OpenMed/multicare-articles huggingface dataset:
Responsiveness of a patient in a persistent vegetative state after a coma to weekly injections of autologous activated immune cells: a case report
Authors: Barbara Fellerhoff, Barbara Laumbacher, Rudolf Wank
Journal: J Med Case Rep (2012)

Introduction:
An 82-year-old Caucasian woman had remained in a persistent vegetative state after a coma of seven months duration, which occurred after a stroke with hemiplegia, nine years previously. The persistent vegetative state could be reversed in part by weekly injections with activated immune cells. After therapy, our patient responded to commands in addition to regaining spontaneous movements of both arms and the ability to swallow. This is the first report on the treatment with activated immune cells of a patient in a persistent vegetative state after a coma.
Case presentation:
An 82-year-old Caucasian woman presented with a persistent vegetative state subsequent to a coma. She retained respiratory and autonomic functions. As contact was not possible, physiotherapy was passive. Her skin was yellowish, and our patient did not move by herself. Vomiting repeatedly resulted from tube feeding. After a once-weekly treatment with activated immune cells sampled from our patient's blood and activated in vitro, several of her functions gradually returned. Our patient opened her eyes in the requested direction and turned her head toward people entering the room. She 'supported' nursing efforts, as the nurse noted a loss of spastic motions. The strength in both her arms returned, and she spontaneously moved her arm on the side experiencing hemiplegia. After three months, our patient could stick out her tongue upon demand. Finally, the swallow reflexes of our patient started to return. However, tube feeding was continued, and our patient died after aspiration of vomit following a feeding.
Conclusion:
The success of treatment with autologous activated immune cells in this patient may have resulted from the production of neuroactive substances, such as neurotrophin-3 and brain-derived neurotrophic factor, by activated immune cells. The deterioration of our patient could be reversed, as demonstrated by the restoration of motor strength in her hemiplegic side. In addition, our patient was able to induce motor responses upon request. It seems reasonable to conclude that activated immune cells may improve the chronic vegetative state in some patients.
The case report of Mycobacterium arupense wound infection in diabetes mellitus patients; the first report and literature review
Authors: Sepehr Navid, Bahar Sadegh-Ehdaei, Mehdi Shabani, Melika Hasani, Arezoo Mirzaei, Kiarash Ghazvini, Masoud Youssefi, Masoud Keikha
Journal: Access Microbiol (2020)
Keywords: 16s rrna, mycobacterium arupense, diabetes mellitus, wound infection
MeSH terms: Case Reports

Mycobacterium arupense is among the opportunist pathogens of atypical mycobacteria emergence (atypical mycobacteria) that is one of the isolated and reported environmental and clinical specimens. Numerous cases of osteo-articular infections of this bacterium are reported nowadays, while the pulmonary infection is rare. We identified Mycobacterium arupense in non-healing wound infection of an elderly woman with history of diabetes mellitus. She has negative tests for HIV, HBV and HCV, but was positive for HTLV-1. The patient was referred according to mild-fever, non-healing, destructive, and swelled lesion on her left foot. The mycobacterial wounds infection was suspected due to her non-conclusive previous treatment. The pathology, acid-fast staining, conventional and 16S rRNA sequencing confirmed the micro-organism to be M. arupense . Finally, the patient recovered following two-week consumption of clarithromycin, ethambutol and rifabutin. The results of this study provide evidence on the potential pathogenicity, clinical outcomes and treatment of infections caused by this bacterium.
Constraints, synergies and avenues for scaling up breastfeeding, antibiotics for pneumonia and IMCI interventions in the Cusco region, Peru
Authors: Giselle Sarganas, Robert Scherpbier, Christian A Gericke
Journal: F1000Res (2012)

Objective:
The purpose of this qualitative case study was to assess the feasibility of scaling up exclusive breastfeeding for 6 months, antibiotics for pneumonia and integrated management of childhood illness (IMCI) child interventions in three districts of the Cusco region, Peru.
Methods:
During field visits, constraints, synergies and solutions to the implementation of the selected interventions were collected through observational recording and interviews of mothers, health workers, and health managers/decision makers. Results are presented for each intervention according to the health system level where they occurred: mother/community, health worker, health centre, and political/managerial levels.
Findings:
This case study demonstrates that it is feasible to scale up exclusive breastfeeding, antibiotics for pneumonia and IMCI interventions in poverty-stricken rural areas of a low-income country. Factors that helped and hindered the implementation were identified for each intervention.
Conclusions:
The need for a coherent multi-sector approach that includes regulation, implementation and monitoring of health policies and education of all involved stakeholders was apparent. This study also demonstrates that global health interventions need to undergo local adaptation. Identifying local constraints and facilitating factors in a systematic way as proposed in this study is a useful step to increase their effectiveness and reach at the local level and to identify areas for improvement in the original intervention policies.
Association of Sweet's Syndrome and Systemic Lupus Erythematosus
Authors: J L Barton, L Pincus, J Yazdany, N Richman, T H McCalmont, L Gensler, M Dall'era, K H Fye
Journal: Case Rep Rheumatol (2011)
MeSH terms: Case Reports

