotide probe confirmed deletion on 8p23.3p23.1 of 7.1 Mb and duplication involving 15q23q26.3 of 30 Mb size leading to 46,XX,der(8)t(8;15)(p23.3;q23)pat.arr 8p23.3p23.1(191,530-7,303,237)x1,15q23q26.3(72,338,961-102,35,195)x3. The unique phenotypic presentation in our case may have resulted from either loss or gain of a series of contiguous genes which may have resulted in a direct phenotypic effect and/or caused a genetic regulatory disturbance. Double segmental aberrations may have conferred phenotypic variability, as in our case, making it difficult to predict the characteristics that evolved as a result of the global gene imbalance, caused by the concomitant deletion and duplication.
Kidney sparing giant retroperitoneal liposarcoma: Case report and literature review
Authors: Masjensen Argadjendra, Rudi Napitupulu, Redemptus Yudadi, Sakti Hoetama, Heru Seno Wibowo
Journal: Int J Surg Case Rep (2019)
Keywords: nephrectomy, retroperitoneal liposarcoma, well-differentiated

Introduction:
Liposarcoma is the most common variant of soft tissue sarcoma. It often originates in retroperitoneum or perirenal fat. Early diagnosis is extremely difficult due to its location in the retroperitoneum that allows for room for growth. Symptoms would only occur when the tumor becomes very large and/or invades into adjacent organs.
Presentation of case:
We report a case of a 30 years old woman who underwent surgical resection for a well-differentiated liposarcoma. CT scan revealed that the mass invaded the left perirenal fascia and displaced the descending colon, pancreas, and duodenum. Complete resection of tumour masses were performed and we opted against nephrectomy due to the tumor's histologic type, the patient's young age, and increased morbidity.
Discussion:
Treatment for Retroperitoneal Liposarcoma involves R0 resection. In cases where the tumor invades into a nearby organ, it is necessary to weigh the benefit of free margin resection against the adversity of medical complication and quality of life loss.
Conclussion:
Due to its rate of recurrence, a life long follow up and routine assessment of intraabdominal mass should be integrated into clinical practice in liposarcoma patients.
Pulmonary parenchymal involvement caused by Tropheryma whipplei
Authors: Wen Mei Zhang, Ling Xu
Journal: Open Med (Wars) (2021)
Keywords: tropheryma whipplei, whipple’s disease, cavity, pulmonary
MeSH terms: Case Reports

We report a 26-year-old man with left chest pain for 4 days. His chest CT showed a cavity in the left upper lung. Tuberculosis was suspected first, but metagenomics next generation sequencing (mNGS) in bronchoalveolar lavage fluid only detected Tropheryma whipplei. Tropheryma whipplei is the pathogen of Whipple's disease. The most frequently involved organs are the eyes, heart, and central nervous system. Pulmonary parenchymal involvement is rare. To our knowledge, this is the first reported case of pulmonary cavity caused by Tropheryma whipplei. Nineteen cases of pulmonary parenchymal involvement were found by literature search. The most common respiratory symptom was cough, followed by dyspnea/breathlessness and chest pain. The most common finding in chest imaging was pulmonary nodules, followed by interstitial changes and patchy infiltration. Our case and literature review highlighted that Tropheryma whipplei infection should be considered in the differential diagnosis of pulmonary cavity, pulmonary nodules, interstitial changes, and patchy infiltration. mNGS is helpful to improve diagnosis rate.
Tracheoesophageal Fistula Caused by Tracheostomy in a Patient with Myasthenia Gravis after a Myasthenic Crisis
Authors: Chen Jiaxin, Li Jingjing, Zhu Kai, Zhou Zhou, Liu Weibin, Wang Haiyan, Feng Huiyu
Journal: Front Neurol (2017)
Keywords: complication, myasthenia gravis, myasthenic crisis, tracheoesophageal fistula, tracheostomy
MeSH terms: Case Reports

