OpenMed/multicare-articles huggingface dataset:
Clinical Characteristics of 5 COVID-19 Cases With Non-respiratory Symptoms as the First Manifestation in Children
Authors: Xiaofang Cai, Yaoling Ma, Songbo Li, Yan Chen, Zhihui Rong, Wenbin Li
Journal: Front Pediatr (2020)
Keywords: clinical characteristics, first manifestation, non-respiratory symptoms, novel coronavirus disease 2019, pediatrics
MeSH terms: Case Reports

An outbreak of the novel coronavirus disease 2019 (COVID-19) occurred in Wuhan, China, in December 2019, which then rapidly spread to more than 80 countries. However, detailed information on the characteristics of COVID-19 in children is still scarce. Five patients with non-respiratory symptoms as the first manifestation were hospitalized from the emergency department, and were later confirmed to have COVID-19, between 23 January and 20 February 2020, at the Wuhan Children's Hospital. SARS-CoV-2 nucleic acid detection was positive for all the patients. Four of the patients were male and one was female, and their ages ranged from 2-months to 5.6 years. All lived in Wuhan. One patient had a clear history of exposure to SARS-CoV-2, one had a suspected history of exposure, while the others had no exposure history. For three of the five patients, the primary onset disease required an emergency operation or treatment, and included intussusception, acute suppurative appendicitis perforation with local peritonitis, and traumatic subdural hemorrhage with convulsion, while for the other two it was acute gastroenteritis (including one patient with hydronephrosis and a stone in his left kidney). During the course of the disease, four of the five patients had a fever, whereas one case had no fever or cough. Two patients had leukopenia, and one also had lymphopenia. In the two cases of severe COVID-19, the levels of CRP, PCT, serum ferritin, IL-6, and IL-10 were significantly increased, whereas the numbers of CD3+, CD4+, CD8+ T lymphocytes, and CD16 + CD56 natural killer cells were decreased. We also found impaired liver, kidney, and myocardial functions; the presence of hypoproteinemia, hyponatremia, and hypocalcemia; and, in one case, abnormal coagulation function. Except for one patient who had a rotavirus infection, all patients tested negative for common pathogens, including the influenza virus, parainfluenza virus, respiratory syncytial virus, adenovirus, enterovirus, mycoplasma, Chlamydia, and Legionella. Chest CT images of all the patients showed patches or ground-glass opacities in the lung periphery or near the pleura, even large consolidations. This case series is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children.
Bone Metastasis as the Only Metastatic Site in a Patient with Pancreatic Cancer following Distal Pancreatectomy
Authors: Muhammad Wasif Saif, Natalie Galanina, L Ravage-Mass, Kristin Kaley, Daniel Cornfeld, Lynne Lamb, David Chhieng
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Pancreatic cancer remains a challenge both diagnostically and therapeutically. The typical sites of metastases in pancreatic cancer include the liver and peritoneum. Other less common sites are the lung, brain, kidney, and bone. Skeletal metastases are less prevalent in occurrence but contribute to significant morbidity associated with pancreatic cancer. The prevalence of osseous metastases remains unknown but has been estimated to be between 5% and 20%. The most common osseous lesions are osteolytic in nature, but the osteoblastic ones are extremely rare. Here, we report an interesting case of pancreatic adenocarcinoma with exclusive bone metastases and discuss briefly the possible pathogenesis.
To What Extent Can Orbital Cellulitis Emergency Aspect Influence the Diagnosis of Maxillary Sinus Lymphoma?
