OpenMed/multicare-articles huggingface dataset:
Acute Pancreatitis after Colonoscopy: A Case Presentation and Literature Review
Authors: Sahil D Doshi, Yelina Alvarez, Shria Kumar, Octavia Pickett-Blakely
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

We report a case of acute pancreatitis after an elective screening colonoscopy. A 51-year-old male with a left ventricular assist device for end-stage nonischemic cardiomyopathy and a family history of colorectal cancer was admitted for an expedited heart transplant evaluation. He underwent screening colonoscopy during this admission which was technically uncomplicated apart from requiring slight maneuvering at the splenic flexure. The following day, the patient developed acute epigastric pain and one episode of emesis. Subsequent laboratory evaluation revealed a significantly elevated lipase level and cross-sectional imaging consistent with acute pancreatitis. With no evidence of gallstones, alcohol use, and hypertriglyceridemia, the acute pancreatitis was deemed to be a complication of colonoscopy. The presumed mechanism of the pancreatitis was due to mechanical trauma from insufflation and abdominal pressure, applied to at the splenic flexure, which is in close proximity to the pancreatic tail. The patient was treated with supportive care (intravenous fluid, analgesia, and pancreatic rest) and improved significantly over a three-day period.
Robotic total hip arthroplasty for fused hips in ankylosing spondylitis patients: Our experience with robotic arm technology
Authors: Ashish Singh, Kartheek Telagareddy, Purushotam Kumar, Sushil Singh
Journal: SICOT J (2022)
Keywords: ankylosing spondylitis, bony fusion, fused hips, robotic total hip arthroplasty

The conversion from a fused hip to conventional total hip arthroplasty (THA) in patients with ankylosing spondylitis can be challenging. The problems are related to patient positioning, surgical exposure, femoral neck osteotomy, identifying the true acetabulum, and proper implant positioning. This case series describes our experience using the Mako Robotic-Arm in four bilateral THA procedures (each conducted in a single session) and one unilateral procedure in a fifth patient. Robotic total hip arthroplasty (RTHA) simplified THA by providing real-time information on the relative positions of the femur, pelvis, instruments, and implants to guide the surgery and implant placement.
To Clot or Not: HELLP Syndrome and Disseminated Intravascular Coagulation in an Eclamptic Patient with Intrauterine Fetal Demise
Authors: Justin Walker, Anthony Bonavia
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

A 39-year-old G2P1001 female presented from an outside hospital following an eclamptic seizure in the setting of HELLP syndrome. This condition was complicated by intrauterine fetal demise and disseminated intravascular coagulation, which required an emergent cesarean section. We report the work-up and intraoperative and postoperative management of this complex patient with multiple medical needs. We focus on the hemostatic abnormalities in this patient and describe how our management would differ from that of a similar, nonpregnant patient.
Papillocystic variant of acinar cell pancreatic carcinoma
Authors: Jasim Radhi, France Tse, Michael Marcaccio
Journal: J Oncol (2010)
MeSH terms: Case Reports

