OpenMed/multicare-articles huggingface dataset:
A rare entity to major outbreak: a case report on mucormycosis
Authors: Dhaman Gupta, Tanvi Dosi
Journal: Pan Afr Med J (2021)
Keywords: covid-19, mucormycosis, case report, diabetes mellitus
MeSH terms: COVID-19 / complications, Cone-Beam Computed Tomography / methods, Mucormycosis / diagnostic imaging, Case Reports, Antifungal Agents / administration & dosage, Cortical Bone / diagnostic imaging, Debridement, Humans, Male, Middle Aged, Mucormycosis / therapy, Paranasal Sinus Diseases / diagnostic imaging, Paranasal Sinus Diseases / microbiology, Paranasal Sinus Diseases / therapy, Antifungal Agents

Mucormycosis is relatively uncommon, fulminant, progressive, life threatening fungal disease which is most often seen in debilitating patients with immunocompromised condition. Mucormycosis cases are seen in patients with the use of systemic steroids in the treatment of severely affected COVID-19 cases and also in the patients with uncontrolled diabetes which causes immunosuppression are being reported with mucormycosis. The main symptoms of this disease include pain on the temporal and the orbital region of the affected side which could be throbbing or lancinating type, mobility of the teeth, jaw pain and often swelling is present which could be extraoral and intraoral both or sometimes only intraorally. The diagnostic approach in such cases is done with the help of clinical diagnosis, histopathology and with advanced imaging like cone beam computed tomography, magnetic resonance imaging and computed tomography. We here used cone beam computed tomography imaging that revealed haziness in the sinuses and breach in cortical bone of the affected area which confirmed the diagnosis of mucormycosis. Early treatment planning like administration of antifungal drugs and surgical debridement will be life saving in such a deadly disease.
Atypical vessels as an early sign of intracardiac myxoma?
Authors: Hans-Peter Dübel, Fabian Knebel, Volker Gliech, Wolfgang Konertz, Wolfgang Rutsch, Gert Baumann, Adrian Constantin Borges
Journal: Cardiovasc Ultrasound (2004)
MeSH terms: Heart Atria / diagnostic imaging, Heart Neoplasms / diagnostic imaging, Myxoma / diagnostic imaging, Case Reports, Chest Pain / diagnosis, Chest Pain / etiology, False Negative Reactions, Female, Humans, Middle Aged, Radiography, Ultrasonography

We report on a woman with previously unknown left atrial myxoma, who underwent percutaneous coronary intervention. 45 months after the initial coronary angiography, echocardiography demonstrated a large atrial myxoma, which was not seen echocardiographically before. The retrospective analysis of the pre-intervention coronary angiography revealed atypical vessels in the atrial septum, which are interpreted as early signs of myxoma.
Misdiagnosis of Susac syndrome as demyelinating disease and primary angiitis of the central nervous system: A case report
Authors: Gang Wu, Wei Jiang, Zunbo Li, Dehui Huang, Lei Wu
Journal: Front Neurol (2022)
Keywords: susac syndrome, acute disseminated encephalomyelitis, demyelinating, encephalopathy, primary angiitis of the central nervous system
MeSH terms: Case Reports