Authors: Yousra Ajhoun, Ismail Aissa, Taoufik Abdellaoui, Yasmine Chaoui Roqai, Ilias Benchafai, Redouan Messaoudi, Rachid Zerrouk, Karim Reda, Abdelbarre Oubaaz
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

We present a case of a 46-year-old woman admitted to the emergency department for acute swelling and erythema of the right eyelid for 3 days. Ophthalmological examination was notable for 10/10, P2 best visual acuity, and inflammatory periorbital edema, without exophthalmia nor extraocular motility disturbance. Intraocular pressure was 14 mmHg and fundoscopic examination was not notable for any abnormality. Preseptal cellulitis diagnosis was made, and oral antibiotherapy was immediately started; after 72 hours, the patient did not improve and started complaining of pain on ocular movements. Brain and orbit MRI scan revealed right retroseptal cellulitis associated with homolateral pansinusitis. Intravenous antibiotherapy with oral corticosteroid was started simultaneously leading to full remission but with steroid dependency; 5 days after finishing prednisone, orbital cellulitis symptoms reappeared. The same treatment protocol was given but with corticosteroid tapering over weeks. Nevertheless, steroid dependency persisted. Except for the inflammatory syndrome, complete biological examinations did not disclose any abnormalities. The patient underwent maxillary sinus and fat orbital biopsy; however, histopathological examination was not contributory. Persistence of steroid dependency, chronic atypical rhinosinusitis, normal paraclinical investigations, and age of patient let us suspect lymphoma origin hidden by chronic corticosteroid. We carried out for the second time a maxillary sinus biopsy after stopping steroids, which disclosed primitive non-Hodgkin lymphoma of the maxillary sinus. The aim of this observation is firstly to evoke though it is exceptional the diagnosis of maxillary lymphoma in case of atypical orbital cellulitis and secondly to incite clinicians to be more vigilant in prescribing corticosteroid even if there is an emergency character of orbital cellulitis.
Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
Authors: Christopher M Naglieri, Ellie Bash, Glen A Karunanayake, Carlos H R Camargo, Takashi Komabayashi
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Auto-transplantation is a procedure that replaces traumatized or congenitally missing teeth. While most auto-transplanted teeth are successfully integrated into recipient sites, the donor tooth may develop apical periodontitis, causing early failure. In the present case report, the periodontic resident performed the procedure on a 15-year-old male by selecting donor teeth #4 and #13 and transplanting them at recipient sites #29 and #20, respectively. After 6 weeks, the patient was referred to the endodontic resident for evaluation of tooth #20 due to symptom development. While one auto-transplanted tooth (donor tooth #4, recipient site #29) was successfully integrated, the other (donor tooth #13, recipient site #20) was unsuccessful: the patient was diagnosed with pulp necrosis and a chronic apical abscess. Because of the patient's age, collaboration among periodontic, endodontic, and orthodontic residents/specialists informed the clinical decision to pursue non-surgical root canal treatment (NSRCT) rather than extraction. The canal was cleaned and shaped to a size #80 using copious irrigation of 2.5% sodium hypochlorite (NaOCl), followed by 17% ethylenediaminetetraacetic acid (EDTA) via the EndoVac Negative Pressure Irrigation system. The tooth was dried with paper points, and then calcium hydroxide was mixed with 2.5% NaOCl and placed with an amalgam carrier 2 mm from the radiographic apex. The tooth was next temporized with Teflon tape and Fuji TRIAGE. Four weeks later, after confirming the patient was asymptomatic and tooth mobility had decreased, the canal was obturated using EndoSequence Bioceramic Root Repair Material Fast Set Putty in 2 mm incremental layers to achieve a three-dimensional fill and create an apical plug to prevent gutta-percha extrusion, then backfilled in incremental layers of gutta-percha to the cementoenamel junction (CEJ). At the 8-month follow-up, the patient was asymptomatic, and the periodontal ligament (PDL) had no signs of periapical pathology. When teeth undergoing auto-transplantation procedures develop apical periodontitis, NSRCT can be implemented.