Acinar cell pancreatic carcinoma is a rare solid malignant neoplasm. Recent review of the literature showed occasional cases with papillary or papillocystic growth patterns, ranging from 2 to 5 cm in diameter. We report a large 10 cm pancreatic tumor with papillocystic pathology features involving the pancreatic head. The growth pattern of these tumors could be mistaken for intraductal papillary mucinous tumors or other pancreatic cystic neoplasms.
Cerebral subdural hematoma following spinal anesthesia: report of two cases
Authors: Mehrdad Moradi, Shoaleh Shami, Fariba Farhadifar, Karim Nesseri
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Postdural puncture headache and cerebral subdural hematoma are among complications of spinal anesthesia with some common characteristics; however misdiagnosis of these two could result in a catastrophic outcome or prevent unwanted results by urgent interventions. With the purpose of increasing awareness of such complications and a speedy diagnosis, we report two cases of postspinal anesthesia headache that was timely diagnosed as cerebral subdural hematoma and prevented the likelihood of a disastrous outcome.
Genital and Intertriginous Rashes Refractory to Antimicrobial Treatments: Have You Thought about Crohn's Disease?
Authors: Candelaria O'Farrell, Annette Roberts, Claudia Riera Canales, Carrie Firestone Baum, Lina Maria Felipez
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Crohn's disease is an inflammatory bowel disease that can have multiple extraintestinal manifestations and can develop prior to, following, or simultaneously with gastrointestinal tract involvement (Aberumand et al. (2017), Georgious et al. (2006), Larsen et al. (2010), Levine and Burakoff (2011), Louis et al. (2018)). This report examines the case of a 16-year-old male with a rash of the genital, intergluteal, and inguinal regions refractory to antimicrobial treatments suspicious for an extraintestinal manifestation of Crohn's disease. The patient was diagnosed with inflammatory, nonfistulizing colonic Crohn's disease following presentation with gastrointestinal symptoms including abdominal pain and bloody stools 6 months after the onset of the rash. The genital lesions resolved after starting treatment for Crohn's disease with adalimumab.
Membranous Nephropathy With Monoclonal IgM Lambda Deposits in a Patient With IgM Monoclonal Gammopathy: A Case Report
Authors: Go Hirose, Takahiro Uchida, Aki Kojima, Kentaro Sugisaki, Muneharu Yamada, Yoshihiro Nagase, Takashi Takaki, Kiyotaka Nagahama, Takashi Oda
Journal: Front Med (Lausanne) (2021)
Keywords: immunoglobulin m, membranous nephropathy, monoclonal gammopathy of renal significance (mgrs), rituximab, thrombospondin-type-1-domain-containing-7a
MeSH terms: Case Reports

We report a case of membranous nephropathy with monoclonal immunoglobulin (Ig)M lambda deposits in a patient with IgM monoclonal gammopathy, in whom histological changes were observed on repeat renal biopsy. A 72-year-old Japanese woman was referred to our hospital because of massive proteinuria. A prominent increase in monoclonal IgM lambda level was identified, and she was diagnosed as having IgM monoclonal gammopathy of undetermined significance. Renal biopsy showed glomerular subepithelial electron-dense deposits that were found to be granular deposits of IgM lambda but not kappa or IgG by immunofluorescence staining, resulting in a diagnosis of membranous nephropathy with monoclonal IgM deposits. The second biopsy, which was performed 2 years later because of exacerbation of her nephrotic syndrome, demonstrated less immunofluorescence staining of IgM, and dominant IgG2 deposition without light chain restriction. Interestingly, immunostaining for thrombospondin-type-1-domain-containing-7A was positive in both renal biopsy tissues, although the second biopsy showed clearly stronger immunoreactivity. The effect of steroid therapy was limited; however, rituximab treatment improved both the hematological and renal abnormalities. Solitary deposition of IgM in membranous nephropathy is a quite rare condition. To our knowledge, this is the first case of monoclonal gammopathy of renal significance presenting as membranous nephropathy with monoclonal IgM deposits, in which chronological immunohistochemical changes were observed and rituximab therapy was effective.
Anesthetic Management for Cesarean Delivery in a Patient with a Gigantic Intracranial Tumor
Authors: C Dos Santos E Santos, C L Mason, J S Neill, B E Grayson, A Calimaran, D R Bacon
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

A 31-year-old G5P1 patient with unremarkable past medical history at 29 weeks of gestation was diagnosed with a gigantic left frontotemporal brain mass. Initial clinical management as an inpatient achieved an improvement in the symptoms. The patient and surgical team agreed to schedule a cesarean delivery at 32 weeks of gestation if no neurological deterioration was observed. Intraoperative course with general endotracheal anesthesia and bilateral transversus abdominis plane block was uneventful and promoted efficient postoperative pain control. Seven days after delivery, the patient underwent craniotomy for brain tumor resection. This report describes the anesthetic management of a patient with an intracranial tumor during pregnancy.
Trichosporon asahii fungemia and COVID-19 co-infection: An emerging fungal pathogen; case report and review of the literature
Authors: Gawahir A Ali, Ahmed Husain, Husam Salah, Wael Goravey
Journal: IDCases (2021)
Keywords: covid-19, central venous catheters, fungemia, trichosporon asahii, voriconazole
MeSH terms: Case Reports