Sweet's syndrome is an acute febrile neutrophilic dermatosis which usually presents as an idiopathic disorder but can also be drug induced, associated with hematopoetic malignancies and myelodysplastic disorders, and more, infrequently, observed in autoimmune disorders. Sweet's syndrome has been reported in three cases of neonatal lupus, three cases of hydralazine-induced lupus in adults, and in nine pediatric and adult systemic lupus erythematosus (SLE) patients. We describe three additional adult cases of Sweet's associated with SLE and provide a focused review on nondrug-induced, nonneonatal SLE and Sweet's. In two of three new cases, as in the majority of prior cases, the skin rash of Sweet's paralleled underlying SLE disease activity. The pathogenesis of Sweet's remains elusive, but evidence suggests that cytokine dysregulation may be central to the clinical and pathological changes in this condition, as well as in SLE. Further research is needed to define the exact relationship between the two conditions.
A structured approach to a diagnostic of collective practices
Authors: Cristina Bicchieri, Jan W Lindemans, Ting Jiang
Journal: Front Psychol (2014)
Keywords: child marriage, experiments, monitoring and evaluation, social norms, surveys, vignettes

"How social norms change" is not only a theoretical question but also an empirical one. Many organizations have implemented programs to abandon harmful social norms. These programs are standardly monitored and evaluated with a set of empirical tools. While monitoring and evaluation (M&E) of changes in objective outcomes and behaviors is well-developed, we will argue that M&E of changes in the wide range of beliefs and preferences important to social norms is still problematic. In this paper, we first present a theoretical framework and then show how it should guide social norms measurement. As a case study, we focus on the harmful practice of child marriage. We show how an operational theory of social norms can guide the design of surveys, experiments, and vignettes. We use examples from existing research to illustrate how to study social norms change.
Recurrent skull vault actinomycosis: A case report and review of literature
Authors: Abdur Rehman Mohamad, Junais Koleri, Hussain Mohamed Sultan Hussain, Hussam Al Soub, Muna Al Maslamani
Journal: IDCases (2021)
Keywords: actinomycosis, calvarial infection, osteomyelitis, recurrent
MeSH terms: Case Reports

Actinomycosis is an uncommon cause of central nervous system infection. A case of skull bone osteomyelitis with epidural empyema is presented. A 44-year-old man presented with chronic osteomyelitis of skull vault with epidural and subgaleal collection diagnosed by histopathology as actinomycosis. He had similar lesion at the same site 10 years ago, which was excised completely. Recurrent Actinomycosis of the skull vault is uncommon in literature. This case highlights the importance of considering actinomycosis as a differential diagnosis of tumorous growths and stresses on the importance of tissue histopathology for diagnosis and need for surgery to control the disease. Treatment is prolonged, therefore compliance with the long-term antibiotic duration is essential to prevent complications and avoid recurrence.
Acquired nonobstructive urinary bladder diverticulum: a case report
Authors: Plamen Yovchevski, Kosta Kostov
Journal: Cases J (2009)

Introduction:
Urinary bladder diverticula are frequently resulting from obstructions. Our literature review did not reveal any cases of acquired urinary bladder diverticulum caused by long-term transurethral catheterization.
Case presentation:
We report a rare case of a nonobstructive big urinary bladder diverticulum developed after a long-term urethral catheterization in a 62-year old male diabetic patient with normal subvesical urinary tract. The diverticulum was demonstrated by ultrasonography. Its formation was associated with the decubital changes of the bladder wall when the Foley catheter stayed for a longer period.
Conclusion:
Ultrasonographic examination of the urinary bladder is necessary to exclude such complication after a long-lasting catheterization as well as to maximally restrict the catheter's stay in the urinary bladder.
An unusual cause of pseudomedian nerve palsy
Authors: Zina-Mary Manjaly, Andreas R Luft, Hakan Sarikaya
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