Susac syndrome (SuS) is a rare neuroinflammatory disease that manifests with a triad of hearing loss, branch retinal artery occlusions, and encephalopathy. Patients with SuS are frequently misdiagnosed because the clinical trial is incompletely present at disease onset. In this report, we present a case of a 29-year-old man manifesting sleepiness, epilepsy, urinary dysfunction, and hemiparesis at the initial stage. Magnetic resonance imaging (MRI) revealed multiple abnormal signals located in the lateral paraventricular, corpus callosal, and pons. In addition, the patient had sustained elevation of CSF pressure and protein. ADEM was considered according to the clinical and radiographic findings. However, symptoms were not significantly improved after methylprednisolone therapy. He showed a vision decline in the third month after the disease onset. It was considered from intracranial hypertension or optic neuritis, and therefore retinal arteriolar impairment was ignored. As the disease progresses, cognitive decline was presented. Brain MRI exhibits multiple significant hyperintensities on the DWI sequence with speck-like gadolinium enhancement. Thus, PACNS was diagnosed. The SuS was not made until the presence of hearing decline in the 4 months after the disease onset. The case will be helpful for clinicians to better recognize the atypical initial manifestation of SuS.
Intoxication after extreme oral overdose of quetiapine to attempt suicide: pharmacological concerns of side effects
Authors: C Müller, H Reuter, C Dohmen
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Quetiapine is an atypical antipsychotic approved for the treatment of patients with psychotic disorders. Since approvement several case reports about intoxication with quetiapine were linked mainly with tachycardia, QT(c)-prolongation, somnolence, and hyperglycemia. Here, we present the first case report of an intoxication with an extreme overdose of quetiapine (36 g), ingested by a 32-year-old female (62 kg bodyweight) to attempt suicide. Symptoms associated with intoxication were coma without arterial hypotension, persistent tachycardia, hyperglycemia, and transient hypothyreoidism. QT(c)-interval was moderately extended. Management consisted of intubation for airway protection, gastric lavage, the use of activated charcoal, i.v. saline, and observation for 17 hours on an intensive care unit. Despite the extremely high dose of quetiapine, the patient recovered completely without residual symptoms.
Bilateral Reverse Total Shoulder Arthroplasty with Soft Tissue Release for Bilateral Posterior Fracture Dislocation after Status Epilepticus
Authors: George El Rassi, Nabil Dib, Joseph Maalouly, Rita Moukarzel, Dany Aouad
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Proximal humerus fracture is a common orthopedic presentation, with bimodal age distribution. On the other hand, bilateral proximal humerus fracture dislocation is a rarely reported pathology, especially when it is not the result of direct trauma. We present a case of a 71-year-old female patient found to have simultaneous bilateral 4-part proximal humerus fractures following status epilepticus treated surgically with bilateral reverse shoulder arthroplasty with constraint and soft tissue release. In a patient with recurrent status epilepticus episodes, the combination of constrained reverse shoulder arthroplasty and the extensive soft tissue release should decrease the rate of failure and dislocation dramatically. We conclude, after reviewing the literature, that there is no straightforward algorithm for treating such patients and that a clear classification should take into account both bone quality and patient comorbidities which has yet to be developed.
Pulmonary Embolism Mimicking Pneumonia in a HIV Patient
Authors: Vivek Nagaraja, Joel A Terriquez, Hemanth Gavini, Lokesh Jha, Stephen A Klotz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Recent studies have shown an increased risk of arterial and venous vascular diseases in HIV patients, pulmonary thromboembolism being one of them. HIV-infected individuals may have procoagulants predisposing them to thromboembolism. Patients with thromboembolism may have a clinical presentation mimicking common opportunistic infections. It is important to consider pulmonary embolism in the differential of HIV patients with fever, cough, and dyspnea, particularly in those with well-controlled HIV infection.
Malignant Melanoma With Neuroendocrine Differentiation: A Case Report and Literature Review
Authors: Jason Cham, Ayal Shavit, Aren Ebrahimi, Miguel Viray, Paul Gibbs, Munveer S Bhangoo
Journal: Front Oncol (2021)
Keywords: checkpoint inhibitor, genomics, malignant melanoma, neuroendocrine differentiation, small cell carcinoma, synaptophysin
MeSH terms: Case Reports