With the evolving COVID-19 pandemic, increasing concerns about invasive fungal infections have been reported particularly with the use of potent immunosuppressant medications to treat the immunological storms in patients with severe COVID-19 illnesses. Trichosporon asahii (T. asahii) is an emerging highly resistant pathogen with considerable mortality particularly in critically ill patients and immunocompromised individuals. We describe a case of a 58-year-old patient who developed T. asahii fungemia after using immunosuppressant agents for his severe COVID-19 related cytokines release syndrome. Pseudohyphae, arthroconidia, and lateral blastoconidia were seen in the stain, and later confirmed to be T. asahii. Voriconazole successfully treated this multi-drug-resistant fungal infection. The clinical presentation, assessment, and management are reviewed to raise awareness of the circumstances leading to coinfection with this emerging resistant yeast.
Genetic Risk of Talon Cusp: Talon Cusp in Five Siblings
Authors: Nuha Abdel-Rahman Elmubarak
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Talon cusp is a rare dental anomaly that appears as a cusp-like projection on anterior teeth. Although numerous articles considering this anomaly have been published, this report has displayed a unique presentation of talon cusp. This case series is the first report in literature on which talon cusp has been presented in multiple siblings which highlights the genetic/familial component of the etiology. The report has also displayed unfamiliar morphological appearance (heart shape) of the talon cusp. Furthermore, talon cusp has shown an association with taurodontism in this report. Taurodontism has never been mentioned in the previous literature among the odontogenic variations that may associate talon cusp. A 25-year-old male has presented with talon cusps on the palatal surface of anterior teeth. Family history revealed four of his siblings had the same anomaly on anterior teeth. Talon cusps in the five cases cause clinical problems like occlusal interference, displacement and proclination of the anterior tooth, caries in the grooves delineating talon cusp, or pulp necrosis. Free dental treatment has been offered in the university clinic. However, they live in remote rural areas making it difficult to follow up with treatment.
Case report: Treatment of advanced CSF1-receptor associated leukoencephalopathy with hematopoietic stem cell transplant
Authors: Caroline G Bergner, Lisa Schäfer, Vladan Vucinic, Birthe Schetschorke, Julia Lier, Cordula Scherlach, Michael Rullmann, Osama Sabri, Joseph Classen, Uwe Platzbecker, Jörn-Sven Kühl, Henryk Barthel, Wolfgang Köhler, Georg-Nikolaus Franke
Journal: Front Neurol (2023)
Keywords: alsp, csf1r-related leukoencephalopathy, hematopoetic stem cell transplant, microglia, white matter dementia
MeSH terms: Case Reports

CSF1 receptor-related leukoencephalopathy is a rare genetic disorder presenting with severe, adult-onset white matter dementia as one of the leading symptoms. Within the central nervous system, the affected CSF1-receptor is expressed exclusively in microglia cells. Growing evidence implicates that replacing the defective microglia with healthy donor cells through hematopoietic stem cell transplant might halt disease progression. Early initiation of that treatment is crucial to limit persistent disability. However, which patients are suitable for this treatment is not clear, and imaging biomarkers that specifically depict lasting structural damage are lacking. In this study, we report on two patients with CSF1R-related leukoencephalopathy in whom allogenic hematopoietic stem cell transplant at advanced disease stages led to clinical stabilization. We compare their disease course with that of two patients admitted in the same timeframe to our hospital, considered too late for treatment, and place our cases in context with the respective literature. We propose that the rate of clinical progression might be a suitable stratification measure for treatment amenability in patients. Furthermore, for the first time we evaluate [18F] florbetaben, a PET tracer known to bind to intact myelin, as a novel MRI-adjunct tool to image white matter damage in CSF1R-related leukoencephalopathy. In conclusion, our data add evidence for allogenic hematopoietic stem cell transplant as a promising treatment in CSF1R-related leukoencephalopathy patients with slow to moderate disease progression.
Successful Treatment of Multiple Multidrug Resistant Intracranial Tuberculomata
Authors: Richard P Sullivan, Hazel F Goldberg, Ross S Mellick, Jeffrey J Post
Journal: Case Rep Infect Dis (2016)
MeSH terms: Case Reports