Photobiomodulation in the treatment of xerostomia associated with hyposalivation in a pediatric patient with systemic scleroderma
Authors: Analú Barros de Oliveira, Túlio Morandin Ferrisse, Karina Borges Salomão, Marina Lins Miranda, Andreia Bufalino, Fernanda Lourenção Brighenti
Journal: Autops Case Rep (2020)
Keywords: laser therapy, low-level light therapy, pediatrics, scleroderma, systemic, xerostomia
MeSH terms: Case Reports

Scleroderma is a rare autoimmune disease characterized by excessive collagen production. The oral manifestations of the patient with scleroderma can include microstomia, xerostomia, and changes in the resorption teeth. We report the case of a 7-year-old female patient diagnosed with systemic scleroderma where photobiomodulation therapy was used to treat xerostomia associated with hyposalivation. She attended a pediatric clinic and presented with dry and rigid facial skin, trismus, xerostomia, malocclusion, and difficulty swallowing. Stimulated salivary flow was assessed before, during, and after treatment. Photobiomodulation therapy was conducted at four points at the sublingual glands with 660 nm, 100 mW, and 0.8 J/cm2 to each point; eight points at the parotid glands; and six points at the submandibular glands with 808 nm, 100 mW, and 0.8 J/cm2 for 8 seconds at each point. After this therapy, an increase in salivary flow, remission of the xerostomia, and an improvement in mastication and swallowing were observed. Photobiomodulation therapy was effective in controlling xerostomia in this pediatric patient, resulting in increased salivary flow and an improvement in her quality of life.
Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature
Authors: Marcello Agus, Maria Elena Ferrara, Paola Bianco, Cristina Manieli, Paolo Mura, Raffaele Sechi, Matteo Runfola, Fabrizio Polo, Nicola Cillara
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.
Different Clinical Features of Acral Abortive Hemangiomas
Authors: N Vega Mata, J C López Gutiérrez, B Vivanco Allende, M S Fernández García
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Some infantile hemangiomas called in literature "minimal or arrested growth hemangiomas" or "abortive hemangiomas" are present at birth and have a proliferative component equaling less than 25% of its total surface area. Often, they are mistaken for vascular malformation. We present five patients (three girls and two boys) with abortive hemangiomas diagnosed between January 2010 and December 2015 localized in acral part of the extremities. They were congenital lesions resembling precursor of hemangiomas but did not show proliferation phase. Immunohistochemical Glut-1 was performed in all of them as a way to confirm the abortive hemangioma diagnosis. The most common appearance was a reticulated erythematous patch with multiple fine telangiectasias on the surface. We remark that one of them presented a segmental patch with two different morphologies and evolutions. The proximal part showed pebbled patches of bright-red hemangioma and presented proliferation and the distal part with a reticulated network-like telangiectasia morphology remained unchanged. We detected lower half of the body preference and dorsal region involvement preference without ventral involvement. The ulceration occurred in three patients with two different degrees of severity.
Visual Snow-Like Symptoms and Posterior Uveitis following COVID-19 Infection
Authors: Kathryn Kelani Braceros, Masumi G Asahi, Ron P Gallemore
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Visual snow (VS) is a neurologic condition consisting of a constant positive visual disturbance described as "static" with diagnosis requiring exclusion of competing neurologic and ophthalmologic disorders. The authors describe the first case of visual snow-like symptoms in a patient following coronavirus disease 2019 (COVID-19) infection. He was found to have a transient subtle mild inflammatory reaction in the vitreous and optic nerve edema which resolved, but the VS persisted. Our findings suggest that COVID-19 may precipitate a transient autoimmune response in some patients with resultant ocular inflammation as well as long-term symptoms of VS. This has potential implications for the understanding and treatment of complications related to COVID-19 and in VS.
Unexpected online gambling disorder in late-life: a case report
Authors: Anne Sauvaget, Susana Jiménez-Murcia, Fernando Fernández-Aranda, Ana B Fagundo, Laura Moragas, Ines Wolz, Misericordia Veciana De Las Heras, Roser Granero, Amparo Del Pino-Gutiérrez, Marta Baño, Eva Real, Maria N Aymamí, Marie Grall-Bronnec, José M Menchón
Journal: Front Psychol (2015)
Keywords: behavioral addictions, elderly, gambling disorder, late-life, medical condition, online gambling
MeSH terms: Case Reports

Background:
The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date.