Background:
Melanoma has a wide range of histologic variants and cytomorphologic features that make its diagnosis challenging. Melanoma can also rarely have neuroendocrine markers adding further diagnostic uncertainty particularly given that unrelated tumor types, such as prostate cancer, can also display focal neuroendocrine differentiations.
Case presentation:
Our patient is a 74-year-old Caucasian man found to have a lung mass. Initial biopsy revealed typical microscopic morphology and neuroendocrine differentiation consistent with small cell carcinoma. Despite standard chemoradiation treatment, the patient continued to progress with new metastasis in the brain, liver and bone. Subsequent chest wall biopsy revealed golden-brown pigment associated with melanin. Further tumor immunohistochemistry revealed extensive neuroendocrine differentiation with CD56, synaptophysin, and INSM1, as well as strong immunoreactivity for melanocyte markers including SOX10, S100, PRAME, and MITF, consistent with metastatic melanoma with neuroendocrine differentiation. Genomic testing revealed increased tumor mutational burden and alterations in NF1, BRAF, CDKN2A/B, TERT. The patient was transitioned to checkpoint inhibitor therapy with nivolumab and ipilimumab and had resolution of his intracranial mass and decrease in size of other metastatic lesions.
Conclusion:
Often the combination of anatomic findings such as a lung mass, typical microscopic morphology, and confirmation of neuroendocrine differentiation correctly identifies a patient with small cell carcinoma. However, in a patient who fails to respond to treatment, a broader immunohistochemical workup along with molecular testing with additional tissue may be warranted.
Complete Resection of a Massive Synovial Osteochondromatosis of the Hip Using an Anterior Approach: A Report of Two Cases
Authors: Masanao Kataoka, Koji Goto, Yutaka Kuroda, Toshiyuki Kawai, Ouki Murata, Masayuki Sugimoto, Shuichi Matsuda
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Arthroscopic excision of synovial osteochondromatosis of the hip is commonly performed. However, when the lesion extends to the extra-articular space of the hip joint, excision using arthroscopy becomes difficult. Although surgical dislocation of the hip with a trochanteric flip osteotomy is commonly used, manual access to the inferomedial portion of the acetabulum remains difficult. In this case report, we describe arthroscopic resection followed by open surgery using an anterior approach with or without surgical dislocation to excise a synovial osteochondromatosis of the hip that had extended to the extra-articular space and formed a herniation sac. Excision was completed without complications. An anterior approach with or without surgical dislocation should be considered as a surgical option for the treatment of a massive synovial osteochondromatosis of the hip joint.
Idiopathic intussusception in an adult-an imageguided diagnosis
Authors: Vivienne Nkechi Eze
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A 22-year-old female with no significant past medical history presented with a short history of sudden onset, central abdominal pain. She was investigated with ultrasound scan of her abdomen, which showed a "lumen in lumen" appearance of the small bowel suggestive of intussusception. Subsequent CT scan of the abdomen confirmed the diagnosis with characteristic appearances of "target" sign and "reniform" mass confirming intussusception and suggestive of consequent bowel ischaemia. She went on to have an emergency laparotomy and right hemicolectomy. No lead points were identified intraoperatively and histopathology results showed no benign or malignant tumours and no polyps in the bowel lumen. She recovered well postoperatively and was discharged. Diagnosing intussusception in adults can be challenging and this case discusses the different imaging modalities that can be used in diagnosis with images of associated pathognomonic signs.
Massive Nasal Arterio-Venous Malformation (AVM) Excision and Reconstruction with Expanded Forehead Flap: A Case Report
Authors: Ghasem Ali Khorasani, Siamak Rakei, Hooman Riazi
Journal: World J Plast Surg (2017)
Keywords: arterio-venous malformations, embolization, vascular lesion
MeSH terms: Case Reports

Nasal arterio-venous malformations (AVM) are uncommon lesions. We present a rare case of huge, long standing AVM in the nasal area which was treated by angioembolization, followed by surgical excision and forehead flap reconstruction.
Transition from hepatopulmonary syndrome to portopulmonary hypertension: a case series of 3 patients
Authors: Radhika Zopey, Irawan Susanto, Igor Barjaktarevic, Tisha Wang
Journal: Case Rep Pulmonol (2013)

Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHTN) are the two major pulmonary vascular complications of liver disease. While HPS is characterized by low pulmonary vascular resistance, PPHTN is defined by the presence of elevated pulmonary vascular resistance. Given these seemingly opposing pathophysiologic mechanisms, these conditions were traditionally felt to be mutually exclusive. In this series, we present three patients with severe hepatopulmonary syndrome who had spontaneous resolution of their HPS with the subsequent development of PPHTN. To our knowledge, this is the largest case series presented of this phenomenon in nontransplanted patients. One proposed mechanism for the occurrence of this phenomenon involves dysregulation of the same vascular signaling pathway, which may lead to both pulmonary vascular dilatations and pulmonary arterial remodeling in the same patient. Another theory involves the possible differential binding of endothelin-1, a vasoactive signaling peptide that induces vasoconstriction when bound to receptor A and vasodilation when bound to receptor B. Although the mechanisms for this phenomenon remain unclear, it is important to be vigilant of this phenomenon as it may change the patient's overall treatment plan, especially in regard to appropriateness and timing of liver transplant.
Torticollis as a sign of spinal tuberculosis
Authors: Rim Boussetta, Mohamed Zairi, Sami Bouchoucha Sami, Rafik Lafrem, Ahmed Msakeni, Walid Saied, Nebil Nessib
Journal: Pan Afr Med J (2020)
Keywords: tuberculosis, apophysis, cervical, spine
MeSH terms: Cervical Vertebrae / pathology, Torticollis / etiology, Tuberculosis, Spinal / diagnosis, Case Reports, Antitubercular Agents / administration & dosage, Biopsy, Cervical Vertebrae / microbiology, Child, Female, Fever / etiology, Humans, Neck Pain / etiology, Torticollis / microbiology, Tuberculosis, Spinal / complications, Tuberculosis, Spinal / drug therapy, Antitubercular Agents