We describe a patient who presented with an acute paresis of her distal right hand suggesting a peripheral median nerve lesion. However, on clinical examination a peripheral origin could not be verified, prompting further investigation. Diffusion-weighted magnetic resonance imaging revealed an acute ischaemic lesion in the hand knob area of the motor cortex. Isolated hand palsy in association with cerebral infarction has been reported occasionally. However, previously reported cases presented predominantly as ulnar or radial palsy. In this case report, we present a rather rare finding of an acute cerebral infarction mimicking median never palsy.
Case Report: Microglia Composition and Immune Response in an Immunocompetent Patient With an Intracranial Syphilitic Gumma
Authors: Qian Yu, Wei Li, Xiaohui Mo, Fei Tan, Lianjuan Yang
Journal: Front Neurol (2021)
Keywords: m2 microglia, treponema pallidum, humoral immunity, intracranial syphilitic gumma, microglia
MeSH terms: Case Reports

The pathogenesis of intracranial syphilitic gummas remains poorly understood. Microglia are generally considered to be the main cell type of the innate immune system in the brain. Determination of the composition of infiltrating microglia of patients with typical intracranial syphilitic gummas may contribute to the understanding of the pathological process. We report a case of an intracranial syphilitic gumma who presented with right upper limb weakness. The histological analysis showed the presence of Treponema pallidum and infiltration with histiocytes. Immunostaining indicated that cells were predominantly the M2a and M2c, which were Arg-1+ and IL-10+. These findings suggest that there is an increased number of M2a/M2c microglia in intracranial syphilitic gummas, which may be part of the immune escape mechanisms triggered by Treponema pallidum.
MRI Findings in a Patient with Known SCAR-16 Type STUB1 Associated Cerebellar Ataxia
Authors: Alexander Thorvaldsson, Pir Abdul Ahad Aziz Qureshi, Vikram Rao Bollineni
Journal: J Belg Soc Radiol (2022)
Keywords: stub1, cerebellar ataxia, magnetic resonance imaging, spinocerebellar ataxias
MeSH terms: Case Reports

Our case report describes a 34-year-old patient sent for magnetic resonance imaging (MRI) after four years of slow onset neurological symptoms. An MRI of her brain showed moderate to severe atrophy of the cerebellum and brainstem. She has a family history of spinocerebellar ataxia and has known STUB1 mutation. Imaging features, genetic analysis, and clinical history are in keeping with the SCAR-16 type of STUB1-associated cerebellar ataxia.
Teaching point:
This case report will help the radiologist to familiarize themselves with the CT and MRI features of STUB1-associated cerebellar ataxia and will provide suggestions to further differentiate between the SCAR-16 and SCA-48 types of STUB1-associated cerebellar ataxia.
A rare presentation of small bowel obstruction
Authors: Sharif Darwish, Daniel J Bell
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A 92-year-old, 41 kg female presented with a 4-day history of abdominal distension, intermittent lower abdominal pain, nausea, vomiting and lack of bowel opening. Contrast-enhanced CT scan of the abdomen and pelvis showed multiple dilated small bowel loops, secondary to incarceration of the ileum in an obturator hernia (OH) on the right. The patient underwent an emergency laparotomy with reduction of the OH. The small bowel was viable and no resection was required. OH is a rare but significant cause of small bowel obstruction, with a high mortality rate. Of all the imaging modalities reviewed, CT scan is highly effective in reducing diagnostic delay, and ultimately can reduce morbidity and mortality rates of patients presenting with an incarcerated OH.
Hemophagocytic Lymphohistiocytosis in a Patient with Classical Hodgkin Lymphoma
Authors: G Hyun, K J Robbins, N Wilgus, L Grosso, S D Goyal
Journal: Case Rep Hematol (2016)