Case description:
We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy.
Conclusion:
The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed.
Acute Respiratory Failure Is the Initial Manifestation in the Adult-Onset A3243G tRNALeu mtDNA Mutation: A Case Report and the Literature Review
Authors: Xiaoli Pan, Lijun Wang, Guoqiang Fei, Jihong Dong, Chunjiu Zhong, Jiahong Lu, Lirong Jin
Journal: Front Neurol (2019)
Keywords: a3243g mutation, mitochondrial myopathy, mtdna, respiratory failure, sedative drug
MeSH terms: Case Reports

Isolated mitochondrial myopathy refers to the condition of mitochondrial disorders that primarily affect the skeletal muscle system. Here we report on a case of a patient who presented with acute respiratory failure as the initial and predominant clinical manifestation after using anesthetic drugs. The diagnosis of mitochondrial myopathy was made by histochemical findings of ragged red fibers with a modified Gomori trichrome Stain in the skeletal muscle biopsy and the genetic detection of an A3243G point mutation in the tRNALeu (UUR) gene of mitochondrial DNA (mtDNA) in a peripheral blood specimen. The patient revealed a benign clinical outcome with ventilator assistance and a cocktail treatment. Further, we performed a literature review on patients with respiratory failure as the early and predominant manifestation in adult-onset isolated mitochondrial myopathy. Eleven cases in nine studies (including our case) have been reported, and five of whom underwent DNA analysis all harbored the A3243G mutation in the tRNALeu gene of the mtDNA. Use of sedative drugs tends to induce acute respiratory failure in such cases.
Cleidocranial dysplasia: Radiological mimic of pyknodysostosis - A case report
Authors: Harmeet Kaur, Kamini Gupta, Punit Tiwari
Journal: SA J Radiol (2018)
MeSH terms: Case Reports

Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal disorder with predominant membranous bone involvement. It may also occur as a sporadic mutation. The diagnosis of this condition is based on the clinical, radiological and genetic findings. It is characterised by hypoplasia or aplasia of the lateral thirds of the clavicles; craniofacial and dental anomalies; and hypoplastic iliac bones. Pyknodysostosis is a close radiological mimic of this entity. Definite diagnosis is based on the genetic analysis. A 36-year-old short-statured female was referred for computed tomography of the paranasal regions for complaints of a deviated nasal septum and midline depression in her forehead. Skeletal screening demonstrated an open metopic suture, wormian bones, maxillary hypoplasia, maldentition and aplastic lateral thirds of both clavicles. In this article, we report a case of CCD, discuss various overlapping features between CCD and pyknodysostosis and attempt to differentiate them radiologically.
Imaging features and transcatheter treatment of a giant pulmonary arteriovenous malformation in an elderly patient
Authors: Ashish Chawla, Suresh Balasubramanian Babu, Anbalagan Kannivelu, Sumer S Shikhare, Raymond Chung
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Pulmonary arteriovenous malformations (PAVMs) comprise an anomalous communication between the pulmonary arterial and systemic circulation. The drainage is usually into one of the pulmonary veins, although rare instances of direct drainage into the left atrium or inferior vena cava have been reported. The result is a high-flow, low-resistance, right-toleft shunt. Although considered uncommon, PAVMs are being diagnosed with increasing frequency in this era of enhanced cross-sectional imaging with CT for lung screening. There is a strong association between PAVMs and hereditary haemorrhagic telangiectasia (HHT); PAVMs are more commonly found in females, with a female to male ratio of 8:1. These have varying clinical presentation, with most symptomatic PAVMs being diagnosed in the first three decades of life. The most common mode of presentation is dyspnoea on exertion. Other reported symptoms are epistaxis, chest pain, cough and, in the event of rupture, haemoptysis. Endocarditis, stroke and brain abscess formation occur frequently in patients with undiagnosed HHT with PAVMs. A 76-year-old female, with a presumed clinical diagnosis of asthma, presented to the emergency department with worsening shortness of breath. The imaging studies revealed a giant PAVM and a radionuclide scan demonstrated a large right-to-left shunt, likely accounting for her symptoms. She underwent successful transcatheter embolization (TCE) with a vascular plug performed by the interventional radiology team. The aim of this case report is to describe the imaging findings and TCE treatment of a giant PAVM.