Bone localization of tuberculosis mainly affects the thoracolumbar spine. The cervical spine is rare. Its diagnosis is often late which exposes to great instability and potentially serious complications. We report the case of a 12-year old girl with no medical history, showing torticollis and high temperature without neurological complication. In the physical examination, he had torticollis and pain in the third, fourth and fifth cervical vertebra. When the biopsy was performed, we find an inter apophysis (between C7 and D1) collection. The histological examination confirmed the diagnosis of apophysis tuberculosis. The management based on tuberculosis chemotherapy and immobilization started as soon as possible.
Ceftriaxone-Induced Immune Hemolytic Anemia: In Vitro Reversal with Peptide Inhibitor of Complement C1 (PIC1)
Authors: Kenji M Cunnion, Lisa M Feagin, Michael F Chicella, Cortney L Kaszowski, Pamela S Hair, Jessica Price, William C Owen
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

We report a case of ceftriaxone-induced immune hemolytic anemia in a 10-year-old with chronic active Epstein-Barr virus disease and hemophagocytic lymphohistiocytosis. After chemotherapy, she became febrile and received ceftriaxone. She rapidly developed respiratory failure and anemia. Her direct antiglobulin test was positive for IgG and C3. To confirm this was ceftriaxone-induced complement-mediated hemolysis, we adapted the complement hemolysis using human erythrocytes (CHUHE) assay by adding exogenous ceftriaxone to the patient's serum which enhanced lysis of her erythrocytes. We confirmed that ceftriaxone initiated a classical complement pathway-mediated hemolysis by in vitro reversal with peptide inhibitor of complement C1 (PIC1).
A Successful Pregnancy in a Hemihysterectomized Patient-A Case Report
Authors: Sofia Jovina Domingues, Luísa Pinto
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Introduction:
Didelphys uterus, two separate uterine horns or a double uterus with two separate cervices, is one of several congenital uterine anomalies (CUA), accounting for 5% of CUA. CUA could be associated with dysmenorrhea, pelvic pain, and decreased fertility. During pregnancy, it has been associated with higher risk of miscarriage, preterm birth, malpresentation, and fetal growth restriction. There still is insufficient evidence on the efficacy and safety of surgical interventions in CUA, including hemihysterectomy, in what improvement of reproductive performance is concerned.
Objective:
The aim of the present case report is to review the literature and complement information on pregnancy outcomes after hemihysterectomy, contributing to a better counseling of women planning a pregnancy under these circumstances. Case Presentation. This paper case reports a successful pregnancy in a woman previously submitted to a hemihysterectomy and removal of a vaginal septum by hysteroscopy, due to a symptomatic didelphys uterus. An ipsilateral renal agenesis was also present. A cesarean was performed at 38 weeks' gestation and a healthy baby was born. Discussion. This paper reports an exceptional clinical situation, with only 9 cases described in the last 6 decades. As in previously reported cases, a cesarean was performed at term, resulting in a live childbirth. In these cases, a higher live birth rate and a lower incidence of preterm deliveries was found, comparing with uterine didelphys pregnancies.
Conclusion:
Understanding both the exact nature of a uterine anomaly before a surgical treatment and the prognosis for a future pregnancy after the intervention are of paramount importance for precise counseling of future parents.
Taking the STING Out of Ureteral Obstruction
Authors: Jack Crozier, Ivan Aw, Philip Huang Min Tan, David Clarke
Journal: J Endourol Case Rep (2016)
Keywords: sting, teflon, flank pain, ureteral obstruction, vesicoureteral reflux
MeSH terms: Case Reports

Vesicoureteral reflux (VUR) is diagnosed in ∼1% of children. The main goal of treatment is preservation of renal function by preventing recurrent urinary tract infection (UTI) refractory to antibiotic therapy. Surgical treatment options include endoscopic injection or ureteral reimplantation. Subureteral Teflon (polytetrafluoroethylene) injection (STING) is an endoscopic treatment option no longer in common practice. Use of Teflon is no longer advised because of a number of documented complications secondary to local and distant migration of injected material. We present a case of delayed ureteral obstruction secondary to the STING procedure occurring 21 years after initial surgery and managed using a novel endoscopic method.
Genomic analysis of four strains of Corynebacterium pseudotuberculosis bv. Equi isolated from horses showing distinct signs of infection
Authors: Rafael A Baraúna, Rommel T J Ramos, Adonney A O Veras, Pablo H C G de Sá, Luís C Guimarães, Diego A das Graças, Adriana R Carneiro, Judy M Edman, Sharon J Spier, Vasco Azevedo, Artur Silva
Journal: Stand Genomic Sci (2017)
Keywords: biovar equi, c pseudotuberculosis, genomic, horse, ulcerative lymphangitis
MeSH terms: Case Reports