Introduction. Hemophagocytic lymphohistiocytosis (HLH) is a rare hyperinflammatory syndrome that can be associated with inherited genetic mutations, malignancy, autoimmune disorders, and viral infections. Though the pathogenesis is not fully known, HLH is understood to be a reactive process in the setting of uncontrolled activation of macrophages, CD8+ cytotoxic lymphocytes, and other immune cells. Hallmark clinicopathological features of HLH include fevers, cytopenias, hepatosplenomegaly, and hemophagocytosis in the bone marrow. Case Presentation. A previously healthy 28-year-old Caucasian male presented with a one-month history of persistent fever, night sweats, and unintentional weight loss. He was diagnosed with classical Hodgkin Lymphoma (HL) by core-needle biopsy of an axillary lymph node. Both bone marrow involvement by HL and hemophagocytosis were seen on subsequent bone marrow biopsy. Other findings included pancytopenia, splenomegaly, and elevated serum ferritin. Extensive work-up for autoimmune and infectious etiologies was unremarkable. The patient had a complete response after chemotherapy with Adriamycin, bleomycin, vincristine, and dacarbazine. Conclusion. This report documents the exceedingly uncommon association between HLH and HL. HLH is a hyperinflammatory syndrome with high mortality, so it is imperative to identify and treat the underlying cause for secondary HLH. Malignancy-associated HLH should be considered in the differential diagnosis for cancer patients who present with fever, cytopenias, and splenomegaly.
Yolk sac tumor of vagina: a rare cause of vaginal bleeding in adolescents - a case report
Authors: Meriem Elbaz, Rabiy El Qadiry, Karima Fouraiji, Hicham Jalal, Jamila Elhoudzi
Journal: Pan Afr Med J (2020)
Keywords: vaginal bleeding, child, serum alpha fetoprotein negative, yolk sac tumor
MeSH terms: Endodermal Sinus Tumor / diagnosis, Uterine Hemorrhage / etiology, Vaginal Neoplasms / diagnosis, Case Reports, Biopsy, Child, Combined Modality Therapy, Endodermal Sinus Tumor / therapy, Female, Humans, Magnetic Resonance Imaging, Ultrasonography, Vaginal Neoplasms / therapy

Yolk sac tumor (YST) is one of the malignant germ-cell tumors (MGCT) that usually occurs in the ovaries and testes of young patients. Its occurrence in the vagina is extremely rare. We present a rare case of extragonadal YST occurring in the vaginal region. A 12-year-old girl, presented with vaginal bleeding and pain in the perineal region. Physical exam identified a limited pelvic mass, 5 x 4cm in size. Abdominal ultrasound and magnetic resonance imaging (MRI) showed a heterogeneous mass in cervico-vaginal region. The patient was taken to the surgery, where an excisional biopsy was obtained. The diagnosis of YST is confirmed by histopathology and immunohistochemistry studies. However, the tumor marker (alpha fetoprotein and BHCG) was normal. The patient was treated according to the French TGM-95 protocol. Surgery was done after chemotherapy, hysterectomy in front of the cervical invasion, with a good decline at 2 years of end of treatment.
Intussusception in a 4-Year-Old Male Due to Burkitt Lymphoma
Authors: Raed Al-Taher, Abdallah Alabadla, Salameh Al-Halaseh, Ghasaq Saleh
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Intussusception is the invagination of a proximal bowel segment into a distal segment causing bowel obstruction, especially in children. In some cases, it can be caused by a pathological lead point, such as Burkitt lymphoma. Burkitt lymphoma has several patterns of clinical presentations, such as jaw or facial bone tumor in the endemic form, in contrast to an abdominal presentation most often with massive disease and ascites. We describe a case of a 4-year-old male who presented bowel obstruction. Using X-ray and ultrasound findings, ileocecal intussusception was then diagnosed. Resection and anastomosis was performed after multiple trials of failed hydrostatic reduction. On the pathology report of the resected segment, Burkitt lymphoma was found to be the cause and chemotherapy was initiated. The patient is doing well and is following up every 6 months for 2 years. A pathological lead point, especially Burkitt lymphoma, should be suspected in patients with failed conservative treatment, and prompt diagnosis of the pathology should be performed to prevent further sequela of the disease.
COVID-19 with Extreme Thrombocytosis: A Case Report and Its Possible Mechanisms
Authors: Cathleen Kenya, Nur Chandra Bunawan, Hardijatmo Muljo Nugroho, Annisa Dian Harlivasari, Edgar David Sigarlaki, Ikhwan Rinaldi
Journal: Caspian J Intern Med (2022)
Keywords: covid-19, sars-cov-2, hematologic manifestations, platelet count, thrombocytosis
MeSH terms: Case Reports