A 57-year-old woman with myasthenia gravis (MG), who had experienced a myasthenic crisis, complained of coughing while drinking. At first, this appeared to be a sequela of the myasthenic crisis. However, after further investigation, the problem was identified as a tracheoesophageal fistula, a complication of tracheostomy. Here, we describe this special case in the hope that we can improve diagnostic accuracy by providing a reminder for other physicians to consider the differences between MG and tracheoesophageal fistula. It is very important to pay more attention to such situations in clinical scenarios and administer the most appropriate treatment without delay.
Empyema caused by Eikenella halliae diagnosed by metagenomic next-generation sequencing (mNGS) after pulmonary surgery: A case report
Authors: Jie Huang, Liming Wang, Yumei Xu, Xinhua Hu, Ronghuan Yu, Shi Chen, Baoqing Wang
Journal: Front Public Health (2022)
Keywords: eikenella halliae, case report, empyema, metagenomic next-generation sequencing (mngs), whole genome sequencing (wgs)
MeSH terms: Eikenella, Empyema / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, High-Throughput Nucleotide Sequencing / methods, Humans, Male, Metagenomics / methods, Middle Aged, RNA, Ribosomal, 16S / genetics, RNA, Ribosomal, 16S

Background:
Empyema is one of the complications of pulmonary surgery for lung cancer, the incidence of which is not very high, but in severe cases, it can even lead to death, and it is always difficult to diagnose the cause by conventional methods.
Case presentation:
In this study, we report a clinical case of empyema caused by Eikenella halliae after pulmonary surgery in a 55-year-old man. He had a fever, cough, and expectoration for 3 days and was diagnosed with right hydropneumothorax and empyema, pneumonia, postoperative malignant tumor of the right lower lobe (adenocarcinoma), and hypertension. The microbiology laboratory reported Gram-negative bacteria in pleural effusion, which was preliminarily considered as Eikenella based on culture and 16S rRNA sequencing. Furthermore, metagenomic next-generation sequencing (mNGS) of sputum samples was performed two times and reported negative results and the presence of E. halliae, respectively. The pathogen was finally confirmed as E. halliae by whole genome sequencing, suggesting the high-resolution ability of mNGS in the clinical diagnosis of this case.
Conclusion:
To our knowledge, this is the first case report of E. halliae infection in China, indicating increased pathogenicity of Eikenella sp. in immunocompromised patients, especially after invasive operations. Our findings emphasize that mNGS allows bacterial diagnosis of empyema and can significantly improve the accuracy of the diagnosis.
Oral floor and gingival metastasis of cholangiocarcinoma: a case report and review of the literature
Authors: Yukihiro Nakanishi, Bo Xu, Charles LeVea
Journal: Case Rep Pathol (2014)

The oral cavity is very unusual site of metastases even though wide spread metastatic disease may be present. The most common primary sites that metastasize to the oral cavity are lung, kidney, breast, and hepatocellular carcinoma. We present a rare case of a 77-year-old Caucasian female with metastasis from a cholangiocarcinoma to the oral floor contiguous with lingual gingival mucosa. The patient presented with left sided rib pain. A CT scan of the chest, abdomen, and pelvis showed multiple pulmonary nodules and a single dominant mass in the right lobe of the liver. This tumor was 6.5 cm with multiple satellite lesions surrounding it. The liver biopsy was diagnostic of a moderately to poorly differentiated adenocarcinoma, consistent with a primary cholangiocarcinoma. After undergoing one cycle of gemcitabine chemotherapy, the patient noticed an extremely rapidly growing mass involving her right lower gingiva and the entire right floor of her mouth. The biopsy of that mass also showed a moderately to poorly differentiated adenocarcinoma. The gingival tumor had a similar cytomorphology and immunophenotype as her cholangiocarcinoma. Therefore, an unusual site for metastatic cholangiocarcinoma was confirmed.