A 21-year-old Bangladesh-born man presented with a month history of evolving neurological symptoms in the context of a six-month history of fever, night sweats, and axillary lymphadenopathy. He was subsequently diagnosed with multiple multidrug resistant intracranial tuberculomata and was successfully treated over two years. Intracranial multidrug resistant tuberculosis has a high mortality and successful treatment is rarely reported. Management is complex and requires consideration of the penetration and likely effect of antituberculous agents within the central nervous system. We discuss the role of various antituberculous agents, the duration of therapy, the utility of corticosteroids, the value of intrathecal and systemic therapy, and the need for rapid diagnosis.
Fortuitous discovery of an anomalous connection of the coronary arteries during an urgent coronary angiography: a case report
Authors: Amine Ech-Chenbouli, Mohamed Elghali Benouna, Salim Arous, Rachida Habbal
Journal: Pan Afr Med J (2021)
Keywords: cardiac computed tomography, a case report, coronary angiogram
MeSH terms: Coronary Angiography, Coronary Vessel Anomalies / diagnostic imaging, Non-ST Elevated Myocardial Infarction / diagnostic imaging, Case Reports, Humans, Male, Middle Aged, Tomography, X-Ray Computed

Anomalous connection of the coronary arteries (ANOCOR) is a rare angiographic finding; although most ANOCORs are benign some are a risky condition that can lead to sudden death. Knowing their particularities is important to know how to manage them. With an angiographic prevalence averaging 1%, proximal anomalous connection of the Coronary arteries (ANOCOR) represents a diverse entity. The challenge is to distinguish the benign ANOCOR to reassure the patient from the high risk ANOCOR that may need surgical repair. We present a case of a 52-years-old man admitted to our cath lab for urgent coronary angiography after a non ST segment elevation myocardial infarction. At coronary angiography we found ectopic left anterior descending and circumflex arteries with a culprit lesion on the right non ectopic coronary artery. A computed tomography (CT) scan showed benign ectopic courses of the left anterior descending and circumflex arteries. No surgical repair was indicated.
A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients
Authors: Mohamed Y Ahmed, Jane B Taylor, Rajesh K Aneja, Qian Wang, John V Williams
Journal: Case Rep Crit Care (2023)
MeSH terms: Case Reports

Diagnosis and management of SARS-CoV-2 infection in immunocompromised patients are extremely challenging. These patients can have atypical clinical courses, and there is a paucity of data regarding clinical features, diagnostic findings, and the safety and efficacy of available therapeutic agents used to treat COVID-19 in these patients. In this case series, we report atypical COVID-19 presentations in 4 immunocompromised pediatric patients who were admitted with acute respiratory failure after an initial diagnosis of COVID-19 a few weeks earlier. All patients included in this cohort showed persistent worsening respiratory symptoms for several weeks before hospital presentation. While they manifested common COVID-19 sequelae, they also had rare COVID-19-related pathognomonic and radiographic features developed along their hospital course. Multiple therapeutic agents were used in their COVID-19 management, including corticosteroids, remdesivir, and monoclonal antibodies. All three patients who have received concurrent therapy with remdesivir, hydrocortisone, and monoclonal antibodies survived, and only one patient died as a direct complication of COVID-19 ARDS with secondary pulmonary mucormycosis. Our outcomes suggest the potential benefit of remdesivir use in combination with hydrocortisone and monoclonal antibodies in the management of severe COVID-19 ARDS in this group, as well as the importance of close surveillance and early administration of broad empirical antimicrobial and antifungal coverage if clinically indicated in this high-risk population.
Primary hyperparathyroidism in pregnancy-a rare cause of life-threatening hypercalcemia: case report and literature review
Authors: S Malekar-Raikar, B P Sinnott
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Objective. To report a case of primary hyperparathyroidism in a pregnant patient, report the obstetric and neonatal outcomes, and review the relevant literature. Results. A 29-year-old primigravida was successfully treated for PHP with minimally invasive resection of a parathyroid adenoma in the second trimester of pregnancy. A healthy baby girl was delivered at 37-week gestation with an unremarkable neonatal course. To the best of our knowledge, this is the second case report in the literature utilizing intraoperative PTH during a parathyroidectomy in a pregnant woman. Conclusions. Primary hyperparathyroidism is a rare life-threatening condition that can present during pregnancy. The diagnosis can be difficult to establish during pregnancy, given the nonspecific symptoms related to hypercalcemia. However, a better understanding of the condition, improved diagnostic studies, and well-organized multidisciplinary management decisions can significantly reduce the morbidity and mortality associated with the disease during pregnancy. This case report is presented to highlight the value of early diagnosis and appropriate management of PHP during pregnancy.
Acute Abdomen due to Mutual Tangle of Two Small Paratubal Cysts
Authors: Hiroharu Kobayashi, Shinichi Shibuya, Kentaro Iga, Keiichiro Kato, Airi Kato, Shuhei Terada, Hiroshi Adachi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