The genomes of four strains (MB11, MB14, MB30, and MB66) of the species Corynebacterium pseudotuberculosis biovar equi were sequenced on the Ion Torrent PGM platform, completely assembled, and their gene content and structure were analyzed. The strains were isolated from horses with distinct signs of infection, including ulcerative lymphangitis, external abscesses on the chest, or internal abscesses on the liver, kidneys, and lungs. The average size of the genomes was 2.3 Mbp, with 2169 (Strain MB11) to 2235 (Strain MB14) predicted coding sequences (CDSs). An optical map of the MB11 strain generated using the KpnI restriction enzyme showed that the approach used to assemble the genome was satisfactory, producing good alignment between the sequence observed in vitro and that obtained in silico. In the resulting Neighbor-Joining dendrogram, the C. pseudotuberculosis strains sequenced in this study were clustered into a single clade supported by a high bootstrap value. The structural analysis showed that the genomes of the MB11 and MB14 strains were very similar, while the MB30 and MB66 strains had several inverted regions. The observed genomic characteristics were similar to those described for other strains of the same species, despite the number of inversions found. These genomes will serve as a basis for determining the relationship between the genotype of the pathogen and the type of infection that it causes.
Case report: Polyarteritis nodosa as a substrate for a massive myocardial infarction
Authors: Fabio Solis-Jimenez, Araceli Gonzalez-Ortiz, Juan H Larios-Lara, Carlos A Castro-Garcia, Eduardo I Arteaga-Chan, Fernando Velazquez-Sanchez, Jorge L Vargas-Estrada, Erika Y Ramirez-Marcano, Diego Araiza Garaygordobil, Jose L Briseño De La Cruz, Rodrigo Gopar-Nieto, Daniel Sierra-Lara Martinez, Alexandra Arias-Mendoza
Journal: Front Cardiovasc Med (2023)
Keywords: stemi, myocardial infarction, polyarteritis nodosa, vasculitis, vasospasm (vs)
MeSH terms: Case Reports

This report describes a rare case of a global myocardial infarction caused by severe vasospasm of the coronary arteries secondary to the administration of pyridostigmine in a patient with polyarteritis nodosa (PAN). Details about the clinical presentation, the typical electrocardiographic pattern of multivessel disease, the differential diagnoses suspected in the multi-imaging approach, and the treatment of cardiogenic shock are described. The definitive diagnosis of infarction and the histopathological findings compatible with polyarteritis nodosa were made by autopsy.
A Rare Case of Henoch-Schönlein Purpura Following a COVID-19 Vaccine-Case Report
Authors: Abdelhamid Naitlho, Wahib Lahlou, Abderrahim Bourial, Hamza Rais, Nabil Ismaili, Imad Abousahfa, Lahcen Belyamani
Journal: SN Compr Clin Med (2021)
Keywords: anti-sars-cov-2 vaccine, covid-19, henoch-schönlein purpura, post-vaccinal vasculitis, rheumatoid purpura, vaccine secondary effects
MeSH terms: Case Reports

In the COVID-19 pandemic era, anti-SARS-CoV-2 vaccination is considered to be the most efficient way to overtake the COVID-19 scourge. Like all medicines, vaccines are not devoid of risks and can in rare cases cause some various side effects. The objective of this case report is to highlight this unusual presentation of Henoch-Schönlein purpura following an anti-COVID-19 vaccination in a 62-year-old adult. The 62-year-old patient admitted to the emergency room for a petechial purpuric rash, sloping, occurring within hours, involving both legs and ascending. The clinical signs also included polyarthralgia and hematuria. Reported in the history the notion of an anti-COVID-19 vaccination 8 days prior to the onset of symptomatology. In the case of our patient, we retain the diagnosis of rheumatoid purpura based on the EULAR/PRINTO/PReS diagnostic criteria. Corticosteroid therapy (prednisone) was started, resulting to a rapid regression of clinical and laboratory symptoms, few days after the treatment. Patient was asymptomatic on subsequent visits. The low number of published cases of post-vaccine vasculitis does not question the safety of vaccines, but knowledge of such complications deserves to be known in order to avoid new immunizations that could have more serious consequences, and to avoid aggravating or reactivating a pre-existing vasculitis.