Background:
Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has spread globally becoming a pandemic. The clinical manifestations of COVID-19 vary from asymptomatic to symptomatic disease. Hematologic manifestation which is commonly found in COVID-19 patients is thrombocytopenia whereas thrombocytosis is rarely reported.
Case presentation:
We report a case of a 55-year-old woman with one week history of fever which spike along the day, dry cough, anosmia, nausea, epigastric pain and loss of appetite. She lived in local transmission area. The patient was diagnosed as mild suspected COVID-19 and confirmed with nasopharyngeal and oropharyngeal swab test (positive result). On admission, the number of platelet count was within normal limit but progressively increased exceeding 1000 x109/L accompanied by worsening of the clinical condition. Interestingly, to our knowledge, no such case has ever been reported. In this study, we will discuss the possible mechanisms of its changes.
Conclusions:
COVID-19 can present with extreme thrombocytosis. Thus, monitoring the platelet count during hospitalization can be helpful for anticipating worsening conditions and progression of COVID-19.
Entamoeba gingivalis in Acute Osteomyelitis of the Mandible
Authors: Feriyl Bhaijee, Diana Bell
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

An 86-year-old woman presented with osteonecrosis of the mandible following bisphosphonate therapy for multiple myeloma, and underwent surgical debridement and multiple dental extractions. Histopathologic examination of the necrotic bone fragments revealed acute osteomyelitis with mixed flora and organisms morphologically consistent with Entamoeba gingivalis. In addition to oral scrapings and sputum, E. gingivalis has been identified in specimens obtained from the uterus, cervix, neck lymph nodes, and lung. It is rarely found in lesions of the head and neck. We present an unusual case of E. gingivalis in acute osteomyelitis of the mandible, following bisphosphonate therapy for multiple myeloma. To our knowledge, this is the first reported case of E. gingivalis in association with osteomyelitis.
Case Report: Severe Listeria Encephalitis With Complicated or Secondary Autoimmune Encephalitis and CNS Demyelinating Diseases
Authors: Xiaomin Zhang, Peng Feng, Pengfei Meng, Dongfang Li, Huizhong Gao, Yang Zhao, Jingjing Yuan, Yongqing Wang, Han Xia
Journal: Front Public Health (2022)
Keywords: cns demyelinating diseases, complicated or secondary autoimmune encephalitis, metagenomic next-generation sequencing, pathogen detection, severe listeria encephalitis
MeSH terms: Demyelinating Diseases, Encephalitis / complications, Encephalitis / diagnosis, Encephalitis / microbiology, Hashimoto Disease, Listeria, Case Reports, Research Support, Non-U.S. Gov't, Adult, Humans, Male, Hashimoto's encephalitis

Background:

Listeria monocytogenes is an important food-borne bacterium. It rarely infects patients with complete immunity and causes meningocephalitis. Patients with severe Listeria encephalitis always experience a bad prognosis.
Case presentation:
A 39-year-old male patient was admitted to our hospital due to fever for more than 10 days and disturbance of consciousness accompanied by convulsions for 2 days. Metagenomic next-generation sequencing (mNGS) results showed L. monocytogenes in both cerebrospinal fluid (CSF) and blood, indicating L. monocytogenes encephalitis. Autoimmune encephalitis and central nervous system (CNS) demyelinating autoantibodies in the CSF also showed positive results. The case was finally diagnosed as severe Listeria encephalitis with complicated or secondary autoimmune encephalitis and CNS demyelinating diseases.
Conclusions:
It is necessary to carry out infection and immunity screening in patients with severe encephalitis, especially for immunocompromised patients. mNGS plays a pivotal role in screening patients with severe and difficult neurological diseases.
Gadolinium Enhancement May Indicate a Condition at Risk of Developing Necrosis in Marchiafava-Bignami Disease: A Case Report and Literature Review
Authors: Zhiqin Wang, Jianfeng Wang, Fang Yi, Lin Zhou, Yafang Zhou
Journal: Front Hum Neurosci (2019)
Keywords: mri, marchiafava–bignami disease, alcoholism, gadolinium enhancement, necrosis, prognosis

Marchiafava-Bignami disease (MBD) is a rare condition characterized by demyelination, necrosis and atrophy of the corpus callosum (CC), and mainly associated with alcoholism. MBD may present with various clinical manifestations. Brain magnetic resonance imaging (MRI) scan is important in prompt diagnosis and treatment of MBD. Here we reported a case of MBD and reviewed literature about the usage of gadolinium-enhanced MRI in MBD. Gadolinium enhancement may indicate a condition at risk of developing necrosis. We therefore recommend a contrast-enhanced MRI study in severe alcoholics with suspected diagnosis of MBD.