A 30-year-old woman (gravida 0) visited our hospital with a complaint of right lower abdominal pain. Transvaginal ultrasonography revealed a 5-cm swollen right ovary, which was suspected to be a mature cystic teratoma. Pelvic examination revealed moderate pain. Contrast-enhanced computed tomography showed a 44-mm cystic mass containing fat and calcified material in the right pelvis. Since torsion was suspected, emergent laparoscopic surgery was performed. Intraoperative findings were a swollen right ovary without torsion or congestion. Two small pedunculated 1- and 2-cm diameter paratubal cysts that grew from almost the same place of the ampulla of the right fallopian tube were observed. The thin stalk of the 1-cm paratubal cyst was entangled around the stalk of the 2-cm paratubal cyst, with its head congested. Through a small abdominal laparoscopic incision, the tumor of the right ovary and the two paratubal cysts were excised. Histopathological examination revealed that the right ovarian tumor was a mature cystic teratoma, and the two paratubal cysts had no malignancy. This case showed that only a 2-cm tumor with congestion caused the acute abdomen.
Rare case report of infective endocarditis due to Kocuria kristinae in a patient with ventricular septal defect
Authors: Arif Maqsood Ali, Gule Raana Waseem, Shazia Arif
Journal: Access Microbiol (2019)
Keywords: endocarditis, kocuria kristinae, ventricular septal defect
MeSH terms: Case Reports

Background:
Infective endocarditis (IE) is an uncommon but life-threatening infection. It is commonly associated with diseased or damaged valves. Patients with congenital heart disease are more prone to getting IE than the general population. The typical organisms that cause IE include Staphylococcus , Coagulase-negative Staphylococcus, Streptococcus viridians and Enterococci. However, the importance of rare micro-organisms like Kocuria kristinae should not be underestimated especially when isolated from multiple blood cultures in patients suspected of IE.
Case presentation:
We report a rare case of right-sided infective endocarditis due to K. kristinae in a young non-diabetic, non-addict female of low socioeconomic class who presented with undiagnosed fever for 1 year. She was investigated and treated for fever by several general practitioners without relief. Later on, she was diagnosed by a local cardiologist to have perimembranous ventricular septal defect with a small pulmonary valve vegetation. She was referred to a tertiary care cardiac hospital in Rawalpindi, Pakistan for further management. Transthoracic and transesophageal echocardiography confirmed IE secondary to preexisting congenital heart disease complicated with a small pulmonary vegetation. Her blood cultures yielded growth of K. kristanae, a rare micro-organism to cause IE. The patient responded to the antibiotic therapy.
Conclusion:
Clinicians should have a high index of suspicion for K. kristanae IE as a possible cause of a prolonged fever especially in the presence of congenital heart disease. Antibiotic susceptibility is required for adequate therapy.
Malignant transformation of a mature cystic ovarian teratoma into thyroid carcinoma, mucinous adenocarcinoma, and strumal carcinoid: a case report and literature review
Authors: Hilary D Hinshaw, Ashlee L Smith, Mohamed Mokhtar Desouki, Alexander B Olawaiye
Journal: Case Rep Obstet Gynecol (2012)

Malignant transformation of a mature cystic teratoma (MCT) is an infrequent, often asymptomatic event. We report the first example of a struma ovarii with a focus of follicular variant of papillary thyroid carcinoma (a), mucinous adenocarcinoma (b), and strumal carcinoid tumor (c)-all three arising in one mature cystic teratoma of the ovary. From our reviews, we found limited data to guide management when these malignant foci occur within an MCT. Consideration should be given to thyroidectomy followed by total-body scanning and serum studies for foci of thyroid carcinoma and adjuvant therapy with thyroidectomy and radioablation if residual disease is identified (a). Additionally, extrapolating from data for mucinous adenocarcinomas, consideration could be given to adjuvant chemotherapy after appropriate staging (b). Strumal carcinoid tumors should be treated as tumors of low malignant potential. Observation is appropriate if after complete staging, no invasive implants are noted (c).