Clandestine abortions: epidemiology at Provincial General Hospital of Kananga
Authors: Antoine Tshimbundu Kayembe, Gérard Kabatantshi Mukengabantu, Sylvain Mulumba Kapuku
Journal: Pan Afr Med J (2022)
Keywords: epidemiology, kananga, provincial general hospital, clandestine abortions
MeSH terms: Abortion, Induced, Hospitals, General, Case Reports, Adult, Contraception, Family Planning Services, Female, Humans, Pregnancy, Sex Education

This study aim is to describe the epidemiological profile of pregnant women who performed clandestine abortions in the gynecological department of the Provincial General Hospital of Kananga. This is a descriptive study of a series conducted from the medical files of pregnant women who secretly aborted in the gynecology department of the Provincial General Hospital of Kananga from January 1st 2015 to December 31st 2019. It is based on the no probabilistic sampling of suitability. We recorded 58 cases of clandestine abortions upon 1667 patients. The frequency of clandestine abortions is of 3.48% with an average age of pregnant women of 26.96 years, 70% of pregnant women under 30 years old, nulliparity is more concerned (34.48%), pupils and students as well as unemployed are more concerned in 55.12%, nurses are the abortionists encountered in 37.70%, cervical dilation and curettage is the most used abortion method (69.07%) and the maternal mortality rate linked to clandestine abortion is 13.79%. The fight against clandestine abortions requires the promotion of sex education in school and academic circles, and the sensitization of women and couples to the use of contraceptive methods and family planning. Our results serve as the basis for in-depth studies on clandestine abortions and their complications with a view to improving their management in our environment.
Subcutaneous Granulomatous Inflammation due to Basidiobolomycosis: Case Reports of 3 Patients in Buruli Ulcer Endemic Areas in Benin
Authors: Luc V C Brun, Jean Jacques Roux, Ghislain E Sopoh, Julia Aguiar, Miriam Eddyani, Wayne M Meyers, Dirk Stubbe, Marie T Akele Akpo, Françoise Portaels, Bouke C de Jong
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Background:
Basidiobolomycosis is a rare subcutaneous mycosis, which can be mistaken for several other diseases, such as soft tissue tumors, lymphoma, or Buruli ulcer in the preulcerative stage. Microbiological confirmation by PCR for Basidiobolus ranarum and culture yield the most specific diagnosis, yet they are not widely available in endemic areas and with varying sensitivity. A combination of histopathological findings, namely, granulomatous inflammation with giant cells, septate hyphal fragments, and the Splendore-Hoeppli phenomenon, can confirm basidiobolomycosis in patients presenting with painless, hard induration of soft tissue.
Case presentations:
We report on three patients misdiagnosed as suffering from Buruli ulcer, who did not respond to Buruli treatment. Histopathological review of the tissue sections from these patients suggests basidiobolomycosis. All patients had been lost to follow-up, and none received antifungal therapy. On visiting the patients at their homes, two were reported to have died of unknown causes. The third patient was found alive and well and had experienced local spontaneous healing.
Conclusion:
Basidiobolomycosis is a rare subcutaneous fungal disease mimicking preulcerative Buruli ulcer. We stress the importance of the early recognition by clinicians and pathologists of this treatable disease, so patients can timely receive antifungal therapy.